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Yu L, Wang L, Xue Y, Ren Y, Liu T, Hu H. Causal associations between platelet count, alcohol consumption, and the risk of liver hepatocellular carcinoma based on a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1400573. [PMID: 38841303 PMCID: PMC11151168 DOI: 10.3389/fendo.2024.1400573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Background and aims Liver hepatocellular carcinoma (LIHC) exhibits a multifactorial etiology, insidious onset, and a significantly low 5-year survival rate. We aimed to evaluate the causal impact of exposure factors (Alzheimer's disease, platelet count, ambidextrousness, cigarettes smoked per day, alcohol consumption, and endocarditis) on the risk of LIHC using a two-sample Mendelian randomization (MR) study. Methods Independent single nucleotide polymorphisms (SNPs) strongly associated with Alzheimer's disease, platelet count, ambidextrousness, daily cigarette consumption, alcohol intake, and endocarditis were selected as instrumental variables (IVs) from the corresponding genome-wide association studies (GWAS). Genetic summary statistics for LIHC came from a GWAS that included 168 cases and 372,016 controls of European individuals. Multivariable MR analyses were performed to find the causal association between 6 exposure factors and LIHC risk. The inverse-variance weighted (IVW)-MR was employed as the primary analysis, and the MR-Egger regression, LASSO regression, and weighted Median approaches were performed as complementary analyses. Results Multivariable MR analysis showed causal association between Alzheimer's disease [Odds ratio (OR) = 0.9999, 95% confidence intervals (CI) = 0.9998-0.9999, p = 0.0010], platelet count (OR = 0.9997, 95% CI = 0.9995-0.9999, p = 0.0066), alcohol consumption (OR = 0.9994, 95% CI = 0.9990-0.9999, p = 0.0098) and the LIHC outcome. After IVW-MR, MR-Egger and LASSO tests, the results are still significant. Next, we used different MR Methods to analyze platelet count, alcohol consumption, and Alzheimer's disease separately. Moreover, both funnel plots and MR-Egger intercepts provided compelling evidence to refute the presence of directional pleiotropy in the association between platelet count, alcohol consumption, Alzheimer's disease and the risk of LIHC. The IVW-MR analysis revealed a significant causal association between an elevated platelet count and a reduced risk of LIHC (OR = 0.9996, 95% CI= 0.9995-0.9998, p = 0.0005). Similarly, the analysis of weighted median revealed a negative correlation between platelet count and the risk of LIHC (OR = 0.9995, 95% CI = 0.9993-0.9999; p = 0.0160). Conversely, we observed a positive causal effect of alcohol consumption on the incidence of LIHC (OR = 1.0004, 95% CI = 0.9999-1.0009). However, no significant causal relationship was found between alcohol assumption, Alzheimer's disease, and LIHC susceptibility. Conclusions A significant causal relationship exists between platelet count, alcohol consumption, Alzheimer's disease, and an increased risk of LIHC. The study presents compelling evidence for a genetically predicted decreased susceptibility to LIHC based on platelet count. The research implies that elevated platelet count may serve as a protective mechanism against LIHC. These findings may inform clinical strategies for LIHC prevention.
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Affiliation(s)
- Lihua Yu
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, China
- School of Medicine, Jiangnan University, Wuxi, China
| | - Leisheng Wang
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
- School of Medicine, Jiangnan University, Wuxi, China
| | - Yuzheng Xue
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Yilin Ren
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Tianhao Liu
- Department of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Hao Hu
- Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Jiangnan University, Wuxi, China
- School of Medicine, Jiangnan University, Wuxi, China
- Wuxi Institute of Hepatobiliary Surgery, Wuxi, China
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2
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Ouranos K, Gardikioti A, Bakaloudi DR, Mylona EK, Shehadeh F, Mylonakis E. Association of the Streptococcus bovis/Streptococcus equinus Complex With Colorectal Neoplasia: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2023; 10:ofad547. [PMID: 38023558 PMCID: PMC10655943 DOI: 10.1093/ofid/ofad547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Background Invasive infection with Streptococcus bovis/Streptococcus equinus complex (SBSEC) bacteria is associated with underlying colorectal neoplasia. However, the link between intestinal or fecal colonization with SBSEC isolates or antibody responses to SBSEC members and colorectal cancer is not thoroughly investigated in the literature. Methods We searched the PubMed, EMBASE, and Web of Science databases for case-control studies as well as retrospective or prospective cohort studies reporting an association between SBSEC bacteria and colorectal neoplasia. Results We identified 22 studies (15 case-control and 7 cohort) that met our inclusion criteria. Among the cohort studies, patients with SBSEC bacteremia were 3.73 times more likely to have underlying colorectal cancer compared with individuals with no bacteremia (relative risk [RR], 3.73; 95% CI, 2.79-5.01), whereas the risk of underlying colorectal adenoma in patients with SBSEC bacteremia was not significantly increased (RR, 5.00; 95% CI, 0.83-30.03). In case-control studies, patients with colorectal cancer were 2.27 times more likely to have evidence of intestinal or fecal colonization with SBSEC isolates (odds ratio [OR], 2.27; 95% CI, 1.11-4.62) and immunoglobulin G (IgG) antibody responses to SBSEC antigens (OR, 2.27; 95% CI, 1.06-4.86) compared with controls. Patients with colorectal adenoma were not more likely to be colonized with SBSEC isolates compared with controls (OR, 1.12; 95% CI, 0.55-2.25). Conclusions Apart from the well-established association of SBSEC bacteremia and underlying colorectal cancer, intestinal or fecal colonization with SBSEC isolates and IgG antibody responses to SBSEC antigens were higher in patients with colorectal cancer compared with controls. Neither bacteremia from SBSEC isolates nor colonization with SBSEC bacteria was associated with underlying colorectal adenoma.
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Affiliation(s)
- Konstantinos Ouranos
- Department of Medicine, Houston Methodist Research Institute, Houston, Texas, USA
| | - Angeliki Gardikioti
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Evangelia K Mylona
- Department of Medicine, Houston Methodist Research Institute, Houston, Texas, USA
| | - Fadi Shehadeh
- Department of Medicine, Houston Methodist Research Institute, Houston, Texas, USA
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Eleftherios Mylonakis
- Department of Medicine, Houston Methodist Research Institute, Houston, Texas, USA
- Weill Cornell Medicine, New York, New York, USA
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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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Pernow G, Shannon O, Öberg J, Nilson B, Rasmussen M. Platelet Activation and Aggregation Induced by Streptococcus bovis /Streptococcus equinus Complex. Microbiol Spectr 2022; 10:e0186122. [PMID: 36374116 PMCID: PMC9769897 DOI: 10.1128/spectrum.01861-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
Streptococcus bovis/Streptococcus equinus complex (SBSEC) is a common cause of infective endocarditis (IE). For IE-pathogens, the capacity to activate and aggregate platelets is believed to be an important virulence mechanism. While the interactions between bacteria and platelets have been described in detail for many Gram-positive pathogens, little research has been carried out with SBSEC in this respect. Twenty-six isolates of the four most common species and subspecies of SBSEC identified in bacteremia were collected, and interactions with platelets were investigated in platelet rich plasma (PRP) from three donors. Aggregation was studied using light-transmission aggregometry and platelet activation using flow cytometry detecting surface upregulation of CD62P. Platelets and serum were treated with different inhibitors to determine mechanisms involved in platelet aggregation and activation. Twenty-two of 26 isolates induced aggregation in at least one donor, and four isolates induced aggregation in all three donors. In PRP from donor 1, isolate SL1 induced a rapid aggregation with a median time of 70 s to reach 50% aggregation. Blockade of the platelet Fc-receptor or enzymatic cleavage of IgG abolished platelet activation and aggregation. The capacity for bacteria-induced platelet aggregation was also shown to be transferable between donors through serum. SBSEC mediates platelet aggregation in an IgG and IgG-Fc-receptor dependent manner. Bacterial activation of platelets through this pathway is common for many bacteria causing IE and could be a potential therapeutic target for the prevention and treatment of this infection. IMPORTANCE The capacity of bacteria to activate and aggregate platelets is believed to contribute to the pathogenesis of IE. The Streptococcus bovis/Streptococcus equinus complex (SBSEC) contains known IE-pathogens, but there is limited research on the different subspecies ability to interact with platelets and what signaling pathways are involved. This study reports that 22 of 26 tested isolates of different subspecies within SBSEC can induce aggregation, and that aggregation is host dependent. The Fc-IgG-receptor pathway was shown essential for platelet activation and aggregation. To the best of our knowledge, this is the first study that reports on platelet interactions of SBSEC-isolates other than Streptococcus gallolyticus subspecies gallolyticus as well as the first study to report of mechanisms of platelet interaction of SBSEC-isolates. It adds SBSEC to a group of bacteria that activate and aggregate platelets via the platelet Fc-receptor. This could be a potential therapeutic target for prevention of IE.
