Nutritionally variant streptococci

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Background

  • Require pyridoxine (vitamin B6) supplementation to group
  • Also called pyridoxal-dependent or stalliting streptococci

Organisms

Clinical Manifestations

Management

  • Susceptibilities shown below are from several studies123
Antibiotic Abiotrophia defectiva Granulicatella adiacens Granulicatella elegans
Penicillin 14 to 57% 34 to 82% 80 to 100%
Ampicillin 86% 100% 100%
Piperacillin 0% 53% 100%
Cefazolin 29% 88% 100%
Ceftriaxone 92 to 100% 22 to 76% 90 to 100%
Ceftazidime 0% 0% 50%
Imipenem 100% 100% 100%
Meropenem 72 to 81% 87 to 95% 91%
Gentamicin 0% 0% 0%
Ciprofloxacin 100% 18% 17%
Levofloxacin 100% 97 to 100% 92%
Minocycline 57% 94% 100%
Vancomycin 100% 100% 83 to 100%
TMP-SMX 14% 0% 17%

References

  1. ^  Taisei Kanamoto, Shigemi Terakubo, Hideki Nakashima. Antimicrobial Susceptibilities of Oral Isolates of Abiotrophia and Granulicatella According to the Consensus Guidelines for Fastidious Bacteria. Medicines. 2018;5(4):129. doi:10.3390/medicines5040129.
  2. ^  Kunatum Prasidthrathsint, Mark A. Fisher. Robin Patel. Antimicrobial Susceptibility Patterns among a Large, Nationwide Cohort of Abiotrophia and Granulicatella Clinical Isolates. Journal of Clinical Microbiology. 2017;55(4):1025-1031. doi:10.1128/jcm.02054-16.
  3. ^  Ammara Mushtaq, Kerryl E. Greenwood-Quaintance, Nicolynn C. Cole, Peggy C. Kohner, Sherry M. Ihde, Gregory J. Strand, Lance W. Harper, Abinash Virk, Robin Patel. Differential Antimicrobial Susceptibilities of Granulicatella adiacens and Abiotrophia defectiva. Antimicrobial Agents and Chemotherapy. 2016;60(8):5036-5039. doi:10.1128/aac.00485-16.