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Corredoira J, Grau I, Garcia-Rodriguez JF, Romay E, Cuervo G, Berbel D, Ayuso B, García-Pais MJ, Rabuñal R, García-Garrote F, Alonso MP, Pallarés R. Species and biotypes of Streptococcus bovis causing infective endocarditis. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:215-220. [PMID: 36610830 DOI: 10.1016/j.eimce.2021.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/25/2021] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Streptococcus bovis/equinus complex (SBEC) is a major cause of infective endocarditis (IE), although its incidence varies greatly depending on the geographical area. The characteristics of IE caused by Streptococcus gallolyticus susp. gallolyticus are well known; there are hardly any descriptions of IE caused by other species or biotypes. METHODS Retrospective cohort study, from 1990 to 2019, of all SBEC IE in adults in three Spanish hospitals, Lugo (LH), Barcelona (BH) and Ferrol (FH) where the population is mainly rural, urban and mixed, respectively. The incidence of IE was analyzed in 3 areas. Clinical characteristics of IE (277 cases, 258 biotyped) were compared according to SBEC species and biotypes. RESULTS There are significant differences between the incidence of SBEC IE in HL (27.9/106) vs. HF and HB (8.8 and 7,1, respectively, p<0.001). We found significant differences (SbI vs. SbII) in mean age (68.5 vs. 73 years; p<0.01), duration of symptoms before diagnosis (46.9±46.5 vs. 30.4±40.9 days; p<0.01), presence of comorbidities: 39.1% (78) vs. 54.2% (32; p<0.04), predisposing heart illness:62.3% (124) vs. 81.3% (48; p<0.006), particularly, prosthetic or intravascular devices IE: 24.6% (49) vs. 52.4% (31; p<0.001), bi-valve involvement:23.6% (47) vs. 11.8% (7; p<0.05) and heart failure: 24.6% (49) vs. 38.9% (23; p<0.03). There were no significant differences in embolic events, need for surgery or mortality. The association with CRC was high in both groups: 77.7% vs. 66.6%. CONCLUSIONS IE due to SBEC has geographical variations in incidence and different clinical characteristics among biotypes. The association with CRC was high.
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Affiliation(s)
- Juan Corredoira
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Inma Grau
- Infectious Disease Unit, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain
| | | | - Eva Romay
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Guillermo Cuervo
- Infectious Disease Unit, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain
| | - Damaris Berbel
- Microbiology Department, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain
| | - Blanca Ayuso
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | - Román Rabuñal
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | - Mª Pilar Alonso
- Microbiology Department, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Román Pallarés
- Infectious Disease Unit, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain
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Peláez Ballesta AI, García Vázquez E, Gómez Gómez J. Infective endocarditis treated in a secondary hospital: epidemiological, clinical, microbiological characteristics and prognosis, with special reference to patients transferred to a third level hospital. REVISTA ESPANOLA DE QUIMIOTERAPIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE QUIMIOTERAPIA 2022; 35:35-42. [PMID: 34845895 PMCID: PMC8790653 DOI: 10.37201/req/092.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/08/2021] [Accepted: 10/14/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To analyse the clinical and epidemiological characteristics and mortality-related factors of patients admitted to a secondary hospital with Infective Endocarditis (IE). METHODS Observational study of a cohort of patients who have been diagnosed with IE in a secondary hospital and evaluated in accordance with a pre-established protocol. RESULTS A total of 101 cases were evaluated (years 2000-2017), with an average age of 64 years and a male-to-female ratio of 2:1. 76% of the cases had an age-adjusted Charlson comorbidity index of >6, with 21% having had a dental procedure and 36% with a history of heart valve disease. The most common microorganism was methicillin-susceptible S. aureus (36%), with bacterial focus of unknown origin in 54%. The diagnostic delay time was 12 days in patients who were transferred, compared to 8 days in patients who were not transferred (p=0.07); the median surgery indication delay time was 5 days (IQR 13.5). The in-hospital mortality rate was 34.6% and the prognostic factors independently associated with mortality were: cerebrovascular events (OR 98.7%, 95% CI, 70.9-164.4); heart failure (OR 27.3, 95% CI, 10.2-149.1); and unsuitable antibiotic treatment (OR 7.2, 95% CI, 1.5-10.5). The mortality rate of the patients who were transferred and who therefore underwent surgery was 20% (5/25). CONCLUSIONS The onset of cerebrovascular events, heart failure and unsuitable antibiotic treatment are independently and significantly associated with in-hospital mortality. The mortality rate was higher than the published average (35%); the diagnostic delay was greater in patients for whom surgery was indicated.
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Affiliation(s)
- A I Peláez Ballesta
- Ana Isabel Peláez Ballesta, Internal Medicine Department of the Hospital General Universitario Rafael Méndez (Lorca). Spain.