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Affiliation(s)
- Gustav Pernow
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Helsingborg Hospital, Lund, Sweden
| | - Oonagh Shannon
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Jonas Öberg
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Helsingborg Hospital, Lund, Sweden
| | - Bo Nilson
- Department of Clinical Microbiology, Infection Control and Prevention, Office for Medical Services, Region Skåne, Lund, Sweden
- Division of Medical Microbiology, Department of Laboratory Medicine Lund, Medical Faculty, Lund University, Office for Medical Services, Region Skåne, Lund, Sweden
| | - Magnus Rasmussen
- Division of Infection Medicine, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
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Shapira R, Weiss T, Goldberg E, Cohen E, Krause I, Sharony R, Goldberg I. Streptococcus gallolyticus endocarditis on a prosthetic tricuspid valve: a case report and review of the literature. J Med Case Rep 2021; 15:528. [PMID: 34702343 PMCID: PMC8549216 DOI: 10.1186/s13256-021-03125-5] [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: 12/10/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background Streptococcus gallolyticus subspecies gallolyticus is a known pathogen that causes infective endocarditis, and most cases involve the left heart valves. We present the first reported case of prosthetic tricuspid valve endocarditis caused by this microorganism. Relevant literature is reviewed. Case presentation A 67-year-old Jewish female with a history of a prosthetic tricuspid valve replacement was admitted to the emergency department because of nonspecific complaints including effort dyspnea, fatigue, and a single episode of transient visual loss and fever. No significant physical findings were observed. Laboratory examinations revealed microangiopathic hemolytic anemia and a few nonspecific abnormalities. Transesophageal echocardiogram demonstrated a vegetation attached to the prosthetic tricuspid valve. The involved tricuspid valve was replaced by a new tissue valve, and Streptococcus gallolyticus subspecies gallolyticus was grown from its culture. Prolonged antibiotic treatment was initiated. Conclusions Based on this report and the reviewed literature, Streptococcus gallolyticus should be considered as a rare but potential causative microorganism in prosthetic right-sided valves endocarditis. The patient’s atypical presentation emphasizes the need for a high index of suspicion for the diagnosis of infective endocarditis.
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Affiliation(s)
- Raz Shapira
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamir Weiss
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elad Goldberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Department of Medicine F - Recanati, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | - Eytan Cohen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Department of Medicine F - Recanati, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | - Ilan Krause
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Department of Medicine F - Recanati, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | - Ram Sharony
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Department of Cardiothoracic Surgery, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | - Idan Goldberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
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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: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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7
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Ioannou P, Savva E, Kofteridis DP. Infective endocarditis in patients with liver cirrhosis: a systematic review. J Chemother 2021; 33:443-451. [PMID: 33512305 DOI: 10.1080/1120009x.2021.1878332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Liver cirrhosis is an increasing cause of mortality and morbidity in developed countries. Infective Endocarditis (IE) is an uncommon disease with notable morbidity and mortality. Even though cirrhosis is associated with immune dysfunction and increased occurrence of bacterial infection, IE is infrequently diagnosed in these patients. Thus, the purpose of this study was to systematically review all published cases of IE in patients with cirrhosis in the literature. A systematic review of PubMed, Scopus and Cochrane (through 23th April 2020) for studies providing epidemiological, clinical, microbiological as well as treatment data and outcomes of IE in patients with cirrhosis was performed. A total of 78 studies, containing data of 602 patients, were included. A prosthetic valve was present in 17.8%, while the most common causative pathogen was S. aureus in 26% followed by Streptococcus spp in 16.8%. Aortic valve was the most commonly infected site, followed by mitral valve. Diagnosis was set with a transthoracic ultrasound in 55.2%, while the diagnosis was set at autopsy in 16.7%. Fever and heart failure were the most common clinical presentations. Aminoglycosides, vancomycin, and cephalosporins were the antimicrobials most frequently used for treatment. Clinical cure was noted in 68.2%, while overall mortality was 41.4%. This systematic review thoroughly describes IE in patients with liver cirrhosis and provides information on epidemiology, clinical presentation, treatment and outcomes.
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Affiliation(s)
- Petros Ioannou
- Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece
| | - Eirini Savva
- Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece
| | - Diamantis P Kofteridis
- Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece
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8
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Ursi MP, Bertolino L, Andini R, D'Amico F, Iossa D, Karruli A, D'Avenia E, Manduca S, Bernardo M, Zampino R, Durante-Mangoni E. Enterococcal infective endocarditis is a marker of current occult or future incident colorectal neoplasia. Eur J Intern Med 2021; 83:68-73. [PMID: 33046347 DOI: 10.1016/j.ejim.2020.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Few studies suggest an association between Enterococcal infective endocarditis (EIE) and colorectal disease, including colorectal neoplasia (CRN) and colorectal cancer (CRC). In this study, we analyze differences in prevalence, risk factors and outcome of CRN and CRC between EIE and Streptococcus gallolyticus infective endocarditis (SGIE). METHODS Single center, observational study of 166 patients with definite EIE or SGIE. Clinical data were collected prospectively in a standardized IE protocol. Colonoscopy data were collected retrospectively on 90 patients. RESULTS 85 patients had EIE, 81 SGIE. EIE patients had a higher rate of prior cancer (20% vs 6%) and health-care associated infection (12% vs 1%), but similar mortality than SGIE. Colonoscopy performed in 90 patients showed intestinal diseases in 30 of 42 (71%) EIE patients vs. 40 of 48 (83%) SGIE patients (p = 0.174), with a predominance of CRN. Among 78 patients who underwent colonoscopy after IE diagnosis, no difference between EIE and SGIE was observed in the rate of non-neoplastic lesions (48% vs 47%), benign (32% vs 40%) or malignant (13% vs 15%) neoplastic lesions. Adverse events during colonoscopy were uncommon, although a careful handling of anticoagulation was required. CONCLUSIONS EIE seems to be associated with colorectal disease, including colorectal neoplasia and colorectal cancer, to the same extent as SGIE. EIE should be considered a marker of colorectal neoplasia, even in patients with a clear health-care related acquisition. Colonoscopy is generally safe in EIE patients, and should be considered to early diagnose and treat colorectal disease.
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Affiliation(s)
- Maria Paola Ursi
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy
| | - Lorenzo Bertolino
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy
| | - Roberto Andini
- Units of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
| | - Fabiana D'Amico
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy
| | - Domenico Iossa
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy
| | - Arta Karruli
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy
| | - Eugenio D'Avenia
- Digestive Endoscopy, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
| | - Sabrina Manduca
- Surgical Echocardiography, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
| | - Mariano Bernardo
- Microbiology, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
| | - Rosa Zampino
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy; Units of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
| | - Emanuele Durante-Mangoni
- Internal Medicine, University of Campania 'L. Vanvitelli', Via De Crecchio 7, 80138 Napoli, Italy; Units of Infectious and Transplant Medicine, AORN Ospedali dei Colli-Monaldi Hospital, Piazzale Ettore Ruggieri, 80131 Napoli, Italy.
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Taddese R, Garza DR, Ruiter LN, de Jonge MI, Belzer C, Aalvink S, Nagtegaal ID, Dutilh BE, Boleij A. Growth rate alterations of human colorectal cancer cells by 157 gut bacteria. Gut Microbes 2020; 12:1-20. [PMID: 32915102 PMCID: PMC7524400 DOI: 10.1080/19490976.2020.1799733] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Several bacteria in the human gut microbiome have been associated with colorectal cancer (CRC) by high-throughput screens. In some cases, molecular mechanisms have been elucidated that drive tumorigenesis, including bacterial membrane proteins or secreted molecules that interact with the human cancer cells. For most gut bacteria, however, it remains unknown if they enhance or inhibit cancer cell growth. Here, we screened bacteria-free supernatants (secretomes) and inactivated cells of over 150 cultured bacterial strains for their effects on cell growth. We observed family-level and strain-level effects that often differed between bacterial cells and secretomes, suggesting that different molecular mechanisms are at play. Secretomes of Bacteroidaceae, Enterobacteriaceae, and Erysipelotrichaceae bacteria enhanced cell growth, while most Fusobacteriaceae cells and secretomes inhibited growth, contrasting prior findings. In some bacteria, the presence of specific functional genes was associated with cell growth rates, including the virulence genes TcdA, TcdB in Clostridiales and FadA in Fusobacteriaceae, which both inhibited growth. Bacteroidaceae cells that enhanced growth were enriched for genes of the cobalamin synthesis pathway, while Fusobacteriaceae cells that inhibit growth were enriched for genes of the ethanolamine utilization pathway. Together, our results reveal how different gut bacteria have wide-ranging effects on cell growth, contribute a better understanding of the effects of the gut microbiome on host cells, and provide a valuable resource for identifying candidate target genes for potential microbiome-based diagnostics and treatment strategies.
