Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 20, Number 5—May 2014
Research

Streptococcus mitis Strains Causing Severe Clinical Disease in Cancer Patients

Samuel A. ShelburneComments to Author , Pranoti Sahasrabhojane, Miguel Saldana, Hui Yao, Xiaoping Su, Nicola Horstmann, Erika Thompson, and Anthony R. Flores
Author affiliations: MD Anderson Cancer Center, Houston, Texas, USA (S.A. Shelburne, P. Sahasrabhojane, M. Saldana, H. Yao, X. Su, N. Horstmann, E. Thompson); Baylor College of Medicine, Houston, Texas, USA (A.R. Flores)

Main Article

Table 2

Association between clinical syndrome and infecting species for 118 patients with viridans group streptococci bacteremia

Clinical syndrome Viridans group streptococci*
mitis oralis infantis/australis Sanguinis Anginosus Salivarius/Vestibularis
Primary bacteremia with neutropenia 58 6 3 3 0 2
Primary bacteremia without neutropenia 1 2 0 3 0 0
Gastrointestinal focus 1 2 0 1 3 1
Skin/soft tissue focus 2 1 0 1 0 0
Infective endocarditis 0 2 0 0 0 0
Polymicrobial bacteremia 6 8 0 4 0 0
Clinically minor bacteremia 0 1 1 5 0 2

*mitis, oralis,infantis, and australis refer to viridans group streptococci species; Sanguinis, Anginosus, Salivarius, and Vestibularis refer to viridans streptococci groups (Figure 1) (29).