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Corredoira J, Grau I, Garcia-Rodriguez JF, Romay E, Cuervo G, Berbel D, Ayuso B, García-Pais MJ, Rabuñal R, García-Garrote F, Alonso MP, Pallarés R. Species and biotypes of Streptococcus bovis causing infective endocarditis. Enferm Infecc Microbiol Clin 2021. [DOI: 10.1016/j.eimc.2021.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Correlation between Streptococcus bovis bacteremia and density of cows in Galicia, northwest of Spain. Infection 2018; 47:399-407. [PMID: 30498902 DOI: 10.1007/s15010-018-1254-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND There are few data on the epidemiology of infections caused by Streptococcus bovis (Sb). Some studies suggest that both residence in rural areas and contact with livestock could be potential risk factors. METHODS We performed a retrospective study for the period 2005-2016 of all cases of bacteremia caused by Sb in Galicia (a region in the northwest of Spain). The association between the incidence rate of Sb bacteremia and the number of cattle by province and district was analyzed. RESULTS 677 cases were included with a median age of 76 years, 69.3% males. The most frequent infections were endocarditis (234 cases, 34.5%), primary bacteremia (213 cases, 31.5%) and biliary infection (119 cases, 17.5%). In 252 patients, colon neoplasms were detected (37.2%). S. gallolyticus subsp. gallolyticus was the predominant species (52.3%). Mortality was 15.5% (105 cases). The annual incidence rate was 20.2 cases/106 inhabitants and was correlated with the density of cattle (p < 0.001), but not with rurality. When comparing the two provinces with a strong predominance of rural population, but with important differences in the number of cattle, such as Orense and Lugo, with 6% and 47.7% of Galician cattle, respectively, the rates were very different: 15.8 and 43.6 cases/106, respectively, with an RR of 2.7 (95% CI, 2.08-3.71). Some districts of the province of Lugo had rates higher than 100 cases/106 inhabitants. CONCLUSIONS Our study shows a significant correlation between the rates of Sb bacteremia and cattle density, suggesting a possible transmission of Sb from cows to people.
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Presencia de Streptococcus bovis en muestras de orina de sujetos con síntomas de infección del aparato urinario. Rev Argent Microbiol 2016; 48:308-312. [DOI: 10.1016/j.ram.2016.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/29/2016] [Accepted: 06/01/2016] [Indexed: 11/20/2022] Open
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Starosta RT, Rivero R, de Oliveira FH, Lopes E, Cerski MR. Misdiagnosis of Streptococcus gallolyticus endocarditis. AUTOPSY AND CASE REPORTS 2016; 6:29-33. [PMID: 27818956 PMCID: PMC5087981 DOI: 10.4322/acr.2016.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 07/17/2016] [Indexed: 11/23/2022] Open
Abstract
Death certificate inaccuracy is of major concern both in the public health domain and in individual health care, since it may yield untruthful data on the incidence, prevalence, and lethality of medical entities, and may hamper prophylactic measures among those who share, with the deceased, the common genetic, environmental, or behavioral risk factors. An effective way to settle this haziness relies on the increase of autopsy performance, increasing manifold the exactitude as well as facing surprising diagnoses. In this report, the authors present the case of a middle-aged woman who sought medical care because of back pain accompanied by weight loss. She died suddenly and unexpectedly in the Emergency Room. In this case, due to the unusual clinical presentation and the patient's unexpected death, the causa mortis would not have been elucidated if the autopsy had not been undertaken.
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Affiliation(s)
| | - Raquel Rivero
- Service of Surgical Pathology - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre/RS - Brazil
| | - Francine Hehn de Oliveira
- Service of Surgical Pathology - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre/RS - Brazil
| | - Eron Lopes
- Service of Surgical Pathology - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre/RS - Brazil
| | - Marcelle Reesink Cerski
- Service of Surgical Pathology - Hospital de Clínicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre/RS - Brazil
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Infección de prótesis articular de cadera por Streptococcus gallolyticus subsp. pasteurianus. Enferm Infecc Microbiol Clin 2015; 33:570-1. [DOI: 10.1016/j.eimc.2015.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/07/2015] [Accepted: 02/11/2015] [Indexed: 11/22/2022]
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García-Pais MJ, Rabuñal R, Corredoira J, Alonso MP. [Spondylodiscitis due to Streptococcus gallolyticus subsp. pasteurianus]. Enferm Infecc Microbiol Clin 2015; 34:141-2. [PMID: 26183441 DOI: 10.1016/j.eimc.2015.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/04/2015] [Accepted: 06/05/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Ramon Rabuñal
- Unidad de Enfermedades Infecciosas, Hospital Universitario Lucus Augusti, Lugo, España.