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Affiliation(s)
- Rahwa Taddese
- Department of Pathology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Daniel R. Garza
- Centre for Molecular and Biomolecular Informatics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lilian N. Ruiter
- Department of Pathology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marien I. de Jonge
- Section Pediatric Infectious Diseases, Laboratory of Medical Immunology, Radboud Center for Infectious Diseases (RCI), Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Clara Belzer
- Laboratory of Microbiology, Wageningen University and Research, Wageningen, The Netherlands
| | - Steven Aalvink
- Laboratory of Microbiology, Wageningen University and Research, Wageningen, The Netherlands
| | - Iris D. Nagtegaal
- Department of Pathology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas E. Dutilh
- Centre for Molecular and Biomolecular Informatics, Radboud University Medical Center, Nijmegen, The Netherlands,Theoretical Biology and Bioinformatics, Utrecht University, Utrecht, The Netherlands,CONTACT Bas E.Dutilh Centre for Molecular and Biomolecular Informatics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annemarie Boleij
- Department of Pathology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands,Annemarie Boleij Department of Pathology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
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10
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Nasomsong W, Vasikasin V, Traipattanakul J, Changpradub D. Is Echocardiography Mandatory for All Streptococcus gallolyticus Subsp. pasteurianus Bacteremia? Infect Drug Resist 2020; 13:2425-2432. [PMID: 32765016 PMCID: PMC7381823 DOI: 10.2147/idr.s265722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022] Open
Abstract
Background Streptococcus gallolyticus, formerly known as one of the Streptococcus bovis group, is frequently associated with endocarditis. Current guidelines recommended diagnostic work-up for endocarditis among patients with S. gallolyticus bacteremia. However, S. gallolyticus subsp. pasteurianus, was found to be associated with neonatal sepsis and liver diseases and is less commonly associated with endocarditis compared with S. gallolyticus subsp. gallolyticus. Our study aimed to identify the risk factors for S. gallolyticus subsp. pasteurianus endocarditis to help select the patients for echocardiography. Methods In this retrospective cohort study, medical records from all adult patients with S. gallolyticus subsp. pasteurianus isolated from blood cultures at Phramongkutklao Hospital from 2009 to 2015 were reviewed. Patients who had mixed bacteremia or missing records were excluded from the study. Results During the study period, S. gallolyticus subsp. pasteurianus was isolated among 106 individuals. Mean age was 66.9±15.6 years. Most patients (61.3%) were male, with cirrhosis as the most common underlying diseases (46.2%), followed by malignancy and chronic kidney disease. Most common manifestations included primary bacteremia (44.3%), followed by spontaneous bacterial peritonitis (23.6%). Infective endocarditis was found among 9 patients. No patients with cirrhosis or single blood specimen of bacteremia had endocarditis (RR 0; p-value 0.003, and RR 1.35; p-value 0.079). The common complications associated with endocarditis were acute respiratory failure (RR 4.32; p-value 0.05), whereas acute kidney injury was a protective factor (RR 0; p-value 0.01). Among 76 patients who had records of 2-year follow-up, no new diagnosis of endocarditis or malignancy was observed. Conclusion Among patients with S. gallolyticus subsp. pasteurianus bacteremia, echocardiography might not be needed among patients with cirrhosis and without sustained bacteremia.
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Affiliation(s)
- Worapong Nasomsong
- Division of Infectious Diseases, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Vasin Vasikasin
- Division of Infectious Diseases, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Jantima Traipattanakul
- Division of Infectious Diseases, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand
| | - Dhitiwat Changpradub
- Division of Infectious Diseases, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand
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Niyas VK, Arjun R, Sasidharan A, Palakunnath GA. Streptococcus gallolyticus Bacteremia: An Experience from a Tertiary Center in South India. Indian J Crit Care Med 2020; 24:943-945. [PMID: 33281319 PMCID: PMC7689116 DOI: 10.5005/jp-journals-10071-23569] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Streptococcus gallolyticus is an important cause of bacteremia and infective endocarditis in adults. Studies from other parts of the world have shown a strong association between S. gallolyticus bacteremia and colonic neoplasia. The profile of S. gallolyticus bacteremia is understudied in Indian population. Materials and methods We retrospectively analyzed the data of 16 patients with S. gallolyticus bacteremia obtained from microbiology registry. BacT/ALERT positive samples were inoculated into blood agar, chocolate agar, and MacConkey agar. Organisms were identified by the VITEK 2 microbial identification system, and susceptibility was done by the microbroth dilution method as per Clinical and Laboratory Standards Institute (CLSI) M100 guidelines. Clinical details were obtained from electronic medical records. Results Majority of our isolates were S. gallolyticus subspecies pasteurianus. Total 16 patients had S. gallolyticus isolated from blood over a 1 year period. The median age was 58 years (IQR: 46.5–66). Eleven were males; type II diabetes mellitus and chronic liver disease were the common comorbidities observed in our patients. None of our patients had underlying infective endocarditis or colonic malignancy. Penicillin sensitivity was 81.2% while all the isolates were susceptible to ceftriaxone. Ampicillin resistance was seen in only one of the isolates. In-hospital mortality was 12.5%. Conclusion Streptococcus gallolyticus subsp. pasteurianus is the commonest subspecies of S. gallolyticus isolated in our population. Unlike previous studies, colonic neoplasia and infective endocarditis were rare in our patients. Type II diabetes mellitus and chronic liver disease were the commonest risk factors identified in patients with S. gallolyticus bacteremia. How to cite this article Niyas VKM, Arjun R, Sasidharan A, Palakunnath GA. Streptococcus gallolyticus Bacteremia: An Experience from a Tertiary Center in South India. Indian J Crit Care Med 2020;24(10):943–945.
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Affiliation(s)
- Vettakkara Km Niyas
- Department of Infectious Diseases, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
| | - Rajalakshmi Arjun
- Department of Infectious Diseases, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
| | - Aswathy Sasidharan
- Department of Infectious Diseases, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
| | - George A Palakunnath
- Department of Internal Medicine, Kerala Institute of Medical Sciences, Thiruvananthapuram, Kerala, India
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Heda RP, Savage Y, Nair SP, Verma R. Enterococcus casseliflavus, Streptococcus equinus and Klebsiella oxytoca septicaemia associated with perinephric haematoma in a post-liver transplant patient with allograft cirrhosis. BMJ Case Rep 2019; 12:12/8/e230096. [PMID: 31466981 DOI: 10.1136/bcr-2019-230096] [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] [Indexed: 11/03/2022] Open
Abstract
Liver transplant recipients are immunocompromised by the virtue of being on immunosuppressive agents which put them at risk of having infections from unusual and even multiple concomitant pathogens. We present a case of a 39-year-old man who developed septicaemia with Enterococcus casseliflavus, Streptococcus equinus and Klebsiella oxytoca in the setting of perinephric haematoma which resulted following a kidney biopsy performed to evaluate his nephrotic range proteinuria. E. casseliflavus has been known to cause infections in patients with liver disease/cirrhosis; however, simultaneous infection with S. equinus and K. oxytoca along with E. casseliflavus has never been reported earlier in post-transplant state.
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Affiliation(s)
| | - Yolanda Savage
- Microbiology, Methodist University Hospital, Memphis, Tennessee, USA
| | - Satheesh P Nair
- Transplant Hepatology, Methodist University Hospital, UTHSC College of Medicine Memphis, Memphis, Tennessee, USA
| | - Rajanshu Verma
- Transplant Hepatology, Methodist University Hospital, UTHSC College of Medicine Memphis, Memphis, Tennessee, USA
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Kale P, Khillan V, Sarin SK. Novel association of Streptococcus gallolyticus subspecies pasteurianus and hepatocelluar carcinoma: opening new frontiers. Scand J Gastroenterol 2019; 53:1354-1357. [PMID: 30332912 DOI: 10.1080/00365521.2018.1511826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Streptococcus gallolyticus subsp. gallolyticus bacteremia is associated with colorectal malignancies. There is limited data regarding the association of Streptococcus gallolyticus subsp. pasteurianus with malignancies. We aimed to study the pattern of isolation of Streptococcus gallolyticus and analysis of risk factors in patients with hepatobiliary diseases. We also planned to evaluate its association with hepatocellular malignancy. METHODS We analyzed clinical and laboratory data of 68 cases of Streptococcus gallolyticus infections (77 isolates) from January 2013 to December 2017. These included blood (58), ascitic fluid (15), bile (2) and pleural fluid (2). We analyzed the risk factors in patients developing malignancy with Streptococcus gallolyticus infections. RESULTS Amongst the 68 patients studied, eight (11.76%) had confirmed malignancies, hepatocellular carcinoma (HCC) (5), rectal adenocarcinoma (1), pancreatic carcinoma (1) and uterine tumors (1). Simultaneous isolation of S. gallolyticus subsp. pasteurianus from blood and ascitic fluid in eight patients (11.8%, p = .01) was significantly associated with the occurrence of HCC. Streptococcus gallolyticus infection with HCC was associated with younger age (median 55 years), lymphocytosis and elevated gamma-glutamyl transferase (GGT). CONCLUSIONS This study provides a novel insight into the association of Streptococcus gallolyticus subspecies pasteurianus with HCC. The isolation of the organism from blood and ascitic fluid should prompt the clinicians to search for evidence of HCC actively.
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Affiliation(s)
- Pratibha Kale
- a Department of Clinical Microbiology , Institute of Liver and Biliary Sciences , New Delhi , India
| | - Vikas Khillan
- a Department of Clinical Microbiology , Institute of Liver and Biliary Sciences , New Delhi , India
| | - Shiv Kumar Sarin
- b Department of Hepatology , Institute of Liver and Biliary Sciences , New Delhi , India
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Righi E. Management of bacterial and fungal infections in end stage liver disease and liver transplantation: Current options and future directions. World J Gastroenterol 2018; 24:4311-4329. [PMID: 30344417 PMCID: PMC6189843 DOI: 10.3748/wjg.v24.i38.4311] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/11/2018] [Accepted: 10/05/2018] [Indexed: 02/06/2023] Open
Abstract
Patients with liver cirrhosis are susceptible to infections due to various mechanisms, including abnormalities of humoral and cell-mediated immunity and occurrence of bacterial translocation from the intestine. Bacterial infections are common and represent a reason for progression to liver failure and increased mortality. Fungal infections, mainly caused by Candida spp., are often associated to delayed diagnosis and high mortality rates. High level of suspicion along with prompt diagnosis and treatment of infections are warranted. Bacterial and fungal infections negatively affect the outcomes of liver transplant candidates and recipients, causing disease progression among patients on the waiting list and increasing mortality, especially in the early post-transplant period. Abdominal, biliary tract, and bloodstream infections caused by Gram-negative bacteria [e.g., Enterobacteriaceae and Pseudomonas aeruginosa (P. aeruginosa)] and Staphylococcus spp. are commonly encountered in liver transplant recipients. Due to frequent exposure to broad-spectrum antibiotics, invasive procedures, and prolonged hospitalizations, these patients are especially at risk of developing infections caused by multidrug resistant bacteria. The increase in antimicrobial resistance hampers the choice of an adequate empiric therapy and warrants the knowledge of the local microbial epidemiology and the implementation of infection control measures. The main characteristics and the management of bacterial and fungal infections in patients with liver cirrhosis and liver transplant recipients are presented.
