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Article: "Streptococcus milleri" endocarditis caused by Streptococcus anginosus

Title"Streptococcus milleri" endocarditis caused by Streptococcus anginosus
Authors
Issue Date2004
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/diagmicrobio
Citation
Diagnostic Microbiology And Infectious Disease, 2004, v. 48 n. 2, p. 81-88 How to Cite?
AbstractUnlike other viridans streptococci, members of the "Streptococcus milleri group" are often associated with abscess formation, but are only rare causes of infective endocarditis. Although it has been shown that almost all S. intermedius isolates and most S. constellatus isolates, but only 19% of S. anginosus isolates, were associated with abscess formation, no report has addressed the relative importance of the 3 species of the "S. milleri group" in infective endocarditis. During a 5-year period (April 1997 through March 2002), 6 cases of "S. milleri" endocarditis (out of 377 cases of infective endocarditis), that fulfil the Duke's criteria for the diagnosis of infective endocarditis, were encountered. All 6 "S. milleri" isolates were identified as S. anginosus by 16S ribosomal RNA (rRNA) gene sequencing. Three patients had underlying chronic rheumatic heart disease and 1 was an IV drug abuser. Five had monomicrobial bacteremia, and 1 had polymicrobial (S. anginosus, S. mitis, Granulicatella adiacens, and Slackia exigua) bacteremia. Two patients died. None of the 6 isolates were identified by the Vitek system (GPI) or the API system (20 STREP) at >95% confidence. All 6 isolates were sensitive to penicillin G (MIC 0.008-0.064 μg/mL), cefalothin, erythromycin, clindamycin, and vancomycin. Accurate identification to the species level, by 16S rRNA gene sequencing, in cases of bacteremia caused by members of the "S. milleri group", would have direct implication on the underlying disease process, hence guiding diagnosis and treatment. Infective endocarditis should be actively looked for in cases of monomicrobial S. anginosus bacteremia, especially if the organism is recovered in multiple blood cultures. © 2004 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/157386
ISSN
2015 Impact Factor: 2.45
2015 SCImago Journal Rankings: 1.142
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWoo, PCYen_US
dc.contributor.authorTse, Hen_US
dc.contributor.authorChan, KMen_US
dc.contributor.authorLau, SKPen_US
dc.contributor.authorFung, AMYen_US
dc.contributor.authorYip, KTen_US
dc.contributor.authorTam, DMWen_US
dc.contributor.authorNg, KHLen_US
dc.contributor.authorQue, TLen_US
dc.contributor.authorYuen, KYen_US
dc.date.accessioned2012-08-08T08:49:33Z-
dc.date.available2012-08-08T08:49:33Z-
dc.date.issued2004en_US
dc.identifier.citationDiagnostic Microbiology And Infectious Disease, 2004, v. 48 n. 2, p. 81-88en_US
dc.identifier.issn0732-8893en_US
dc.identifier.urihttp://hdl.handle.net/10722/157386-
dc.description.abstractUnlike other viridans streptococci, members of the "Streptococcus milleri group" are often associated with abscess formation, but are only rare causes of infective endocarditis. Although it has been shown that almost all S. intermedius isolates and most S. constellatus isolates, but only 19% of S. anginosus isolates, were associated with abscess formation, no report has addressed the relative importance of the 3 species of the "S. milleri group" in infective endocarditis. During a 5-year period (April 1997 through March 2002), 6 cases of "S. milleri" endocarditis (out of 377 cases of infective endocarditis), that fulfil the Duke's criteria for the diagnosis of infective endocarditis, were encountered. All 6 "S. milleri" isolates were identified as S. anginosus by 16S ribosomal RNA (rRNA) gene sequencing. Three patients had underlying chronic rheumatic heart disease and 1 was an IV drug abuser. Five had monomicrobial bacteremia, and 1 had polymicrobial (S. anginosus, S. mitis, Granulicatella adiacens, and Slackia exigua) bacteremia. Two patients died. None of the 6 isolates were identified by the Vitek system (GPI) or the API system (20 STREP) at >95% confidence. All 6 isolates were sensitive to penicillin G (MIC 0.008-0.064 μg/mL), cefalothin, erythromycin, clindamycin, and vancomycin. Accurate identification to the species level, by 16S rRNA gene sequencing, in cases of bacteremia caused by members of the "S. milleri group", would have direct implication on the underlying disease process, hence guiding diagnosis and treatment. Infective endocarditis should be actively looked for in cases of monomicrobial S. anginosus bacteremia, especially if the organism is recovered in multiple blood cultures. © 2004 Elsevier Inc. All rights reserved.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/diagmicrobioen_US
dc.relation.ispartofDiagnostic Microbiology and Infectious Diseaseen_US
dc.rightsDiagnostic Microbiology and Infectious Disease. Copyright © Elsevier Inc.-
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBase Sequenceen_US
dc.subject.meshDna, Bacterial - Chemistry - Geneticsen_US
dc.subject.meshEndocarditis, Bacterial - Microbiologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMicrobial Sensitivity Testsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMolecular Sequence Dataen_US
dc.subject.meshPolymerase Chain Reactionen_US
dc.subject.meshRna, Ribosomal, 16S - Chemistry - Geneticsen_US
dc.subject.meshSequence Alignmenten_US
dc.subject.meshStreptococcal Infections - Microbiologyen_US
dc.subject.meshStreptococcus Anginosus - Genetics - Isolation & Purificationen_US
dc.title"Streptococcus milleri" endocarditis caused by Streptococcus anginosusen_US
dc.typeArticleen_US
dc.identifier.emailWoo, PCY:pcywoo@hkucc.hku.hken_US
dc.identifier.emailTse, H:herman@graduate.hku.hken_US
dc.identifier.emailLau, SKP:skplau@hkucc.hku.hken_US
dc.identifier.emailYuen, KY:kyyuen@hkucc.hku.hken_US
dc.identifier.authorityWoo, PCY=rp00430en_US
dc.identifier.authorityTse, H=rp00519en_US
dc.identifier.authorityLau, SKP=rp00486en_US
dc.identifier.authorityYuen, KY=rp00366en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.diagmicrobio.2003.09.011en_US
dc.identifier.pmid14972375-
dc.identifier.scopuseid_2-s2.0-10744227750en_US
dc.identifier.hkuros87964-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-10744227750&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume48en_US
dc.identifier.issue2en_US
dc.identifier.spage81en_US
dc.identifier.epage88en_US
dc.identifier.isiWOS:000189278400002-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWoo, PCY=7201801340en_US
dc.identifier.scopusauthoridTse, H=7006070596en_US
dc.identifier.scopusauthoridChan, KM=7406034671en_US
dc.identifier.scopusauthoridLau, SKP=7401596211en_US
dc.identifier.scopusauthoridFung, AMY=7101926801en_US
dc.identifier.scopusauthoridYip, KT=7101909925en_US
dc.identifier.scopusauthoridTam, DMW=7006053712en_US
dc.identifier.scopusauthoridNg, KHL=27467782600en_US
dc.identifier.scopusauthoridQue, TL=7003786628en_US
dc.identifier.scopusauthoridYuen, KY=36078079100en_US

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