Clinical characteristics and antibiotic susceptibility of viridans streptococcal bacteremia in children with febrile neutropenia

Han, Seung-Beom; Bae, Eun Young; Lee, J. W.; Lee, D. G.; Chung, Nack‐Gyun; Jeong, Dae Chul; Cho, Byung-Sik; Kang, Jin Han; Kim, H. K.

doi:10.1007/s15010-013-0470-7

Cited by 12 publications

(12 citation statements)

References 29 publications

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“…Fifteen per cent of VGSB resulted in VSSS, which is equal to the rate of VSSS from the last British study, 2 a single-center descriptive study conducted from 1995 to 1999. The mortality rate directly attributable to VGSB of 5.6% is similar to recent data both from oncology units from the rest of the world of 1.8% to 7%, 6 – 8 and from larger population-based studies examining VGS in AML. 9 Research from centers with lower mortality rates excludes high-risk patients such as those undergoing HSCT, 4 relapsed patients, 5 high-risk chemotherapy regimens, or those with comorbidities such as Down syndrome.…”

Section: Discussionsupporting

confidence: 83%

“…The most frequent hematological or oncological diagnosis was relapsed ALL, whereas previous studies have found AML the most common hemato-oncology diagnosis in VGSB patients. 6 , 8 The Relapsed ALL R3 protocol was introduced in 2003; patients most frequently developed VGS during weeks 7 to 11 of the protocol. Clinicians should therefore be vigilant for the development of VGSB when patients are being treated during these weeks of this protocol.…”

Section: Discussionmentioning

confidence: 99%

“…3 , 5 – 8 Predisposing factors linked to the development of VGSB are well described and include acute myeloid leukemia (AML), HSCT, high-dose cytarabine, severe mucositis, prolonged fever, prolonged neutropenia, and pneumonia. 6 , 7 , 9 …”

Section: Introductionmentioning

confidence: 99%

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Viridans Group Streptococcal Infections in Children After Chemotherapy or Stem Cell Transplantation

et al. 2016

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Viridans Group Streptococci (VGS) are associated with high mortality rates in febrile neutropenia; yet there are no recent European pediatric studies to inform antimicrobial therapy. The aim of this study was to describe the characteristics, outcome, and resistance patterns of children with VGS bacteremia (VGSB) undergoing treatment of malignancy or hematopoietic stem cell transplant.Patients aged 0 to 18 years, admitted to a tertiary pediatric hemato-oncology center with VGSB, from 2003 to 2013, were included in the study. All data were collected retrospectively from medical records.A total of 54 bacteremic episodes occurred in 46 patients. The most common underlying diagnosis was relapsed acute lymphoblastic leukemia.Streptococcus mitis was the most frequent organism. A total of 30% of isolates were resistant to penicillin and 100% sensitive to vancomycin. There were 8 episodes (14.8%) of Viridans Group Streptococcal Shock Syndrome; 6 resulted in admission to intensive care and 3 of these patients died of multiorgan failure.The potentially fatal nature of VGSB is confirmed. The high risk in relapsed acute lymphoblastic leukemia is of note. Research is needed to develop risk-stratification scores that identify children at risk of Viridans Group Streptococcal Shock Syndrome to guide empirical antimicrobial therapy in febrile neutropenia.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Viridans Group Streptococcal Infections in Children After Chemotherapy or Stem Cell Transplantation

et al. 2016

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“…Multiple sources have demonstrated that our chosen identification method shows results that are similar to those obtained using other methods with regards to the genus Streptococcus [ 16 , 21 , 22 ]. However, it should also be noted that the identification of alpha-hemolytic streptococci to the species level is one of the limitations of the VITEK2 system [ 23 ].…”

Section: Discussionmentioning

confidence: 68%

“…It was noticed that the rise of penicillin resistant strains was mostly observed in the S. mitis and S. sanguinis groups, whereas the S. anginosus group remains mostly susceptible to penicillin. It was also observed that some studies disregarded the difference in antimicrobial susceptibility among species when investigating VGS bacteremia [ 16 , 17 , 18 ]. We suggest that this premise can be misleading, since our data clearly shows that there is such a difference, specifically among the resistant strains of the different species.…”

Section: Discussionmentioning

confidence: 99%

Species-Specific Difference in Antimicrobial Susceptibility Among Viridans Group Streptococci

2015

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BackgroundViridans group streptococci (VGS) are both commensal microbes and potential pathogens. Increasing resistance to penicillin in VGS is an ongoing issue in the clinical environment. We investigated the difference in susceptibility and resistance to penicillin among various VGS species.MethodsIn total 1,448 VGS isolated from various clinical specimens were analyzed over a two-yr period. Identification and antimicrobial susceptibility test was performed by the automated VITEK 2 system (bioMerieux, France) or the MicroScan MICroSTREP system (Siemens, Germany).ResultsAmong the 1,448 isolates, 412 were isolated from blood (28.4%). Streptococcus mitis group was the most frequently isolated (589 isolates, 40.7%), followed by the S. anginosus group (290 isolates, 20.0%), S. sanguinis group (179 isolates, 12.4%) and S. salivarius group (57 isolates, 3.9%). In total, 314 isolates could not be identified up to the species level. The overall non-susceptibility to penicillin was observed to be 40.0% (resistant, 11.2% and intermediately resistant, 28.8%) with uneven distribution among groups; 40.2% in S. sanguinis group (resistant, 5.0% and intermediately resistant, 35.2%), 60.3% in S. mitis group (resistant, 20.9% and intermediately resistant, 39.4%), 78.9% in S. salivarius group (resistant, 8.8% and intermediately resistant, 70.1%), and 6.2% in S. anginosus group (resistant, 1.7% and intermediately resistant, 4.5%).ConclusionsAntimicrobial resistance patterns towards penicillin show differences among various VGS; this should be considered while devising an effective antimicrobial treatment against VGS.

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Infections in Cancer

Zimmer

Freifeld

2018

Management of Infections in the Immunocompromised Host

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Clinical characteristics and antibiotic susceptibility of viridans streptococcal bacteremia in children with febrile neutropenia

Cited by 12 publications

References 29 publications

Viridans Group Streptococcal Infections in Children After Chemotherapy or Stem Cell Transplantation

Viridans Group Streptococcal Infections in Children After Chemotherapy or Stem Cell Transplantation

Species-Specific Difference in Antimicrobial Susceptibility Among Viridans Group Streptococci

Infections in Cancer

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