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Affiliation(s)
- Elda Righi
- Department of Infectious Diseases, Santa Maria della Misericordia University Hospital, Udine 33100, Italy
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Jans C, Boleij A. The Road to Infection: Host-Microbe Interactions Defining the Pathogenicity of Streptococcus bovis/Streptococcus equinus Complex Members. Front Microbiol 2018; 9:603. [PMID: 29692760 PMCID: PMC5902542 DOI: 10.3389/fmicb.2018.00603] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/15/2018] [Indexed: 12/17/2022] Open
Abstract
The Streptococcus bovis/Streptococcus equinus complex (SBSEC) comprises several species inhabiting the animal and human gastrointestinal tract (GIT). They match the pathobiont description, are potential zoonotic agents and technological organisms in fermented foods. SBSEC members are associated with multiple diseases in humans and animals including ruminal acidosis, infective endocarditis (IE) and colorectal cancer (CRC). Therefore, this review aims to re-evaluate adhesion and colonization abilities of SBSEC members of animal, human and food origin paired with genomic and functional host-microbe interaction data on their road from colonization to infection. SBSEC seem to be a marginal population during GIT symbiosis that can proliferate as opportunistic pathogens. Risk factors for human colonization are considered living in rural areas and animal-feces contact. Niche adaptation plays a pivotal role where Streptococcus gallolyticus subsp. gallolyticus (SGG) retained the ability to proliferate in various environments. Other SBSEC members have undergone genome reduction and niche-specific gene gain to yield important commensal, pathobiont and technological species. Selective colonization of CRC tissue is suggested for SGG, possibly related to increased adhesion to cancerous cell types featuring enhanced collagen IV accessibility. SGG can colonize, proliferate and may shape the tumor microenvironment to their benefit by tumor promotion upon initial neoplasia development. Bacteria cell surface structures including lipotheichoic acids, capsular polysaccharides and pilus loci (pil1, pil2, and pil3) govern adhesion. Only human blood-derived SGG contain complete pilus loci and other disease-associated surface proteins. Rumen or feces-derived SGG and other SBSEC members lack or harbor mutated pili. Pili also contribute to binding to fibrinogen upon invasion and translocation of cells from the GIT into the blood system, subsequent immune evasion, human contact system activation and collagen-I-binding on damaged heart valves. Only SGG carrying complete pilus loci seem to have highest IE potential in humans with significant links between SGG bacteremia/IE and underlying diseases including CRC. Other SBSEC host-microbe combinations might rely on currently unknown mechanisms. Comparative genome data of blood, commensal and food isolates are limited but required to elucidate the role of pili and other virulence factors, understand pathogenicity mechanisms, host specificity and estimate health risks for animals, humans and food alike.
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Affiliation(s)
- Christoph Jans
- Laboratory of Food Biotechnology, Institute of Food Nutrition and Health, Department of Health Science and Technology, ETH Zurich, Zurich, Switzerland
| | - Annemarie Boleij
- Department of Pathology, Radboud Institute for Molecular Life Sciences, Radboudumc, Nijmegen, Netherlands
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Tricuspid Valve Endocarditis due to Streptococcus bovis in a Patient with Ventricular Septal Defect: A Rare Manifestation-Case Report and Review of the Literature. Case Rep Infect Dis 2017; 2017:7152902. [PMID: 29225981 PMCID: PMC5687147 DOI: 10.1155/2017/7152902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/12/2017] [Accepted: 10/19/2017] [Indexed: 12/24/2022] Open
Abstract
Streptococcus bovis endocarditis has 18%-62% association with colonic neoplasms with multivalvular involvement and affects mainly elderly males leading to severe cardiac dysfunction, septic embolization, and neurological complications. The aortic valve is the commonest valve to be affected followed by aortic and mitral valves together. However, involvement of tricuspid valve is extremely rare. There are no reported cases of Streptococcus bovis endocarditis affecting the tricuspid valve in the presence of ventricular septal defect with left to right shunt. We report the case of a 25-year-old female with ventricular septal defect who was diagnosed to have tricuspid valve endocarditis caused by Streptococcus bovis. Her detailed colonoscopy, upper gastrointestinal endoscopy, liver biochemistry, and ultrasound scan of the abdomen were normal. She made a very good recovery with six weeks of intravenous antibiotics. This is the first case of tricuspid valve endocarditis caused by Streptococcus bovis in association with ventricular septal defect without any colonic lesions.
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Corredoira J, Grau I, Garcia-Rodriguez JF, García-País MJ, Rabuñal R, Ardanuy C, García-Garrote F, Coira A, Alonso MP, Boleij A, Pallares R. Colorectal neoplasm in cases of Clostridium septicum and Streptococcus gallolyticus subsp. gallolyticus bacteraemia. Eur J Intern Med 2017; 41:68-73. [PMID: 28236516 DOI: 10.1016/j.ejim.2017.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 02/12/2017] [Accepted: 02/14/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Bacteremia with Clostridium septicum (CS) and Streptococcus gallolyticus subsp. gallolyticus (SGG) have both been associated with colorectal neoplasms (CRN) and colonoscopic examination is advised, however the differences and similarities in colorectal findings are not well known. METHODS This is a multicenter, comparative study of patients with CS bacteremia [44 of 664 cases (6.6%) of Clostridium spp.] and SGG bacteremia [257 of 596 cases (44.2%) of S. bovis group], carried out in three hospitals from Spain. Clinical findings related to bacteremia and associated CRN were collected. RESULTS The main sources of infection were abdominal (77.7%) for CS bacteremia and endovascular (75%) for SGG bacteremia. CS bacteremia was more often associated with malignancies, (72.6% vs. 19.4%) and neutropenia (29.5% vs. 3.1%), and was more acute, with shock at presentation (63.6% vs. 3.9%) and higher 30-day mortality (47.7% vs. 9.7%) compared to SGG (P<0.05 for all). Both, patients with CS and SGG bacteremia often had concomitant CRN (43.1% vs. 49.8%) and most of them presented as occult CRN (73.7% vs. 91.4%; P=0.02). CS cases more often had invasive carcinomas (94.7% vs. 19.5%), location of CRN in the right colon (73.7% vs. 23.4%), larger tumor size (median 7 vs. 1.5cm), and a higher overall CRN related mortality rate (68.4% vs. 7.8%) compared to SGG cases (P<0.05 for all). CONCLUSIONS Both, CS and SGG bacteremia are associated with occult CRN. CS cases more often had advanced carcinomas than SGG cases, suggesting a distinct temporal association with CRN.
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Affiliation(s)
- Juan Corredoira
- Infectious Disease Unit and Microbiology Departments, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Imma Grau
- Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
| | | | - María Jose García-País
- Infectious Disease Unit and Microbiology Departments, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Ramón Rabuñal
- Infectious Disease Unit and Microbiology Departments, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Carmen Ardanuy
- Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
| | - Fernando García-Garrote
- Infectious Disease Unit and Microbiology Departments, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Amparo Coira
- Infectious Disease Unit and Microbiology Departments, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Maria Pilar Alonso
- Infectious Disease Unit and Microbiology Departments, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Annemarie Boleij
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Roman Pallares
- Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
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Corredoira J, Rabuñal R, Alonso MP. Streptococcus bovis: 100 Years of an Intriguing Pathogen. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.clinmicnews.2016.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Clarke LL, Fathke RL, Sanchez S, Stanton JB. Streptococcus bovis/S. equinus complex septicemia in a group of calves following intramuscular vaccination. J Vet Diagn Invest 2016; 28:423-8. [PMID: 27216720 DOI: 10.1177/1040638716648364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Organisms previously classified as Streptococcus bovis (i.e., the S. bovis/S. equinus complex) are common in cattle feces, but may also act as opportunistic pathogens. In the current work, Streptococcus infantarius subsp. coli, a member of this complex, was associated of a cluster of calves that died within hours of injection with a modified live viral vaccine. Within 12 h of vaccination of 46 calves at a cow/calf operation, 4 calves had died, 3 calves were ill, and 1 unvaccinated cow was dead. Autopsies were performed on the cow, 2 dead calves, and 1 affected surviving calf, which was euthanized ~24 h after vaccine administration. The animals had similar gross anatomic and microscopic lesions, including subcutaneous and intramuscular dark hemorrhage on the caudal neck, multiorgan ecchymosis and petechiation, and alveolitis to interstitial pneumonia. Gram-positive cocci were in the vasculature of the lung and skeletal muscle, and S. infantarius subsp. coli was cultured from tissues and from the vaccines used on affected animals, but not in vials used on unaffected animals. Together, these findings suggest death caused by streptococcal septicemia and toxemia as a result of contamination.
