Streptococcus bacteremia: Difference between revisions
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Streptococcus bacteremia
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!Number of BSIs |
!Number of BSIs |
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|[[Streptococcus pyogenes]] |
|[[Streptococcus pyogenes]] |
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| style="color:darkgreen" |1.9% |
| style="color:darkgreen" |1.9% |
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| style="color:darkgreen" |592 |
| style="color:darkgreen" |592 |
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|[[Streptococcus agalactiae]] |
|[[Streptococcus agalactiae]] |
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| style="color:goldenrod" |9.1% |
| style="color:goldenrod" |9.1% |
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| style="color:goldenrod" |441 |
| style="color:goldenrod" |441 |
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− | |[[ |
+ | |[[Group C Streptococcus]] |
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+ | |[[Group C Streptococcus|Group C]] or [[Group G Streptococcus|G Streptococcus]] |
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|[[Streptococcus anginosus]] |
|[[Streptococcus anginosus]] |
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| style="color:goldenrod" |4.8% |
| style="color:goldenrod" |4.8% |
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| style="color:goldenrod" |437 |
| style="color:goldenrod" |437 |
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− | | |
+ | |[[Streptococcus constellatus]] |
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+ | | rowspan="3" |[[VGS]], [[Streptococcus mitis group]] |
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|[[Streptococcus mitis]] or [[Streptococcus oralis|oralis]] |
|[[Streptococcus mitis]] or [[Streptococcus oralis|oralis]] |
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| style="color:darkred" |19.4% |
| style="color:darkred" |19.4% |
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| style="color:darkred" |408 |
| style="color:darkred" |408 |
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+ | |'''[[Streptococcus cristatus]] or [[Streptococcus sinensis|sinensis]]''' |
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− | | |
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− | | style="color:darkred" |''' |
+ | | style="color:darkred" |'''9''' |
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+ | |[[Streptococcus peroris]] |
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− | |[[Streptococcus salivarius]] |
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− | | style="color: |
+ | | style="color:darkgreen" |10 |
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+ | | rowspan="3" |[[VGS]], [[Streptococcus sanguinis group]] |
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|'''[[Streptococcus sanguinis]]''' |
|'''[[Streptococcus sanguinis]]''' |
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| style="color:darkred" |'''34.6%''' |
| style="color:darkred" |'''34.6%''' |
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| style="color:darkred" |'''133''' |
| style="color:darkred" |'''133''' |
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|[[Streptococcus parasanguinis]] |
|[[Streptococcus parasanguinis]] |
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| style="color:darkred" |10.3% |
| style="color:darkred" |10.3% |
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| style="color:darkred" |107 |
| style="color:darkred" |107 |
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− | |[[VGS]], [[Streptococcus |
+ | | rowspan="3" |[[VGS]], [[Streptococcus salivarius group]] |
− | | |
+ | |[[Streptococcus salivarius]] |
− | | style="color: |
+ | | style="color:goldenrod" |5.8% |
− | | style="color: |
+ | | style="color:goldenrod" |191 |
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+ | |[[Streptococcus vestibularis]] |
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− | |[[Streptococcus constellatus]] |
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| style="color:goldenrod" |<4% |
| style="color:goldenrod" |<4% |
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− | | style="color:goldenrod" | |
+ | | style="color:goldenrod" |45 |
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− | |[[VGS]], [[Streptococcus mutans group]] |
+ | | rowspan="2" |[[VGS]], [[Streptococcus mutans group]] |
|'''[[Streptococcus mutans]]''' |
|'''[[Streptococcus mutans]]''' |
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| style="color:darkred" |'''47.9%''' |
| style="color:darkred" |'''47.9%''' |
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| style="color:darkred" |'''48''' |
| style="color:darkred" |'''48''' |
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+ | |[[Streptococcus sobrinus]] |
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− | | style="color: |
+ | | style="color:darkgreen" |<4 |
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− | |[[Nutritionally variant streptococci]] |
+ | | rowspan="2" |[[Nutritionally variant streptococci]] |
|[[Granulicatella adiacens]] |
|[[Granulicatella adiacens]] |
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| style="color:darkred" |12.2% |
| style="color:darkred" |12.2% |
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| style="color:darkred" |41 |
| style="color:darkred" |41 |
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− | | style="color:darkgreen" | |
+ | | style="color:darkgreen" |5 |
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|- |
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− | | |
