Streptococcus bacteremia: Difference between revisions

From IDWiki
Streptococcus bacteremia
No edit summary
No edit summary
Line 15: Line 15:
!Number of BSIs
!Number of BSIs
|-
|-
⚫
|[[Group A Streptococcus]]
⚫
|
⚫
|[[Streptococcus pneumoniae]]
⚫
| style="color:darkgreen" |1.2%
⚫
| style="color:darkgreen" |2,598
⚫
|-
⚫
|
⚫
|[[Streptococcus dysgalactiae]]
⚫
| style="color:goldenrod" |6.6%
⚫
| style="color:goldenrod" |901
⚫
|-
⚫
|
|[[Streptococcus pyogenes]]
|[[Streptococcus pyogenes]]
| style="color:darkgreen" |1.9%
| style="color:darkgreen" |1.9%
| style="color:darkgreen" |592
| style="color:darkgreen" |592
|-
|-
⚫
|[[Group B Streptococcus]]
⚫
|
|[[Streptococcus agalactiae]]
|[[Streptococcus agalactiae]]
| style="color:goldenrod" |9.1%
| style="color:goldenrod" |9.1%
| style="color:goldenrod" |441
| style="color:goldenrod" |441
|-
|-
|[[VGS]], [[Streptococcus anginosus group]]
|[[Group C Streptococcus]]
⚫
|[[Streptococcus equi]]
⚫
| style="color:darkgreen" |0
⚫
| style="color:darkgreen" |<4
⚫
|-
|[[Group C Streptococcus|Group C]] or [[Group G Streptococcus|G Streptococcus]]
⚫
|[[Streptococcus dysgalactiae]]
⚫
| style="color:goldenrod" |6.6%
⚫
| style="color:goldenrod" |901
⚫
|-
⚫
| rowspan="3" |[[VGS]], [[Streptococcus anginosus group]]
|[[Streptococcus anginosus]]
|[[Streptococcus anginosus]]
| style="color:goldenrod" |4.8%
| style="color:goldenrod" |4.8%
| style="color:goldenrod" |437
| style="color:goldenrod" |437
|-
|-
|[[VGS]], [[Streptococcus mitis group]]
|[[Streptococcus constellatus]]
⚫
| style="color:goldenrod" |<4%
⚫
| style="color:goldenrod" |91
⚫
|-
⚫
|[[Streptococcus intermedius]]
⚫
| style="color:darkgreen" |0%
⚫
| style="color:darkgreen" |40
⚫
|-
| rowspan="3" |[[VGS]], [[Streptococcus mitis group]]
|[[Streptococcus mitis]] or [[Streptococcus oralis|oralis]]
|[[Streptococcus mitis]] or [[Streptococcus oralis|oralis]]
| style="color:darkred" |19.4%
| style="color:darkred" |19.4%
| style="color:darkred" |408
| style="color:darkred" |408
|-
|-
|'''[[Streptococcus cristatus]] or [[Streptococcus sinensis|sinensis]]'''
|
⚫
| style="color:darkred" |'''44%'''
⚫
|'''[[Streptococcus gallolyticus]]'''
| style="color:darkred" |'''30.7%'''
| style="color:darkred" |'''9'''
⚫
| style="color:darkred" |'''225'''
|-
|-
|[[VGS]], [[Streptococcus salivarius group]]
|[[Streptococcus peroris]]
⚫
| style="color:darkgreen" |0
|[[Streptococcus salivarius]]
| style="color:goldenrod" |5.8%
| style="color:darkgreen" |10
⚫
|-
⚫
| style="color:goldenrod" |191
| rowspan="3" |[[VGS]], [[Streptococcus sanguinis group]]
⚫
|'''[[Streptococcus gordonii]]'''
⚫
| style="color:darkred" |'''44.2%'''
⚫
| style="color:darkred" |'''95'''
|-
|-
⚫
|[[VGS]], [[Streptococcus sanguinis group]]
|'''[[Streptococcus sanguinis]]'''
|'''[[Streptococcus sanguinis]]'''
| style="color:darkred" |'''34.6%'''
| style="color:darkred" |'''34.6%'''
| style="color:darkred" |'''133'''
| style="color:darkred" |'''133'''
|-
|-
⚫
|[[VGS]], [[Streptococcus sanguinis group]]
|[[Streptococcus parasanguinis]]
|[[Streptococcus parasanguinis]]
| style="color:darkred" |10.3%
| style="color:darkred" |10.3%
| style="color:darkred" |107
| style="color:darkred" |107
|-
|-
|[[VGS]], [[Streptococcus sanguinis group]]
| rowspan="3" |[[VGS]], [[Streptococcus salivarius group]]
|'''[[Streptococcus gordonii]]'''
|[[Streptococcus salivarius]]
| style="color:darkred" |'''44.2%'''
| style="color:goldenrod" |5.8%
| style="color:darkred" |'''95'''
| style="color:goldenrod" |191
|-
|-
|[[VGS]], [[Streptococcus anginosus group]]
|[[Streptococcus vestibularis]]
⚫
| style="color:goldenrod" |low