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Affiliation(s)
- Lorelei L Clarke
- Virginia Maryland College of Veterinary Medicine, Blacksburg, VA (Fathke)Departments of Pathology (Clarke, Stanton), The University of Georgia, College of Veterinary Medicine, Athens, GAInfectious Diseases (Sanchez), The University of Georgia, College of Veterinary Medicine, Athens, GA
| | - Robert L Fathke
- Virginia Maryland College of Veterinary Medicine, Blacksburg, VA (Fathke)Departments of Pathology (Clarke, Stanton), The University of Georgia, College of Veterinary Medicine, Athens, GAInfectious Diseases (Sanchez), The University of Georgia, College of Veterinary Medicine, Athens, GA
| | - Susan Sanchez
- Virginia Maryland College of Veterinary Medicine, Blacksburg, VA (Fathke)Departments of Pathology (Clarke, Stanton), The University of Georgia, College of Veterinary Medicine, Athens, GAInfectious Diseases (Sanchez), The University of Georgia, College of Veterinary Medicine, Athens, GA
| | - James B Stanton
- Virginia Maryland College of Veterinary Medicine, Blacksburg, VA (Fathke)Departments of Pathology (Clarke, Stanton), The University of Georgia, College of Veterinary Medicine, Athens, GAInfectious Diseases (Sanchez), The University of Georgia, College of Veterinary Medicine, Athens, GA
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Sun LM, Wu JN, Lin CL, Day JD, Liang JA, Liou LR, Kao CH. Infective Endocarditis and Cancer Risk: A Population-Based Cohort Study. Medicine (Baltimore) 2016; 95:e3198. [PMID: 27015220 PMCID: PMC4998415 DOI: 10.1097/md.0000000000003198] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This study investigated the possible relationship between endocarditis and overall and individual cancer risk among study participants in Taiwan.We used data from the National Health Insurance program of Taiwan to conduct a population-based, observational, and retrospective cohort study. The case group consisted of 14,534 patients who were diagnosed with endocarditis between January 1, 2000 and December 31, 2010. For the control group, 4 patients without endocarditis were frequency matched to each endocarditis patient according to age, sex, and index year. Competing risks regression analysis was conducted to determine the effect of endocarditis on cancer risk.A large difference was noted in Charlson comorbidity index between endocarditis and nonendocarditis patients. In patients with endocarditis, the risk for developing overall cancer was significant and 119% higher than in patients without endocarditis (adjusted subhazard ratio = 2.19, 95% confidence interval = 1.98-2.42). Regarding individual cancers, in addition to head and neck, uterus, female breast and hematological malignancies, the risks of developing colorectal cancer, and some digestive tract cancers were significantly higher. Additional analyses determined that the association of cancer with endocarditis is stronger within the 1st 5 years after endocarditis diagnosis.This population-based cohort study found that patients with endocarditis are at a higher risk for colorectal cancer and other cancers in Taiwan. The risk was even higher within the 1st 5 years after endocarditis diagnosis. It suggested that endocarditis is an early marker of colorectal cancer and other cancers. The underlying mechanisms must still be explored and may account for a shared risk factor of infection in both endocarditis and malignancy.
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Affiliation(s)
- Li-Min Sun
- From the Department of Radiation Oncology, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung (L-MS); General Affairs Office, China Medical University Hospital, Taichung (J-NW); Department of Industrial Engineering and Management, National Kaohsiung University of Applied Sciences, Kaohsiung (J-NW, J-DD); Management Office for Health Data, China Medical University Hospital (C-LL); College of Medicine (C-LL); Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University, Taichung (J-AL, C-HK); Department of Surgery, Zuoying Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung (L-RL); Department of Radiation Oncology (J-AL); and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan (C-HK)
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García-País MJ, Rabuñal R, Armesto V, López-Reboiro M, García-Garrote F, Coira A, Pita J, Rodríguez-Macías AIB, López-Álvarez MJ, Alonso MP, Corredoira J. Streptococcus bovis septic arthritis and osteomyelitis: A report of 21 cases and a literature review. Semin Arthritis Rheum 2016; 45:738-46. [PMID: 26992635 DOI: 10.1016/j.semarthrit.2016.02.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/25/2016] [Accepted: 02/02/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Streptococcus bovis group (SBG) is a well-known cause of endocarditis, but its role in osteoarticular infections (OAIs) has not been well described. METHODS We analyzed all patients with OAIs by SBG diagnosed in our hospital (1988-2014). We selected those cases with septic arthritis and osteomyelitis, as defined according to clinical, microbiological, and imaging studies. Identification of the strains was performed by using the API 20 Strep and the GP card of the Vitek 2 system, and confirmed the identification by molecular methods. In addition, we reviewed the literature to select all cases of OAI by SBG during the period 1980-2015. RESULTS From the 83 cases of OAI included in the analysis (21 from our center and 62 from the literature review), 59 were osteomyelitis (57 of them spondylodiscitis) and 24 were arthritis (2 with associated spondylodiscitis). The mean age was 66.9 years, and 79.2% of the patients were men. Endocarditis (IE) was associated with 59% of the cases and this association was greater for osteomyelitis than for arthritis (78.9% vs. 13.6%; P = 0.001). OAI was a presenting symptom in 63% of the cases of IE. Colonoscopy was performed in 64 cases, which detected colorectal neoplasm (CRN) in 46 patients (71.8%), almost all asymptomatic. Some 69.5% of these neoplasm were carcinomas or advanced adenomas. The blood cultures were positive in 78.3% cases. In 45 cases, the S. bovis species was identified; in 82.2% of the cases the cause was Streptococcus gallolyticus subsp. gallolyticus. The mortality was 7.2%, which in no case was attributable to the OAI. CONCLUSIONS OAIs are frequently the initial manifestation of IE caused by SBG. S. gallolyticus causes most of these infections. Echocardiogram and colonoscopy are therefore mandatory, given the species' close association with IE and CRN.
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Affiliation(s)
| | - Ramón Rabuñal
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain.
| | - Victor Armesto
- Department of Radiology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | | | - Amparo Coira
- Department of Radiology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Julia Pita
- Department of Radiology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | | | - María Pilar Alonso
- Department of Radiology, Hospital Universitario Lucus Augusti, Lugo, Spain
| | - Juan Corredoira
- Infectious Disease Unit, Hospital Universitario Lucus Augusti, Lugo, Spain
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Olmos C, Vilacosta I, Sarriá C, López J, Ferrera C, Sáez C, Vivas D, Hernández M, Sánchez-Enrique C, García-Granja PE, Pérez-Cecilia E, Maroto L, San Román JA. Streptococcus bovis endocarditis: Update from a multicenter registry. Am Heart J 2016; 171:7-13. [PMID: 26699595 DOI: 10.1016/j.ahj.2015.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 10/09/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Infective endocarditis (IE) due to Streptococcus bovis has been classically associated with elderly patients, frequently involving >1 valve, with large vegetations and high embolic risk, which make it a high-risk group. Our aim is to analyze the current clinical profile and prognosis of S bovis IE episodes, in comparison to those episodes caused by viridans group streptococci and enterococci. METHODS We analyzed 1242 consecutive episodes of IE prospectively recruited on an ongoing multipurpose database, of which 294 were streptococcal left-sided IE and comprised our study group. They were classified into 3 groups: group I (n = 47), episodes of IE due to S bovis; group II (n = 134), episodes due to viridans group streptococci; and group III (n = 113), those episodes due to enterococci. RESULTS The incidence of enterococci IE has significantly increased in the last 2 decades (6.4% [1996-2004] vs 11.1% [2005-2013]; P = .005), whereas the incidence of IE due to S bovis and viridans streptococci have remained stable (4% and 10%, respectively). Gender distribution was similar in the 3 groups. Patients with S bovis and enterococci IE were older than those from group II. Nosocomial acquisition was more frequent in group III. Concerning comorbidity, diabetes mellitus (36.7% vs 9.2% vs 26.8%; P < .001) was more common in groups I and III. Chronic renal failure was more prevalent in patients from group III (4.2% vs 1.5% vs 19%; P < .001). Prosthetic valve IE was more frequent in enterococcal IE. Infection upon normal native valves was more frequent in S bovis IE. Colorectal tumors were found in 69% of patients from this group. Vegetation detection was similar in the 3 groups. However, vegetation size was smaller in S bovis IE. During hospitalization, in-hospital complications and in-hospital mortality were higher in enterococci episodes. CONCLUSIONS S bovis IE accounts for 3.8% of all IE episodes in our cohort; it is associated with a high prevalence of colonic tumors, with predominance of benign lesions, and affects patients without preexisting valve disease. It is related to small vegetations and a low rate of in-hospital complications, including systemic embolisms. In-hospital mortality is similar to that of viridans group streptococci.
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Vouga M, Greub G. Emerging bacterial pathogens: the past and beyond. Clin Microbiol Infect 2015; 22:12-21. [PMID: 26493844 PMCID: PMC7128729 DOI: 10.1016/j.cmi.2015.10.010] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 09/29/2015] [Accepted: 10/05/2015] [Indexed: 01/03/2023]
Abstract
Since the 1950s, medical communities have been facing with emerging and reemerging infectious diseases, and emerging pathogens are now considered to be a major microbiologic public health threat. In this review, we focus on bacterial emerging diseases and explore factors involved in their emergence as well as future challenges. We identified 26 major emerging and reemerging infectious diseases of bacterial origin; most of them originated either from an animal and are considered to be zoonoses or from water sources. Major contributing factors in the emergence of these bacterial infections are: (1) development of new diagnostic tools, such as improvements in culture methods, development of molecular techniques and implementation of mass spectrometry in microbiology; (2) increase in human exposure to bacterial pathogens as a result of sociodemographic and environmental changes; and (3) emergence of more virulent bacterial strains and opportunistic infections, especially affecting immunocompromised populations. A precise definition of their implications in human disease is challenging and requires the comprehensive integration of microbiological, clinical and epidemiologic aspects as well as the use of experimental models. It is now urgent to allocate financial resources to gather international data to provide a better understanding of the clinical relevance of these waterborne and zoonotic emerging diseases.
