Streptococcus bacteremia: Difference between revisions
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Streptococcus bacteremia
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|[[Streptococcus pneumoniae]] |
|[[Streptococcus pneumoniae]] |
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| style="color:darkgreen" |1.2% |
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| style="color:darkgreen" |2,598 |
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|[[Streptococcus massiliensis]] |
|[[Streptococcus massiliensis]] |
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| style="color:darkgreen" |5 |
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|[[Streptococcus pluranimalium]] |
|[[Streptococcus pluranimalium]] |
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|[[Streptococcus suis]] |
|[[Streptococcus suis]] |
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| style="color:darkgreen" |0 |
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Latest revision as of 10:02, 27 August 2024
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.