Main Article

References
  1. Human Microbiome Project Consortium. Structure, function and diversity of the healthy human microbiome. Nature. 2012;486:20714 . DOIPubMedGoogle Scholar
  2. Tunkel  AR, Sepkowitz  KA. Infections caused by viridans streptococci in patients with neutropenia. Clin Infect Dis. 2002;34:15249 . DOIPubMedGoogle Scholar
  3. Dix  D, Cellot  S, Price  V, Gillmeister  B, Ethier  MC, Johnston  DL, Association between corticosteroids and infection, sepsis, and infectious death in pediatric acute myeloid leukemia (AML): results from the Canadian Infections in AML Research Group. Clin Infect Dis. 2012;55:160814. DOIPubMedGoogle Scholar
  4. Murdoch  DR, Corey  GR, Hoen  B, Miro  JM, Fowler  VG Jr, Bayer  AS, Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis–Prospective Cohort Study. Arch Intern Med. 2009;169:46373 . DOIPubMedGoogle Scholar
  5. Seltz  LB, Smith  J, Durairaj  VD, Enzenauer  R, Todd  J. Microbiology and antibiotic management of orbital cellulitis. Pediatrics. 2011;127:e56672. DOIPubMedGoogle Scholar
  6. Seo  HS, Xiong  YQ, Mitchell  J, Seepersaud  R, Bayer  AS, Sullam  PM. Bacteriophage lysin mediates the binding of Streptococcus mitis to human platelets through interaction with fibrinogen. PLoS Pathog. 2010;6:e1001047. DOIPubMedGoogle Scholar
  7. Facklam  R. What happened to the streptococci: overview of taxonomic and nomenclature changes. Clin Microbiol Rev. 2002;15:61330 . DOIPubMedGoogle Scholar
  8. Teles  C, Smith  A, Ramage  G, Lang  S. Identification of clinically relevant viridans group streptococci by phenotypic and genotypic analysis. Eur J Clin Microbiol Infect Dis. 2011;30:24350. DOIPubMedGoogle Scholar
  9. Hoshino  T, Fujiwara  T, Kilian  M. Use of phylogenetic and phenotypic analyses to identify nonhemolytic streptococci isolated from bacteremic patients. J Clin Microbiol. 2005;43:607385. DOIPubMedGoogle Scholar
  10. Kawamura  Y, Hou  XG, Sultana  F, Miura  H, Ezaki  T. Determination of 16S rRNA sequences of Streptococcus mitis and Streptococcus gordonii and phylogenetic relationships among members of the genus Streptococcus. Int J Syst Bacteriol. 1995;45:4068 . DOIPubMedGoogle Scholar
  11. Bochud  PY, Eggiman  P, Calandra  T, Van Melle  G, Saghafi  L, Francioli  P. Bacteremia due to viridans streptococcus in neutropenic patients with cancer: clinical spectrum and risk factors. Clin Infect Dis. 1994;18:2531 . DOIPubMedGoogle Scholar
  12. Gassas  A, Grant  R, Richardson  S, Dupuis  LL, Doyle  J, Allen  U, Predictors of viridans streptococcal shock syndrome in bacteremic children with cancer and stem-cell transplant recipients. J Clin Oncol. 2004;22:12227. DOIPubMedGoogle Scholar
  13. Wisplinghoff  H, Reinert  RR, Cornely  O, Seifert  H. Molecular relationships and antimicrobial susceptibilities of viridans group streptococci isolated from blood of neutropenic cancer patients. J Clin Microbiol. 1999;37:187680 .PubMedGoogle Scholar
  14. Elting  LS, Bodey  GP, Keefe  BH. Septicemia and shock syndrome due to viridans streptococci: a case-control study of predisposing factors. Clin Infect Dis. 1992;14:12017. DOIPubMedGoogle Scholar
  15. Kitten  T, Munro  CL, Zollar  NQ, Lee  SP, Patel  RD. Oral streptococcal bacteremia in hospitalized patients: taxonomic identification and clinical characterization. J Clin Microbiol. 2012;50:103942. DOIPubMedGoogle Scholar
  16. Bilgrami  S, Feingold  JM, Dorsky  D, Edwards  RL, Clive  J, Tutschka  PJ. Streptococcus viridans bacteremia following autologous peripheral blood stem cell transplantation. Bone Marrow Transplant. 1998;21:5915. DOIPubMedGoogle Scholar
  17. Husain  E, Whitehead  S, Castell  A, Thomas  EE, Speert  DP. Viridans streptococci bacteremia in children with malignancy: relevance of species identification and penicillin susceptibility. Pediatr Infect Dis J. 2005;24:5636. DOIPubMedGoogle Scholar
  18. Ikryannikova  LN, Lapin  KN, Malakhova  MV, Filimonova  AV, Ilina  EN, Dubovickaya  VA, Misidentification of alpha-hemolytic streptococci by routine tests in clinical practice. Infect Genet Evol. 2011;11:170915 . DOIPubMedGoogle Scholar
  19. Bishop  CJ, Aanensen  DM, Jordan  GE, Kilian  M, Hanage  WP, Spratt  BG. Assigning strains to bacterial species via the Internet. BMC Biol. 2009;7:3 . DOIPubMedGoogle Scholar
  20. Swenson  FJ, Rubin  SJ. Clinical significance of viridans streptococci isolated from blood cultures. J Clin Microbiol. 1982;15:7257 .PubMedGoogle Scholar