|[[Streptococcus constellatus]]
⚫
| style="color:goldenrod" |26
⚫
|-
⚫
|[[Streptococcus thermophilus]]
| style="color:goldenrod" |<4%
| style="color:goldenrod" |<4%
| style="color:goldenrod" |91
| style="color:goldenrod" |45
|-
|-
|[[VGS]], [[Streptococcus mutans group]]
| rowspan="2" |[[VGS]], [[Streptococcus mutans group]]
|'''[[Streptococcus mutans]]'''
|'''[[Streptococcus mutans]]'''
| style="color:darkred" |'''47.9%'''
| style="color:darkred" |'''47.9%'''
| style="color:darkred" |'''48'''
| style="color:darkred" |'''48'''
|-
|-
|[[VGS]], [[Streptococcus salivarius group]]
|[[Streptococcus sobrinus]]
⚫
| style="color:darkgreen" |0
⚫
|[[Streptococcus thermophilus]]
| style="color:goldenrod" |<4%
| style="color:darkgreen" |<4
⚫
| style="color:goldenrod" |45
|-
|-
|[[Nutritionally variant streptococci]]
| rowspan="2" |[[Nutritionally variant streptococci]]
|[[Granulicatella adiacens]]
|[[Granulicatella adiacens]]
| style="color:darkred" |12.2%
| style="color:darkred" |12.2%
| style="color:darkred" |41
| style="color:darkred" |41
|-
|-
⚫
|[[Granulicatella elegans]]
⚫
|[[VGS]], [[Streptococcus anginosus group]]
⚫
| style="color:darkgreen" |0
⚫
|[[Streptococcus intermedius]]
| style="color:darkgreen" |0%
| style="color:darkgreen" |5
⚫
| style="color:darkgreen" |40
|-
|-
|[[VGS]], [[Streptococcus salivarius group]]
| rowspan="5" |[[Streptococcus bovis group]]
|[[Streptococcus vestibularis]]
|'''[[Streptococcus gallolyticus]]'''
| style="color:goldenrod" |low
| style="color:darkred" |'''30.7%'''
| style="color:goldenrod" |26
| style="color:darkred" |'''225'''
|-
|-
|
|[[Streptococcus lutetiensis]]
|[[Streptococcus lutetiensis]]
| style="color:goldenrod" |low
| style="color:goldenrod" |low
| style="color:goldenrod" |23
| style="color:goldenrod" |23
|-
|-
|
|[[Streptococcus infantarius]]
|[[Streptococcus infantarius]]
| style="color:darkred" |low
| style="color:darkred" |low
| style="color:darkred" |14
| style="color:darkred" |14
|-
|-
|
|[[Streptococcus equinus]]
|[[Streptococcus equinus]]
| style="color:darkred" |low
| style="color:darkred" |low
| style="color:darkred" |12
| style="color:darkred" |12
|-
|-
⚫
|[[Streptococcus alactolyticus]]
|
|[[Streptococcus peroris]]
| style="color:darkgreen" |0
| style="color:darkgreen" |0
| style="color:darkgreen" |10
| style="color:darkgreen" |<4
|-
|-
|
|
|'''[[Streptococcus cristatus]] or [[Streptococcus sinensis|sinensis]]'''
|[[Streptococcus pneumoniae]]
| style="color:darkred" |'''44%'''
| style="color:darkgreen" |1.2%
| style="color:darkred" |'''9'''
| style="color:darkgreen" |2,598
|-
|-
|
|
|[[Streptococcus massiliensis]]
|[[Streptococcus massiliensis]]
⚫
| style="color:darkgreen" |0
⚫
| style="color:darkgreen" |5
|-
|[[Nutritionally variant streptococci]]
⚫
|[[Granulicatella elegans]]
| style="color:darkgreen" |0
| style="color:darkgreen" |0
| style="color:darkgreen" |5
| style="color:darkgreen" |5
Line 137: Line 138:
|
|
|[[Streptococcus pluranimalium]]
|[[Streptococcus pluranimalium]]
⚫
| style="color:darkgreen" |0
⚫
| style="color:darkgreen" |<4
|-
|
|[[Streptococcus equi]]
⚫
| style="color:darkgreen" |0
⚫
| style="color:darkgreen" |<4
|-
|
|[[Streptococcus sobrinus]]
| style="color:darkgreen" |0
| style="color:darkgreen" |0
| style="color:darkgreen" |<4
| style="color:darkgreen" |<4
Line 152: Line 143:
|
|
|[[Streptococcus suis]]
|[[Streptococcus suis]]
⚫
| style="color:darkgreen" |0
⚫
| style="color:darkgreen" |<4
|-
|
⚫
|[[Streptococcus alactolyticus]]
| style="color:darkgreen" |0
| style="color:darkgreen" |0
| style="color:darkgreen" |<4
| style="color:darkgreen" |<4

