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Vinciguerra M, Santamaria V, Romiti S, D'Abramo M, Toto G, De Bellis A, Taliani G, Sangiorgi G, Greco E. Case Report: Streptococcus alactolyticus as a Rare Pathogen of Mitral Endocarditis. Front Cardiovasc Med 2021; 8:648213. [PMID: 33996945 PMCID: PMC8116484 DOI: 10.3389/fcvm.2021.648213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
Streptococcus bovis/Streptococcus equinus complex (SBSEC) is a group of non-enterococcal group D Streptococci that colonizes both humans and animals. Due to gastrointestinal disease, they can switch in opportunistic pathogens passing through intestinal mucosal barrier and may cause bacteremia and distant organs damage. Despite infective endocarditis (IE), extra-cardiac manifestations of organs damage include osteoarticular infections, meningitis, and biliary infections among others; moreover, the association with colonic pathological lesions has been largely described. Streptococcus alactolyticus as a species included in SBSEC may share pathophysiological similarities, although it represents an extremely rare cause of distant organ infections, being reported in literature as causative agent of IE in only two other cases. We describe a case of 69-year-old male admitted to our institution due to mild-moderate dyspnea and fever, affected by cervico-brachialgia for 3 weeks. Streptococcus alactolyticus was identified as causative agent of IE on the mitral valve, causing severe regurgitation.
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Affiliation(s)
- Mattia Vinciguerra
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Valeria Santamaria
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvia Romiti
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Mizar D'Abramo
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Gianmarco Toto
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio De Bellis
- Department of Cardiology and Cardiac Surgery, Casa di Cura "S. Michele", Maddaloni, Italy
| | - Gloria Taliani
- Hepatology Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Sangiorgi
- Division of Cardiology, Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Ernesto Greco
- Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Sillanpää J, Nallapareddy SR, Qin X, Singh KV, Muzny DM, Kovar CL, Nazareth LV, Gibbs RA, Ferraro MJ, Steckelberg JM, Weinstock GM, Murray BE. A collagen-binding adhesin, Acb, and ten other putative MSCRAMM and pilus family proteins of Streptococcus gallolyticus subsp. gallolyticus (Streptococcus bovis Group, biotype I). J Bacteriol 2009; 191:6643-53. [PMID: 19717590 PMCID: PMC2795296 DOI: 10.1128/jb.00909-09] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2009] [Accepted: 08/24/2009] [Indexed: 11/20/2022] Open
Abstract
Members of the Streptococcus bovis group are important causes of endocarditis. However, factors associated with their pathogenicity, such as adhesins, remain uncharacterized. We recently demonstrated that endocarditis-derived Streptococcus gallolyticus subsp. gallolyticus isolates frequently adhere to extracellular matrix (ECM) proteins. Here, we generated a draft genome sequence of an ECM protein-adherent S. gallolyticus subsp. gallolyticus strain and found, by genome-wide analyses, 11 predicted LPXTG-type cell wall-anchored proteins with characteristics of MSCRAMMs, including a modular architecture of domains predicted to adopt immunoglobulin (Ig)-like folding. A recombinant segment of one of these, Acb, showed high-affinity binding to immobilized collagen, and cell surface expression of Acb correlated with the presence of acb and collagen adherence of isolates. Three of the 11 proteins have similarities to major pilus subunits and are organized in separate clusters, each including a second Ig-fold-containing MSCRAMM and a class C sortase, suggesting that the sequenced strain encodes three distinct types of pili. Reverse transcription-PCR demonstrated that all three genes of one cluster, acb-sbs7-srtC1, are cotranscribed, consistent with pilus operons of other gram-positive bacteria. Further analysis detected expression of all 11 genes in cells grown to mid to late exponential growth phases. Wide distribution of 9 of the 11 genes was observed among S. gallolyticus subsp. gallolyticus isolates with fewer genes present in other S. bovis group species/subspecies. The high prevalence of genes encoding putative MSCRAMMs and pili, including a collagen-binding MSCRAMM, among S. gallolyticus subsp. gallolyticus isolates may play an important role in the predominance of this subspecies in S. bovis endocarditis.