  21. Paterson  DL, Ko  WC, Von Gottberg  A, Mohapatra  S, Casellas  JM, Goossens  H, International prospective study of Klebsiella pneumoniae bacteremia: implications of extended-spectrum β-lactamase production in nosocomial Infections. Ann Intern Med. 2004;140:2632 . DOIPubMedGoogle Scholar
  22. Bone  RC, Balk  RA, Cerra  FB, Dellinger  RP, Fein  AM, Knaus  WA, Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. 1992. Chest. 2009;136(Suppl):e28 .PubMedGoogle Scholar
  23. Phares  CR, Lynfield  R, Farley  MM, Mohle-Boetani  J, Harrison  LH, Petit  S, Epidemiology of invasive group B streptococcal disease in the United States, 1999–2005. JAMA. 2008;299:205665. DOIPubMedGoogle Scholar
  24. Li  JS, Sexton  DJ, Mick  N, Nettles  R, Fowler  VG Jr, Ryan  T, Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30:6338. DOIPubMedGoogle Scholar
  25. Han  XY, Kamana  M, Rolston  KV. Viridans streptococci isolated by culture from blood of cancer patients: clinical and microbiologic analysis of 50 cases. J Clin Microbiol. 2006;44:1605. DOIPubMedGoogle Scholar
  26. Hillier  LW, Marth  GT, Quinlan  AR, Dooling  D, Fewell  G, Barnett  D, Whole-genome sequencing and variant discovery in C. elegans. Nat Methods. 2008;5:1838. DOIPubMedGoogle Scholar
  27. Tritt  A, Eisen  JA, Facciotti  MT, Darling  AE. An integrated pipeline for de novo assembly of microbial genomes. PLoS ONE. 2012;7:e42304. DOIPubMedGoogle Scholar
  28. Aziz  RK, Bartels  D, Best  AA, DeJongh  M, Disz  T, Edwards  RA, The RAST server: rapid annotations using subsystems technology. BMC Genomics. 2008;9:75. DOIPubMedGoogle Scholar
  29. Sinner  SW, Tunkel  AR. Viridans group streptococci, groups C and G streptococci, and Gemella morbilliform. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 7th ed. Philadelphia: Elsevier; 2011. p. 2434–50.
  30. Denapaite  D, Bruckner  R, Nuhn  M, Reichmann  P, Henrich  B, Maurer  P, The genome of Streptococcus mitis B6—what is a commensal? PLoS ONE. 2010;5:e9426. DOIPubMedGoogle Scholar
  31. Kilian  M, Poulsen  K, Blomqvist  T, Havarstein  LS, Bek-Thomsen  M, Tettelin  H, Evolution of Streptococcus pneumoniae and its close commensal relatives. PLoS ONE. 2008;3:e2683. DOIPubMedGoogle Scholar
  32. Pérez-Dorado  I, Galan-Bartual  S, Hermoso  JA. Pneumococcal surface proteins: when the whole is greater than the sum of its parts. Mol Oral Microbiol. 2012;27:221–45.
  33. Pizzo  PA, Ladisch  S, Witebsky  FG. Alpha-hemolytic streptococci: clinical significance in the cancer patient. Med Pediatr Oncol. 1978;4:36770. DOIPubMedGoogle Scholar
  34. Burden  AD, Oppenheim  BA, Crowther  D, Howell  A, Morgenstern  GR, Scarffe  JH, Viridans streptococcal bacteraemia in patients with haematological and solid malignancies. Eur J Cancer. 1991;27:40911. DOIPubMedGoogle Scholar
  35. Villablanca  JG, Steiner  M, Kersey  J, Ramsay  NK, Ferrieri  P, Haake  R, The clinical spectrum of infections with viridans streptococci in bone marrow transplant patients. Bone Marrow Transplant. 1990;5:38793 .PubMedGoogle Scholar
  36. Ramphal  R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis. 2004;39(Suppl 1):S2531 . DOIPubMedGoogle Scholar
  37. Roberts  RB, Krieger  AG, Schiller  NL, Gross  KC. Viridans streptococcal endocarditis: the role of various species, including pyridoxal-dependent streptococci. Rev Infect Dis. 1979;1:95566 . DOIPubMedGoogle Scholar
  38. Jung  CJ, Yeh  CY, Shun  CT, Hsu  RB, Cheng  HW, Lin  CS, Platelets enhance biofilm formation and resistance of endocarditis-inducing streptococci on the injured heart valve. J Infect Dis. 2012;205:106675. DOIPubMedGoogle Scholar
  39. Westling  K, Julander  I, Ljungman  P, Vondracek  M, Wretlind  B, Jalal  S. Identification of species of viridans group streptococci in clinical blood culture isolates by sequence analysis of the RNase P RNA gene, rnpB. J Infect. 2008;56:20410. DOIPubMedGoogle Scholar
  40. Musher  DM, Roig  IL, Cazares  G, Stager  CE, Logan  N, Safar  H. Can an etiologic agent be identified in adults who are hospitalized for community-acquired pneumonia: results of a one-year study. J Infect. 2013;67:118 . DOIPubMedGoogle Scholar

Main Article

Page created: April 16, 2014
Page updated: April 16, 2014
Page reviewed: April 16, 2014
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external