Revision as of 13:52, 4 May 2023


Background

Risk of Infective Endocarditis

Group Species Risk of IE Number of BSIs
Group A Streptococcus Streptococcus pyogenes 1.9% 592
Group B Streptococcus Streptococcus agalactiae 9.1% 441
Group C Streptococcus Streptococcus equi 0 <4
Group C or G Streptococcus Streptococcus dysgalactiae 6.6% 901
VGS, Streptococcus anginosus group Streptococcus anginosus 4.8% 437
Streptococcus constellatus <4% 91
Streptococcus intermedius 0% 40
VGS, Streptococcus mitis group Streptococcus mitis or oralis 19.4% 408
Streptococcus cristatus or sinensis 44% 9
Streptococcus peroris 0 10
VGS, Streptococcus sanguinis group Streptococcus gordonii 44.2% 95
Streptococcus sanguinis 34.6% 133
Streptococcus parasanguinis 10.3% 107
VGS, Streptococcus salivarius group Streptococcus salivarius 5.8% 191
Streptococcus vestibularis low 26
Streptococcus thermophilus <4% 45
VGS, Streptococcus mutans group Streptococcus mutans 47.9% 48
Streptococcus sobrinus 0 <4
Nutritionally variant streptococci Granulicatella adiacens 12.2% 41
Granulicatella elegans 0 5
Streptococcus bovis group Streptococcus gallolyticus 30.7% 225
Streptococcus lutetiensis low 23
Streptococcus infantarius low 14
Streptococcus equinus low 12
Streptococcus alactolyticus 0 <4
Streptococcus pneumoniae 1.2% 2,598
Streptococcus massiliensis 0 5
Streptococcus pluranimalium 0 <4
Streptococcus suis 0 <4
  • 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

  1. 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.

Retrieved from "https://idwiki.org/index.php?title=Streptococcus_bacteremia&oldid=9941"
Powered by MediaWiki
Powered by Semantic MediaWiki