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Affiliation(s)
- M Vouga
- Center for Research on Intracellular Bacteria, Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland
| | - G Greub
- Center for Research on Intracellular Bacteria, Institute of Microbiology, Faculty of Biology and Medicine, University of Lausanne and University Hospital, Lausanne, Switzerland.
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Alozie A, Köller K, Pose L, Raftis M, Steinhoff G, Westphal B, Lamprecht G, Podbielski A. Streptococcus bovis infectious endocarditis and occult gastrointestinal neoplasia: experience with 25 consecutive patients treated surgically. Gut Pathog 2015; 7:27. [PMID: 26473016 PMCID: PMC4607100 DOI: 10.1186/s13099-015-0074-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 09/23/2015] [Indexed: 11/17/2022] Open
Abstract
To assess the prevalence of gastrointestinal neoplasia in patients with Streptococcus bovis infectious endocarditis we performed a retrospective cohort analysis of all episodes of S. bovis infectious endocarditis treated at our institution between January 2000 through December 2014. Twenty-five patients were identified for this purpose. 12/25 patients received colonoscopy and 1/25 of the patients was assessed with CT colonography. Of the 13 who underwent colonic assessment, 11 were diagnosed with colonic neoplasms at different stages of development. In the absence of any strong contraindication, gastroenteroscopic evaluation in all patients diagnosed with S. bovis infectious endocarditis should be pursued.
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Affiliation(s)
- Anthony Alozie
- Department of Cardiac Surgery, University Heart Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Kerstin Köller
- Institute of Medical Microbiology, Virology and Hygiene, University Hospital Rostock, Schillingallee 70, 18055 Rostock, Germany
| | - Lumi Pose
- Department of Cardiac Surgery, University Heart Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Maximilian Raftis
- Department of Cardiac Surgery, University Heart Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Gustav Steinhoff
- Department of Cardiac Surgery, University Heart Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Bernd Westphal
- Department of Cardiac Surgery, University Heart Center Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Georg Lamprecht
- Zentrum für Innere Medizin, Klinik II -Abteilung für Gastroenterology, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany
| | - Andreas Podbielski
- Institute of Medical Microbiology, Virology and Hygiene, University Hospital Rostock, Schillingallee 70, 18055 Rostock, Germany
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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: 3.1] [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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Corredoira J, Grau I, Garcia-Rodriguez JF, Alonso-Garcia P, Garcia-Pais MJ, Rabuñal R, Garcia-Garrote F, Ardanuy C, Coira A, Lopez-Alvarez MJ, Pallares R. The clinical epidemiology and malignancies associated with Streptococcus bovis biotypes in 506 cases of bloodstream infections. J Infect 2015; 71:317-25. [PMID: 25982024 DOI: 10.1016/j.jinf.2015.05.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 05/06/2015] [Accepted: 05/09/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To determine the incidence of Streptococcus bovis (Sb) biotypes causing bacteraemia and associated malignancies. METHODS This is a retrospective analysis of patients with Sb bacteraemia, pulled out from a prospective surveillance protocol of bacteraemia cases, in three areas of Spain (1990-2013): a cattle area (Lugo), a fishing area (Ferrol) and an urban area (Barcelona). Colonoscopy and Sb biotypes (Sb-I and Sb-II) were determined in most cases. RESULTS 506 patients with Sb bacteraemia; mean age 68.1 (±14.1) years, and 66.2% were males. The cattle area, compared with the fishing and urban areas, had higher incidence of bacteraemia by SbI (40.29 vs 9.38 vs 6.15 cases/10(6) person-years, P < 0.001) and bacteraemia by Sb-II (29.07 vs 9.84 vs 13.37 cases/10(6) person-years, P < 0.001). The Sb-I cases (n = 224), compared with Sb-II cases (n = 270), had greater rates of endocarditis (77.6% vs 9.6%, P < 0.001) and colorectal neoplasm (CRN) (50.9% vs 16.6%, P < 0.001), and smaller rates of biliary tract infection (2.2% vs 29.6%, P < 0.001) and non-colorectal malignancy (8.9% vs 31.4%, P < 0.001). CONCLUSION There was a link between the cattle area and higher incidence of Sb bacteraemia. Sb-I differed from Sb-II cases in clinical findings and associated malignancies. Colonoscopy is mandatory in cases of endocarditis or bacteraemia caused by Sb-I.
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Affiliation(s)
- Juan Corredoira
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - Imma Grau
- Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
| | | | - Pilar Alonso-Garcia
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - M J Garcia-Pais
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - Ramon Rabuñal
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - Fernando Garcia-Garrote
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - Carmen Ardanuy
- Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
| | - Amparo Coira
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - M J Lopez-Alvarez
- Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain.
| | - Roman Pallares
- Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain.
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Mello R, da Silva Santos M, Golebiosvki W, Weksler C, Lamas C. Streptococcus bovis endocarditis: analysis of cases between 2005 and 2014. Braz J Infect Dis 2015; 19:209-12. [PMID: 25636194 PMCID: PMC9425377 DOI: 10.1016/j.bjid.2014.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/16/2014] [Indexed: 11/16/2022] Open
Abstract
Background Streptococcus bovis is a classical etiology of endocarditis and is associated with colonic lesions. No series of cases from Brazil has been described. Objectives To describe aspects of S. bovis endocarditis. Methods This is a case series of patients admitted to a cardiac surgery referral center, during the years 2005–2014. Clinical, laboratory, echochardiographic, colonoscopic, treatment, surgical and outcome variables were studied. Results Nine patients with S. bovis endocarditis were included; all cases fulfilled the modified Duke criteria. Incidence was 8/220 (4%) in years 2006–2014. There were seven male and two female patients; mean age was 56.7 years, standard deviation 13.4. All patients had native aortic valve involvement. Presentation was subacute in 7/9 (71%). Fever was present in 7/9 (77.7%), embolic lesions to solid organs occurred in three, and perivalvular abscess in two patients. All echocardiograms showed moderate to severe valvular regurgitation and vegetations. Microcytic anemia was seen in 7/7 patients. Colonoscopy showed abnormal findings in 7/9 (77.7%). Surgery was indicated for 6/9 patients due to acute aortic regurgitation and left ventricular failure. All patients were discharged home. Conclusions S. bovis most frequently affected the aortic valve of male patients. Colon disease was frequent. Surgery was indicated frequently due to hemodynamic compromise.
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Affiliation(s)
| | | | | | - Clara Weksler
- Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil
| | - Cristiane Lamas
- Unigranrio, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Cardiologia, Rio de Janeiro, RJ, Brazil; Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro, RJ, Brazil.
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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: 0.9] [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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The Genus Streptococcus – Part I: Emerging Pathogens in the “Pyogenic Cocci” and the “Streptococcus bovis” Groups. ACTA ACUST UNITED AC 2014. [DOI: 10.1016/j.clinmicnews.2014.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Krishnan S, Eslick GD. Streptococcus bovis infection and colorectal neoplasia: a meta-analysis. Colorectal Dis 2014; 16:672-80. [PMID: 24824513 DOI: 10.1111/codi.12662] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 04/29/2014] [Indexed: 12/23/2022]
Abstract
AIM A meta-analysis was conducted to determine the risk associated with Streptococcus bovis infection and the occurrence of colorectal neoplasia (CRN). The level of risk remains unknown. METHOD We conducted a search of MEDLINE, PubMed and EMBASE up to January 2014. We used a random-effects model to analyse the data. RESULTS We identified 48 studies concerning three main topics: S. bovis septicaemia, S. bovis endocarditis and S. bovis faecal carriage. The total sample sizes were 1729, 807 and 1145, respectively; the 48 studies included 9 case-control studies and 39 case series. Overall, the presence of S. bovis infection was found to be significantly associated with the presence of CRN. Streptococcus bovis endocarditis showed the strongest association in analyses of case-control studies and case series (OR 14.54, 95% CI 5.66-37.35, test for heterogeneity I2 = 43.53; event rate of 0.53, 95% CI 0.45-0.61, test for heterogeneity I2 = 53.50). Similarly, S. bovis septicaemia was also associated with a high level of concurrence with CRN (OR 7.48, 95% CI 3.10-18.06, test for heterogeneity I(2) = 43.32; event rate 0.49, 95% CI 0.42-0.56, test for heterogeneity I2 = 69.97). Patients with CRN were found to have a higher incidence of S. bovis in faeces upon stool culture (OR 2.52, 95% CI 1.14-5.58, test for heterogeneity I2 = 69.17). CONCLUSION The meta-analysis showed a statistically significant association between the presence of S. bovis endocarditis or S. bovis septicaemia and CRN. Furthermore, there is a statistically significant increase in likelihood of finding S. bovis in the stool of individuals with CRN.