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Affiliation(s)
- Jouko Sillanpää
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Sreedhar R. Nallapareddy
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Xiang Qin
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Kavindra V. Singh
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Donna M. Muzny
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Christie L. Kovar
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Lynne V. Nazareth
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Richard A. Gibbs
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Mary J. Ferraro
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - James M. Steckelberg
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - George M. Weinstock
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
| | - Barbara E. Murray
- Division of Infectious Diseases, Department of Internal Medicine, Center for the Study of Emerging and Re-emerging Pathogens, Department of Microbiology and Molecular Genetics, University of Texas Medical School, Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas 77030, Massachusetts General Hospital, Boston, Massachusetts 02114, Division of Infectious Diseases, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905
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Henry-Stanley MJ, Hess DJ, Erlandsen SL, Wells CL. ABILITY OF THE HEPARAN SULFATE PROTEOGLYCAN SYNDECAN-1 TO PARTICIPATE IN BACTERIAL TRANSLOCATION ACROSS THE INTESTINAL EPITHELIAL BARRIER. Shock 2005; 24:571-6. [PMID: 16317389 DOI: 10.1097/01.shk.0000184286.95493.78] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although hundreds of microbial species reside in the human intestinal tract, comparatively few (e.g., Escherichia coli and other enterobacteria, Enterococcus faecalis, etc.) are typically associated with systemic infection in postsurgical, shock, and trauma patients. Syndecan-1 is the predominant cell surface heparan sulfate proteoglycan expressed on epithelia, and there is substantial evidence that heparan sulfate participates in interactions of a variety of frankly pathogenic microbes with mammalian cells. To investigate the role of syndecan-1 in interactions of enteric flora with intestinal epithelium, bacteria that might use the enterocyte as a portal of entry for systemic infection (including E. faecalis, E. coli, and other enterobacteria, and several species of staphylococci and streptococci) were studied for their abilities to interact with syndecan-1. Streptococcus bovis, S. agalactiae, S. pyogenes, Staphylococcus aureus, and S. epidermidis showed increased adherence to ARH-77 cells transfected to express syndecan-1. Heparin, a heparan sulfate analog, inhibited internalization of S. bovis, S. agalactiae, S. pyogenes, and S. aureus by HT-29 enterocytes (prominent syndecan-1 expression), but not Caco-2 enterocytes (relatively low syndecan-1 expression). Data from experiments with Chinese hamster ovary cells with altered glycosaminoglycan expression indicated that heparan sulfate and chondroitin sulfate (glycosaminoglycans on the syndecan-1 ectodomain) participated in bacterial interactions with mammalian cells. Thus, although E. faecalis, E. coli, and other gram-negative enterobacteria did not appear to interact with syndecan-1, this heparan sulfate proteoglycan may mediate enterocyte interactions with some staphylococci and streptococci that are known to cause systemic infections in specific populations of high-risk, immunosuppressed, postsurgical, and trauma patients.
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Affiliation(s)
- Michelle J Henry-Stanley
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455-0374, USA
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Lee RA, Woo PCY, To APC, Lau SKP, Wong SSY, Yuen KY. Geographical difference of disease association in Streptococcus bovis bacteraemia. J Med Microbiol 2003; 52:903-908. [PMID: 12972586 DOI: 10.1099/jmm.0.05199-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
From 1996 to 2001, 48 Streptococcus bovis strains were isolated from blood cultures of 37 patients in one hospital. Median patient age was 68 years (range: 1 day-88 years). The male : female ratio was 23 : 14. Most patients (97 %) had underlying diseases, including biliary tract disease in 14 (38 %), diabetes mellitus in 12 (32 %), liver parenchymal disease in seven (19 %), carcinoma of the colon in four (11 %) and other malignancies in four (11 %). No infective foci (indicative of primary bacteraemia) were identified in 15 patients (40 %) and 14 (38 %) had acute cholangitis/cholecystitis, but only four (11 %) had infective endocarditis. Two (5 %), three (8 %) and 32 (87 %) patients had S. bovis of biotypes I, II/1 and II/2, respectively, and three (8 %), two (5 %) and 32 (87 %) patients had S. bovis of genotypes 1, 2a and 2b, respectively. All isolates were sensitive to penicillin, cephalothin and vancomycin, 24 (65 %) were resistant to erythromycin and 15 (41 %) were resistant to clindamycin (these strains were also resistant to erythromycin). Thirteen isolates that were erythromycin- and clindamycin-resistant possessed the ermB gene, 10 possessed the ermT gene and one possessed both the ermB and ermT genes. Overall, seven patients (19 %) died. In contrast to most other reports from western countries, where carcinoma of the colon and infective endocarditis were the major underlying disease and infective focus associated with S. bovis bacteraemia, biliary tract disease and acute cholangitis and/or cholecystitis were the major underlying diseases associated with S. bovis bacteraemia in our locality.
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Affiliation(s)
- Rodney A Lee
- Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2HKU-Pasteur Research Centre, Hong Kong
| | - Patrick C Y Woo
- Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2HKU-Pasteur Research Centre, Hong Kong
| | - Amanda P C To
- Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2HKU-Pasteur Research Centre, Hong Kong
| | - Susanna K P Lau
- Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2HKU-Pasteur Research Centre, Hong Kong
| | - Samson S Y Wong
- Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2HKU-Pasteur Research Centre, Hong Kong
| | - Kwok-Yung Yuen
- Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2HKU-Pasteur Research Centre, Hong Kong
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