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Bacteraemia and infective endocarditis with Streptococcus bovis-Streptococcus equinus-complex: a retrospective cohort study

Öberg, Jonas LU orcid ; Nilson, Bo LU orcid ; Gilje, Patrik LU ; Rasmussen, Magnus LU and Inghammar, Malin LU (2022) In Infectious Diseases 54(10). p.760-765
Abstract

BACKGROUND: Streptococcus bovis/equinus complex (SBSEC) comprise several species and subspecies and is a common cause of infective endocarditis (IE). S. gallolyticus subsp. gallolyticus (Sg gallolyticus) accounts for a majority of SBSEC IE, but the risk of IE for other subspecies is largely unknown. We aimed to investigate the clinical presentation of bacteraemia, and proportion of patients with IE in bacteraemia with the most common subspecies.

METHODS: A retrospective cohort study of SBSEC-bacteraemia identified in clinical laboratory databases, in Skåne Region, Sweden, 2003-2018. Bacteraemia with Sg gallolyticus, S. gallolyticus subsp. pasteurianus (Sg pasteurianus), S. lutetiensis and S. infantarius subsp. infantarius (Si... (More)

BACKGROUND: Streptococcus bovis/equinus complex (SBSEC) comprise several species and subspecies and is a common cause of infective endocarditis (IE). S. gallolyticus subsp. gallolyticus (Sg gallolyticus) accounts for a majority of SBSEC IE, but the risk of IE for other subspecies is largely unknown. We aimed to investigate the clinical presentation of bacteraemia, and proportion of patients with IE in bacteraemia with the most common subspecies.

METHODS: A retrospective cohort study of SBSEC-bacteraemia identified in clinical laboratory databases, in Skåne Region, Sweden, 2003-2018. Bacteraemia with Sg gallolyticus, S. gallolyticus subsp. pasteurianus (Sg pasteurianus), S. lutetiensis and S. infantarius subsp. infantarius (Si infantarius) were included. Subspecies was identified by whole genome sequencing. Medical charts were reviewed according to a predetermined protocol, IE was defined by the criteria from European Society of Cardiology.

RESULTS: In total, 210 episodes of SBSEC-bacteraemia were included. Definite IE was identified in 28/210 (13%) episodes. Of these, 7/28 (25%) were prosthetic valve-IE, 1/28 (4%) related to a cardiovascular implantable electronic device and 10/28 (36%) required heart valve surgery. The proportions of IE among different subspecies were: Sg gallolyticus 17/52 (33%), Si infantarius 5/31 (16%), Sg pasteurianus 4/83 (5%) and S. lutetiensis 2/44 (5%) (p < 0.001). Sg pasteurianus and S. lutetiensis were more often associated with intra-abdominal- and polymicrobial infection.

CONCLUSION: The proportion of IE in SBSEC-bacteraemia varies substantially depending on subspecies. Echocardiography should always be considered in bacteraemia with Sg gallolyticus and Si infantarius, and can sometimes be omitted in bacteraemia with Sg pasteurianus and S. lutetiensis.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bacteremia/epidemiology, Endocarditis/epidemiology, Endocarditis, Bacterial/epidemiology, Humans, Retrospective Studies, Streptococcal Infections/epidemiology, Streptococcus/genetics, Streptococcus bovis/genetics
in
Infectious Diseases
volume
54
issue
10
pages
760 - 765
publisher
Informa Healthcare
external identifiers
  • scopus:85132733146
  • pmid:35730935
ISSN
2374-4235
DOI
10.1080/23744235.2022.2089730
project
Streptococcus bovis och gastrointestinal cancer: Epidemiologi, etiologi och diagnostik
language
English
LU publication?
yes
id
597f48da-ef3a-4f0b-b7e4-52985963398d
date added to LUP
2022-09-05 11:58:28
date last changed
2024-04-18 13:37:08
@article{597f48da-ef3a-4f0b-b7e4-52985963398d,
  abstract     = {{<p>BACKGROUND: Streptococcus bovis/equinus complex (SBSEC) comprise several species and subspecies and is a common cause of infective endocarditis (IE). S. gallolyticus subsp. gallolyticus (Sg gallolyticus) accounts for a majority of SBSEC IE, but the risk of IE for other subspecies is largely unknown. We aimed to investigate the clinical presentation of bacteraemia, and proportion of patients with IE in bacteraemia with the most common subspecies.</p><p>METHODS: A retrospective cohort study of SBSEC-bacteraemia identified in clinical laboratory databases, in Skåne Region, Sweden, 2003-2018. Bacteraemia with Sg gallolyticus, S. gallolyticus subsp. pasteurianus (Sg pasteurianus), S. lutetiensis and S. infantarius subsp. infantarius (Si infantarius) were included. Subspecies was identified by whole genome sequencing. Medical charts were reviewed according to a predetermined protocol, IE was defined by the criteria from European Society of Cardiology.</p><p>RESULTS: In total, 210 episodes of SBSEC-bacteraemia were included. Definite IE was identified in 28/210 (13%) episodes. Of these, 7/28 (25%) were prosthetic valve-IE, 1/28 (4%) related to a cardiovascular implantable electronic device and 10/28 (36%) required heart valve surgery. The proportions of IE among different subspecies were: Sg gallolyticus 17/52 (33%), Si infantarius 5/31 (16%), Sg pasteurianus 4/83 (5%) and S. lutetiensis 2/44 (5%) (p &lt; 0.001). Sg pasteurianus and S. lutetiensis were more often associated with intra-abdominal- and polymicrobial infection.</p><p>CONCLUSION: The proportion of IE in SBSEC-bacteraemia varies substantially depending on subspecies. Echocardiography should always be considered in bacteraemia with Sg gallolyticus and Si infantarius, and can sometimes be omitted in bacteraemia with Sg pasteurianus and S. lutetiensis.</p>}},
  author       = {{Öberg, Jonas and Nilson, Bo and Gilje, Patrik and Rasmussen, Magnus and Inghammar, Malin}},
  issn         = {{2374-4235}},
  keywords     = {{Bacteremia/epidemiology; Endocarditis/epidemiology; Endocarditis, Bacterial/epidemiology; Humans; Retrospective Studies; Streptococcal Infections/epidemiology; Streptococcus/genetics; Streptococcus bovis/genetics}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{760--765}},
  publisher    = {{Informa Healthcare}},
  series       = {{Infectious Diseases}},
  title        = {{Bacteraemia and infective endocarditis with Streptococcus bovis-Streptococcus equinus-complex: a retrospective cohort study}},
  url          = {{http://dx.doi.org/10.1080/23744235.2022.2089730}},
  doi          = {{10.1080/23744235.2022.2089730}},
  volume       = {{54}},
  year         = {{2022}},
}