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Affiliation(s)
- S Krishnan
- The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, Nepean Hospital, Penrith, New South Wales, Australia
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Rizzi M, Ravasio V, Carobbio A, Mattucci I, Crapis M, Stellini R, Pasticci MB, Chinello P, Falcone M, Grossi P, Barbaro F, Pan A, Viale P, Durante-Mangoni E. Predicting the occurrence of embolic events: an analysis of 1456 episodes of infective endocarditis from the Italian Study on Endocarditis (SEI). BMC Infect Dis 2014; 14:230. [PMID: 24779617 PMCID: PMC4101861 DOI: 10.1186/1471-2334-14-230] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 04/24/2014] [Indexed: 12/28/2022] Open
Abstract
Background Embolic events are a major cause of morbidity and mortality in patients with infective endocarditis. We analyzed the database of the prospective cohort study SEI in order to identify factors associated with the occurrence of embolic events and to develop a scoring system for the assessment of the risk of embolism. Methods We retrospectively analyzed 1456 episodes of infective endocarditis from the multicenter study SEI. Predictors of embolism were identified. Risk factors identified at multivariate analysis as predictive of embolism in left-sided endocarditis, were used for the development of a risk score: 1 point was assigned to each risk factor (total risk score range: minimum 0 points; maximum 2 points). Three categories were defined by the score: low (0 points), intermediate (1 point), or high risk (2 points); the probability of embolic events per risk category was calculated for each day on treatment (day 0 through day 30). Results There were 499 episodes of infective endocarditis (34%) that were complicated by ≥ 1 embolic event. Most embolic events occurred early in the clinical course (first week of therapy: 15.5 episodes per 1000 patient days; second week: 3.7 episodes per 1000 patient days). In the total cohort, the factors associated with the occurrence of embolism at multivariate analysis were prosthetic valve localization (odds ratio, 1.84), right-sided endocarditis (odds ratio, 3.93), Staphylococcus aureus etiology (odds ratio, 2.23) and vegetation size ≥ 13 mm (odds ratio, 1.86). In left-sided endocarditis, Staphylococcus aureus etiology (odds ratio, 2.1) and vegetation size ≥ 13 mm (odds ratio, 2.1) were independently associated with embolic events; the 30-day cumulative incidence of embolism varied with risk score category (low risk, 12%; intermediate risk, 25%; high risk, 38%; p < 0.001). Conclusions Staphylococcus aureus etiology and vegetation size are associated with an increased risk of embolism. In left-sided endocarditis, a simple scoring system, which combines etiology and vegetation size with time on antimicrobials, might contribute to a better assessment of the risk of embolism, and to a more individualized analysis of indications and contraindications for early surgery.
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Affiliation(s)
- Marco Rizzi
- USC Malattie Infettive, Ospedale Papa Giovanni XXIII, piazza OMS 1, Bergamo, BG 24127, Italia.
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Fagiuoli S, Colli A, Bruno R, Burra P, Craxì A, Gaeta GB, Grossi P, Mondelli MU, Puoti M, Sagnelli E, Stefani S, Toniutto P. Management of infections in cirrhotic patients: report of a consensus conference. Dig Liver Dis 2014; 46:204-12. [PMID: 24021271 DOI: 10.1016/j.dld.2013.07.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 07/04/2013] [Accepted: 07/17/2013] [Indexed: 12/11/2022]
Abstract
The statements produced by the consensus conference on infection in end-stage liver disease promoted by the Italian Association for the Study of the Liver, are here reported. The topics of epidemiology, risk factors, diagnosis, prophylaxis, and treatment of infections in patient with compensated and decompensated liver cirrhosis were reviewed by a scientific board of experts who proposed 26 statements that were graded according to level of evidence and strength of recommendation, and approved by an independent jury. Each topic was explored focusing on the more relevant clinical questions. By systematic literature search of available evidence, comparison and discussion of expert opinions, pertinent statements answering specific questions were presented and approved. Short comments were added to explain the basis for grading evidence particularly on case of controversial areas.
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Affiliation(s)
- Stefano Fagiuoli
- Gastroenterology and Transplant Hepatology, Papa Giovanni XXIII Hospital, Bergamo, Italy.
| | | | - Raffaele Bruno
- Department of Infectious Diseases, IRCCS San Matteo, University of Pavia, Pavia, Italy
| | - Patrizia Burra
- Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Antonio Craxì
- Gastroenterology and Hepatology, Di.Bi.M.I.S., University of Palermo, Italy
| | - Giovan Battista Gaeta
- Infectious Diseases, Department of Internal and Experimental Medicine, Second University of Naples, Italy
| | - Paolo Grossi
- Infectious & Tropical Diseases Unit, Department of Surgical & Morphological Sciences, Insubria University, Varese, Italy
| | - Mario U Mondelli
- Research Laboratories, Department of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo and Department of Internal Medicine, University of Pavia, Italy
| | - Massimo Puoti
- Infectious Diseases Department, Niguarda Cà Granda Hospital, Milano, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Preventive Medicine, Second University of Naples, Italy
| | - Stefania Stefani
- Department of Bio-Medical Sciences, Section of Microbiology, University of Catania, Italy
| | - Pierluigi Toniutto
- Department of Medical Sciences, Experimental and Clinical, Medical Liver Transplant Section, Internal Medicine, University of Udine, Italy
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Fitzmaurice GJ, McKenna AJ, Murphy J, McMullan R, O'Donnell ME. Streptococcus bovis bacteraemia: an evaluation of the long-term effect on cardiac outcomes. Gen Thorac Cardiovasc Surg 2013; 62:142-8. [PMID: 24022385 DOI: 10.1007/s11748-013-0316-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 08/27/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Streptococcus bovis can lead to bacteraemia, septicaemia, and ultimately endocarditis. The objective of this study was to evaluate the long-term implications of S. bovis endocarditis on cardiac morbidity and mortality. METHODS A retrospective cohort study was performed between January 2000 and March 2009 to assess all patients diagnosed with S. bovis bacteraemia from the Belfast Health and Social Care Trust. The primary end-point for cardiac investigations was the presence of endocarditis. Secondary end-points included referral for cardiac surgery and overall mortality. RESULTS Sixty-one positive S. bovis blood cultures from 43 patients were included. Following echocardiography, seven patients were diagnosed with infective endocarditis (16.3 % of total patients); four patients (9.3 %) had native valve involvement while three (7.0 %) had prosthetic valve infection. Five of these seven patients had more than one positive S. bovis culture (71.4 %). Three had significant valve dysfunction that warranted surgical repair/replacement, one of whom was unfit for surgery. There was a 100 % recurrence rate amongst the valve replacement patients (n = 2) and six patients with endocarditis had colorectal pathology. Patients with endocarditis had similar long-term survival as those with non-endocarditic bacteraemia (57.1 % alive vs. 50 % of non-endocarditis patients, p = 0.73). CONCLUSION Streptococcus bovis endocarditis patients tended to have pre-existing valvular heart disease and those with prosthetic heart valves had higher surgical intervention and relapse rates. These patients experienced a higher rate of co-existing colorectal pathology but currently have reasonable long-term outcomes. This may suggest that they represent a patient population that merits consideration for an early surgical strategy to maximise long-term results, however, further evaluation is warranted.
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Affiliation(s)
- Gerard J Fitzmaurice
- Department of Cardiothoracic Surgery, The Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK,
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Is colonoscopy necessary in cases of infection by Streptococcus bovis biotype II? Eur J Clin Microbiol Infect Dis 2013; 33:171-7. [DOI: 10.1007/s10096-013-1940-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 07/22/2013] [Indexed: 01/02/2023]
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Deering EM, Muravec Z, Castineira CF, O'Donoghue G. Streptococcus bovis-related cholecystitis. BMJ Case Rep 2013; 2013:bcr-2013-008581. [PMID: 23605823 DOI: 10.1136/bcr-2013-008581] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acute cholecystitis is a common inflammatory condition of the gallbladder caused most commonly by Escherichia coli, Enterococcus, and Klebsiella organisms. Streptococcus bovis is a Gram-positive, catalase-negative, anaerobic coccus found as a commensal inhabitant of the digestive system in 16% of healthy people. We report a rare case of acute cholecystitis caused by S bovis and discuss its implications with regard to the two known S bovis biotypes (I & II) both of which are associated with a number of other gastrointestinal diseases.
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Chirouze C, Patry I, Duval X, Baty V, Tattevin P, Aparicio T, Pagenault M, Carbonnel F, Couetdic G, Hoen B. Streptococcus bovis/Streptococcus equinus complex fecal carriage, colorectal carcinoma, and infective endocarditis: a new appraisal of a complex connection. Eur J Clin Microbiol Infect Dis 2013; 32:1171-6. [DOI: 10.1007/s10096-013-1863-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 03/12/2013] [Indexed: 01/01/2023]
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39
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The Role of Bacteria in Cancer Development. Infect Agent Cancer 2013. [DOI: 10.1007/978-94-007-5955-8_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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40
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The increasing incidence of Streptococcus bovis endocarditis and bacteraemia: a case series from 1997 to 2010. Int J Cardiol 2012; 161:111-3. [PMID: 22738785 DOI: 10.1016/j.ijcard.2012.06.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 06/09/2012] [Indexed: 01/24/2023]
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41
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Leone S, Ravasio V, Durante-Mangoni E, Crapis M, Carosi G, Scotton PG, Barzaghi N, Falcone M, Chinello P, Pasticci MB, Grossi P, Utili R, Viale P, Rizzi M, Suter F. Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis. Infection 2012; 40:527-35. [PMID: 22711599 DOI: 10.1007/s15010-012-0285-y] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 06/05/2012] [Indexed: 12/30/2022]
Abstract
BACKGROUND The characteristics of patients with infective endocarditis (IE) vary significantly by region of the world. The aim of this study was to evaluate the contemporary epidemiology, characteristics, and outcome of IE in a large, nationwide cohort of Italian patients. METHODS We conducted a prospective, observational study at 24 medical centers in Italy, including all the consecutive patients with a definite or possible diagnosis of IE (modified Duke criteria) admitted from January 2004 through December 2009. A number of clinical variables were collected through an electronic case report form and analyzed to comprehensively delineate the features of IE. We report the data on patients with definite IE. RESULTS A total of 1,082 patients with definite IE were included. Of these, 753 (69.6%) patients had infection on a native valve, 277 (25.6%) on a prosthetic valve, and 52 (4.8%) on an implantable electronic device. Overall, community-acquired (69.2%) was more common than nosocomial (6.2%) or non-nosocomial (24.6%) health care-associated IE. Staphylococcus aureus was the most common pathogen (22.0%). In-hospital mortality was 15.1%. From the multivariate analysis, congestive heart failure (CHF), stroke, prosthetic valve infection, S. aureus, and health care-associated acquisition were independently associated with increased in-hospital mortality, while surgery was associated with decreased mortality. CONCLUSIONS The current mortality of IE remains high, and is mainly due to its complications, such as CHF and stroke.