| | - Juan Corredoira
- Unidad de Enfermedades Infecciosas, Hospital Universitario Lucus Augusti, Lugo, España
| | - María Pilar Alonso
- Servicio de Microbiología, Hospital Universitario Lucus Augusti, Lugo, España
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Differences between endocarditis caused by Streptococcus bovis and Enterococcus spp. and their association with colorectal cancer. Eur J Clin Microbiol Infect Dis 2015; 34:1657-65. [DOI: 10.1007/s10096-015-2402-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 05/03/2015] [Indexed: 12/24/2022]
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Matesanz M, Rubal D, Iñiguez I, Rabuñal R, García-Garrote F, Coira A, García-País MJ, Pita J, Rodriguez-Macias A, López-Álvarez MJ, Alonso MP, Corredoira J. Is Streptococcus bovis a urinary pathogen? Eur J Clin Microbiol Infect Dis 2014; 34:719-25. [PMID: 25416160 DOI: 10.1007/s10096-014-2273-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/30/2014] [Indexed: 10/24/2022]
Abstract
The Streptococcus bovis group (SBG) comprises several microorganisms associated with human infections. They have been associated with bacteremia, endocarditis, biliary tract infection, meningitis, and colorectal cancer, but their role as urinary pathogens is not well known. The objective of this investigation was to discover the incidence and clinical significance of the bacteriuria associated with this complex. A retrospective analysis of all adult patients with bacteriuria caused by SBG during the period 1995-2012 was carried out. During the study period, SBG was isolated in 153 adult patients, who had a mean age of 67 years, most of them being women (80%). Most of our patients (65%) had some underlying disease, with urologic disease being the most common (37%), followed by diabetes mellitus (27%) and neurologic disease (25%). Among the 88 patients in whom we were able to correctly assess symptoms, 45% had asymptomatic bacteriuria, 35% had lower urinary tract infection, and 20% had upper urinary tract infection. In 14 cases (9%), SBG was also isolated in blood cultures. Most of the isolates of SBG (72%) were S. gallolyticus subsp. pasteurianus. All isolates were susceptible to penicillin, 98% to nitrofurantoin, and 77% to fosfomycin. Although SBG bacteriuria is uncommon, it should not always be taken as a contaminant, mainly when S. pasteurianus is isolated, because it may cause urinary tract infections and, occasionally, sepsis, whereas when S. gallolyticus is isolated from urine, it may be a marker of underlying endocarditis and colorectal cancer.
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Affiliation(s)
- M Matesanz
- Department of Internal Medicine, Hospital Lucus Augusti, Lugo, Spain
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Vélez Balestro LM, Baroni MR, Ochoteco MC, Zurbriggen ML, Virgolini SM. [Streptococcus gallolyticus subsp. pasteurianus isolated from cerebrospinal fluid in a pediatric patient]. Rev Argent Microbiol 2014; 45:254-6. [PMID: 24401779 DOI: 10.1016/s0325-7541(13)70032-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 08/08/2013] [Indexed: 11/28/2022] Open
Abstract
Streptococcus gallolyticus subsp. pasteurianus is known to cause bacterial meningitis in adults, and most of the few pediatric cases observed occurred in neonates. We report the case of a 9-month old boy with a history of repeated hospitalizations due to respiratory diseases, who presented meningitis and bacteremia by Streptococcus gallolyticus subsp. pasterianus. To our knowledge, this is the first reported case in Santa Fe to this date.
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Affiliation(s)
- Liz M Vélez Balestro
- Sección Bacteriología, División Laboratorio, Hospital de Niños «Dr. O. Alassia», Mendoza 4158, Santa Fe, Argentina.
| | - María R Baroni
- Sección Bacteriología, División Laboratorio, Hospital de Niños «Dr. O. Alassia», Mendoza 4158, Santa Fe, Argentina
| | - Maria C Ochoteco
- Sección Bacteriología, División Laboratorio, Hospital de Niños «Dr. O. Alassia», Mendoza 4158, Santa Fe, Argentina
| | - María L Zurbriggen
- Sección Bacteriología, División Laboratorio, Hospital de Niños «Dr. O. Alassia», Mendoza 4158, Santa Fe, Argentina
| | - Stella M Virgolini
- Sección Bacteriología, División Laboratorio, Hospital de Niños «Dr. O. Alassia», Mendoza 4158, Santa Fe, Argentina
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Corredoira J, Coira A, Iñiguez I, Pita J, Varela J, Alonso MP. Advanced intestinal cancer associated with Streptococcus infantarius (former S. bovis II/1) sepsis. Int J Clin Pract 2013; 67:1358-9. [PMID: 24246215 DOI: 10.1111/ijcp.12190] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- J Corredoira
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain.
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[Is it necessary to identify the isolates of the Streptococcus bovis group correctly at subspecies level?]. Enferm Infecc Microbiol Clin 2012; 30:173-4. [PMID: 22405138 DOI: 10.1016/j.eimc.2012.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 01/11/2012] [Indexed: 11/23/2022]
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