+ | | rowspan="5" |[[Streptococcus bovis group]] |
− | |[[Streptococcus |
+ | |'''[[Streptococcus gallolyticus]]''' |
− | | style="color: |
+ | | style="color:darkred" |'''30.7%''' |
− | | style="color: |
+ | | style="color:darkred" |'''225''' |
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|[[Streptococcus lutetiensis]] |
|[[Streptococcus lutetiensis]] |
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| style="color:goldenrod" |low |
| style="color:goldenrod" |low |
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| style="color:goldenrod" |23 |
| style="color:goldenrod" |23 |
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− | | |
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|[[Streptococcus infantarius]] |
|[[Streptococcus infantarius]] |
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| style="color:darkred" |low |
| style="color:darkred" |low |
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| style="color:darkred" |14 |
| style="color:darkred" |14 |
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|[[Streptococcus equinus]] |
|[[Streptococcus equinus]] |
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| style="color:darkred" |low |
| style="color:darkred" |low |
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| style="color:darkred" |12 |
| style="color:darkred" |12 |
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− | | |
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− | |[[Streptococcus peroris]] |
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| style="color:darkgreen" |0 |
| style="color:darkgreen" |0 |
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− | | style="color:darkgreen" | |
+ | | style="color:darkgreen" |<4 |
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+ | |[[Streptococcus pneumoniae]] |
− | | style="color: |
+ | | style="color:darkgreen" |1.2% |
− | | style="color: |
+ | | style="color:darkgreen" |2,598 |
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|[[Streptococcus massiliensis]] |
|[[Streptococcus massiliensis]] |
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− | |- |
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− | |[[Nutritionally variant streptococci]] |
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| style="color:darkgreen" |0 |
| style="color:darkgreen" |0 |
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| style="color:darkgreen" |5 |
| style="color:darkgreen" |5 |
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|[[Streptococcus pluranimalium]] |
|[[Streptococcus pluranimalium]] |
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− | |- |
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− | |[[Streptococcus equi]] |
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− | |- |
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− | | |
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− | |[[Streptococcus sobrinus]] |
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| style="color:darkgreen" |0 |
| style="color:darkgreen" |0 |
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| style="color:darkgreen" |<4 |
| style="color:darkgreen" |<4 |
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|[[Streptococcus suis]] |
|[[Streptococcus suis]] |
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− | |- |
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| style="color:darkgreen" |0 |
| style="color:darkgreen" |0 |
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| style="color:darkgreen" |<4 |
| style="color:darkgreen" |<4 |
Revision as of 08:52, 4 May 2023
Background
- Bacteremia caused by streptococci
Risk of Infective Endocarditis
- Among all patients with Streptococcus bacteremia, the prevalence of infective endocarditis is about 7%1
- This varies greatly by species, with the highest-risk species being Streptococcus gallolyticus and three Viridans group streptococci, Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus mutans
- Other risk factors include ≥3 positive BC bottles, prosthetic valve, native valve disease, cardiac device, previous endocarditis, and male sex (in descending order of important)
Investigations
- For non-β-hemolytic streptococci, consider using the HANDOC score to risk stratify for need for echocardiography
- Can effectively exclude the diagnosis of IE without needing imaging
- Alternatively, can use an approach based on species, number of positive blood culture bottles, and presence of risk factors (native valve disease, previous IE, prosthetic valve, or cardiac device)1
Risk | Species | <3 Bottles | ≥3 Bottles | ||
---|---|---|---|---|---|
No RFs | RFs | No RFs | RFs | ||
low | Streptococcus intermedius | no echo | TTE | ||
Streptococcus pneumoniae | |||||
Streptococcus pyogenes | |||||
moderate | Streptococcus agalactiae | no echo | TTE | TTE+TEE | |
Streptococcus anginosus | |||||
Streptococcus constellatus | |||||
Streptococcus dysgalactiae | |||||
Streptococcus salivarius | |||||
Streptococcus thermophilus | |||||
high | Granulicatella adiacens | TTE | TTE+TEE | ||
Streptococcus mitis/oralis | |||||
Streptococcus parasanguinis | |||||
very high | Streptococcus gallolyticus | TTE+TEE | |||
Streptococcus gordonii | |||||
Streptococcus mutans | |||||
Streptococcus sanguinis |
References
- a b Sandra Chamat-Hedemand, Anders Dahl, Lauge Østergaard, Magnus Arpi, Emil Fosbøl, Jonas Boel, Louise Bruun Oestergaard, Trine K. Lauridsen, Gunnar Gislason, Christian Torp-Pedersen, Niels Eske Bruun. Prevalence of Infective Endocarditis in Streptococcal Bloodstream Infections Is Dependent on Streptococcal Species. Circulation. 2020;142(8):720-730. doi:10.1161/circulationaha.120.046723.