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Affiliation(s)
- S Leone
- USC di Malattie Infettive, Ospedali Riuniti di Bergamo, Bergamo, Italy.
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Gómez-Garcés JL, Gil Y, Burillo A, Wilhelmi I, Palomo M. Cuadros clínicos asociados a bacteriemia causada por las nuevas especies incluidas en el antiguo grupo Streptococcus bovis. Enferm Infecc Microbiol Clin 2012; 30:175-9. [DOI: 10.1016/j.eimc.2011.09.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 09/06/2011] [Accepted: 09/10/2011] [Indexed: 10/28/2022]
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Bacteriemia por Streptococcus gallolyticus: actualización clínica y diagnóstica. Rev Clin Esp 2012; 212:113-5. [DOI: 10.1016/j.rce.2011.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 05/09/2011] [Accepted: 05/17/2011] [Indexed: 11/21/2022]
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Fernández-Ruiz M, Aguado JM. Actitud diagnóstica ante la bacteriemia por Streptococcus bovis, o los límites de la medicina basada en la evidencia. Med Clin (Barc) 2011; 137:546-8. [DOI: 10.1016/j.medcli.2011.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 04/28/2011] [Indexed: 11/24/2022]
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Boleij A, van Gelder MMHJ, Swinkels DW, Tjalsma H. Clinical Importance of Streptococcus gallolyticus infection among colorectal cancer patients: systematic review and meta-analysis. Clin Infect Dis 2011; 53:870-8. [PMID: 21960713 DOI: 10.1093/cid/cir609] [Citation(s) in RCA: 257] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Streptococcus bovis has long been associated with colorectal cancer (CRC). However, not all genospecies are as closely related to CRC. With this systematic review, we aim to increase the awareness of the association between S. bovis biotype I (Streptococcus gallolyticus) and CRC and urge for uniform molecular microbiological classification. METHODS In January 2011, the PubMed database was searched for all studies that investigated the association between S. bovis, infective endocarditis (IE), and CRC. A total of 191 studies were screened for eligibility and yielded 52 case reports and 31 case series, of which 11 were used for meta-analysis on the association between S. bovis biotype, IE, and adenomas/carcinomas (CRC). RESULTS Among the S. bovis-infected patients who underwent colonic evaluation, the median percentage of patients who had concomitant adenomas/carcinomas was 60% (interquartile range, 22%), which largely exceeds the disease rate reported in the general asymptomatic population. Meta-analysis showed that patients with S. bovis biotype I infection had a strongly increased risk of having CRC (pooled odds ratio [OR], 7.26; 95% confidence interval [CI], 3.94-13.36) and IE (pooled OR, 16.61; 95% CI, 8.85-31.16), compared with S. bovis biotype II-infected patients. Notably, CRC occurred more often among patients with S. bovis IE than among patients with S. bovis infection at other sites (pooled OR, 3.72; 95% CI, 2.03-6.81). CONCLUSIONS Our meta-analysis clearly indicates that S. bovis should no longer be regarded as a single species in clinical practice, because S. gallolyticus (S. bovis biotype I) infection, in particular, has an unambiguous association with CRC.
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Affiliation(s)
- Annemarie Boleij
- Department of Laboratory Medicine/830, Nijmegen Institute for Infection, Inflammation and Immunity (N4i), The Netherlands.
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Surrun SK, Cheah KL. Streptococcus Gallolyticus Endocarditis: A Case Report Contrasting the Response in Frail and in Strong Elderly Patients. PROCEEDINGS OF SINGAPORE HEALTHCARE 2011. [DOI: 10.1177/201010581102000210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The elderly are at increased risk of developing Streptococcus gallolyticus endocarditis. The infection is easily controlled by antibiotics but a valvular replacement may be needed for gross valvular dysfunction. Some patients may have associated colonic or hepatic lesions needing surgical intervention that increase morbidity, mortality and costs. We describe a 71-year-old patient with Streptococcus gallolyticus endocarditis and discuss the differences of response between the strong and the frail elderly.
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Affiliation(s)
| | - Kee Leong Cheah
- Department of Internal Medicine, Singapore General Hospital, Singapore
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Lin IH, Liu TT, Teng YT, Wu HL, Liu YM, Wu KM, Chang CH, Hsu MT. Sequencing and comparative genome analysis of two pathogenic Streptococcus gallolyticus subspecies: genome plasticity, adaptation and virulence. PLoS One 2011; 6:e20519. [PMID: 21633709 PMCID: PMC3102119 DOI: 10.1371/journal.pone.0020519] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 04/28/2011] [Indexed: 11/25/2022] Open
Abstract
Streptococcus gallolyticus infections in humans are often associated with bacteremia, infective endocarditis and colon cancers. The disease manifestations are different depending on the subspecies of S. gallolyticus causing the infection. Here, we present the complete genomes of S. gallolyticus ATCC 43143 (biotype I) and S. pasteurianus ATCC 43144 (biotype II.2). The genomic differences between the two biotypes were characterized with comparative genomic analyses. The chromosome of ATCC 43143 and ATCC 43144 are 2,36 and 2,10 Mb in length and encode 2246 and 1869 CDS respectively. The organization and genomic contents of both genomes were most similar to the recently published S. gallolyticus UCN34, where 2073 (92%) and 1607 (86%) of the ATCC 43143 and ATCC 43144 CDS were conserved in UCN34 respectively. There are around 600 CDS conserved in all Streptococcus genomes, indicating the Streptococcus genus has a small core-genome (constitute around 30% of total CDS) and substantial evolutionary plasticity. We identified eight and five regions of genome plasticity in ATCC 43143 and ATCC 43144 respectively. Within these regions, several proteins were recognized to contribute to the fitness and virulence of each of the two subspecies. We have also predicted putative cell-surface associated proteins that could play a role in adherence to host tissues, leading to persistent infections causing sub-acute and chronic diseases in humans. This study showed evidence that the S. gallolyticus still possesses genes making it suitable in a rumen environment, whereas the ability for S. pasteurianus to live in rumen is reduced. The genome heterogeneity and genetic diversity among the two biotypes, especially membrane and lipoproteins, most likely contribute to the differences in the pathogenesis of the two S. gallolyticus biotypes and the type of disease an infected patient eventually develops.
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Affiliation(s)
- I-Hsuan Lin
- Institute of BioMedical Informatics, National Yang-Ming University, Taipei, Taiwan
- Taiwan International Graduate Program, Academia Sinica, Taipei, Taiwan
| | - Tze-Tze Liu
- VGH Yang-Ming Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Ting Teng
- VGH Yang-Ming Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Hui-Lun Wu
- VGH Yang-Ming Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Yen-Ming Liu
- VGH Yang-Ming Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Keh-Ming Wu
- VGH Yang-Ming Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Chuan-Hsiung Chang
- Institute of BioMedical Informatics, National Yang-Ming University, Taipei, Taiwan
- Center for Systems and Synthetic Biology, National Yang-Ming University, Taipei, Taiwan
| | - Ming-Ta Hsu
- VGH Yang-Ming Genome Research Center, National Yang-Ming University, Taipei, Taiwan
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
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Abdulamir AS, Hafidh RR, Bakar FA. The association of Streptococcus bovis/gallolyticus with colorectal tumors: the nature and the underlying mechanisms of its etiological role. J Exp Clin Cancer Res 2011; 30:11. [PMID: 21247505 PMCID: PMC3032743 DOI: 10.1186/1756-9966-30-11] [Citation(s) in RCA: 220] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2010] [Accepted: 01/20/2011] [Indexed: 12/12/2022] Open
Abstract
Streptococcus bovis (S. bovis) bacteria are associated with colorectal cancer and adenoma. S. bovis is currently named S. gallolyticus. 25 to 80% of patients with S. bovis/gallolyticus bacteremia have concomitant colorectal tumors. Colonic neoplasia may arise years after the presentation of bacteremia or infectious endocarditis of S. bovis/gallolyticus. The presence of S. bovis/gallolyticus bacteremia and/or endocarditis is also related to the presence of villous or tubular-villous adenomas in the large intestine. In addition, serological relationship of S. gallolyticus with colorectal tumors and direct colonization of S. gallolyticus in tissues of colorectal tumors were found. However, this association is still under controversy and has long been underestimated. Moreover, the etiological versus non-etiological nature of this associationis not settled yet. Therefore, by covering the most of up to date studies, this review attempts to clarify the nature and the core of S. bovis/gallolyicus association with colorectal tumors and analyze the possible underlying mechanisms.
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Affiliation(s)
- Ahmed S Abdulamir
- Institute of Bioscience, University Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Rand R Hafidh
- Institute of Bioscience, University Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Fatimah Abu Bakar
- Institute of Bioscience, University Putra Malaysia, 43400 Serdang, Selangor, Malaysia
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Acute cholecystitis and bacteraemia due to Streptococcus bovis biotype II. Enferm Infecc Microbiol Clin 2011; 29:70-1. [DOI: 10.1016/j.eimc.2010.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 03/20/2010] [Accepted: 04/08/2010] [Indexed: 11/21/2022]
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