Recurrent bacteremia with Streptococcus dysgalactiae: a case–control study

Beta-hemolytic Streptococcus dysgalactiae is a well-known pathogen for a wide range of animals and humans. Two subspecies are recognized: (i) equisimilis, associated to disease in horses and humans, and (ii) dysgalactiae mainly isolated from animal illness with only a few humans’ cases. This study describes the isolation and characterization of Streptococcus dysgalactiae subsp. dysgalactiae (SDSD) from vampire bats, maintained in captivity for research proposes. Animals presented neurologic, respiratory and gastroenteric symptoms and sudden death. Beta-hemolytic Gram-positive cocci were isolated in blood agar plates and further characterized as Lancefield group C. All isolates were identified as S. dysgalactiae by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry and subspecies dysgalactiae was confirmed by 16S rRNA sequencing and phylogenetic analysis. Genotyping through SE-ALFP resulted in three profiles (A1–A3) with one bat being infected by profiles A1 and A3. This is the first report of SDSD causing illness in bats and especially in Desmodus rotundus species.

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“…S . dysgalactiae of group C occasionally causes lower limb cellulitis, meningitis, and bacteremia in humans 19 – 21 . β-hemolytic S .…”

Section: Discussionmentioning

confidence: 99%

“…β-hemolytic S . dysgalactiae of groups C and G can cause severe and recurring invasive infections 21 .…”

Section: Discussionmentioning

confidence: 99%

Septicemia due to Streptococcus dysgalactiae subspecies dysgalactiae in vampire bats (Desmodus rotundus)

Castro

Moreno

Apolinário

et al. 2018

Sci Rep

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“…The laboratory database was reviewed to identify patients with BHS isolation from the aforementioned sterile sites. Repeated positive cultures of the same organism within 30 days of the initial isolation were considered to be from a single episode based on previous reports [15, 16] and opinions from multiple infectious disease physicians in the research team. Data on demographic characteristics, as well as laboratory, microbiological, clinical, and patients’ outcome data, were retrieved from medical records.…”

Section: Methodsmentioning

confidence: 99%

Age-related differences in clinical characteristics of invasive group G streptococcal infection: Comparison with group A and group B streptococcal infections

Fujiya

Hayakawa

et al. 2019

PLoS ONE

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Purpose Invasive Group G streptococcal infection (iGGS) has increasingly been recognized as a cause of severe disease, mainly among elderly people with chronic illnesses. This study aimed to examine age-related differences in clinical characteristics of iGGS and describe its characteristics among very elderly individuals (≥80 years). Methods Fifty-four iGGS patients for whom detailed clinical information was available were identified from 2002 to 2014 in a tertiary care hospital in Japan. iGGS (n = 54) was compared with invasive Group A (iGAS; n = 17) and B streptococcal infection patients (iGBS; n = 52) based on patient age. Results The incidence of iGGS in our catchment area significantly increased during the study period. The prevalence of iGGS in the very elderly population was higher than that of iGAS or iGBS (p<0.001). Among iGGS patients, cardiovascular disease, chronic kidney disease, oxygen demand, and bacteremia with unknown focus of infection were more frequent in the very elderly population (p = 0.009, p = 0.02, p = 0.04, and p = 0.04, respectively). Altered mental status was present in half of iGGS patients aged ≥60 years (p = 0.03). In contrast, alcohol drinking and liver cirrhosis were significantly more frequent in patients with iGGS aged <60 years than in other age groups (p<0.001, p = 0.001, respectively). Levofloxacin resistance in GBS isolates was significantly more frequent among very elderly patients than among other age groups (p<0.001). Conclusions The burden of iGGS has been increasing in our catchment area. Different iGGS-associated clinical characteristics were found in each age group. Unclear and atypical clinical manifestations and syndromes were likely to be observed in very elderly patients. Alcohol drinking and liver cirrhosis may contribute to iGGS even in patients aged <60 years. Understanding these age-related differences could be helpful for optimal diagnosis and treatment.

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“…equisimilis (SDSE) bacteremia followed by streptococcal toxic shock syndrome in a patient with Noonan syndrome was documented in Japan [3]. Trell et al [4] performed clinical trials on patients with recurrent S. dysgalactiae bacteremia (N=22) and controls with a single episode of S. dysgalactiae bacteremia (N=92). Their case-control study showed comparable demographics, Charlson comorbidity scores, and clinical presentations.…”

mentioning

confidence: 99%

“…We retrospectively retrieved medical information of 15 patients (median age=82 years, range=64 to 88 years, 6 males and 9 females) with invasive SDSE infection because such patients possess the possibility for repetitive onsets [1234]. The information pertained to underlying medical conditions, clinical diagnoses, laboratory test data while obtaining bacterial cultures, therapeutic antimicrobial agents, surgical interventions, and outcomes.…”

mentioning

confidence: 99%

Comparison of Characteristics of Streptococcus dysgalactiae subsp. equisimilis Isolates Causing Repetitive vs Single Infections

et al. 2019

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No study has described Streptococcus dysgalactiae subsp. equisimilis (SDSE) isolates that cause repetitive infections (recurrence and reinfection). We compared the microbiological characteristics of SDSE causing repetitive infections with those causing single infections. Three patients with invasive infections were identified based on their medical records, and multiple SDSE isolates were collected at intervals over three weeks, using a laboratory repository. Isolates from 12 patients with single-episode infections served as controls. Six isolates were collected from three patients with first and second episodes of infection. All isolates causing either repetitive or single-episode infection were subjected to emm typing, multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and random amplified polymorphic DNA (RAPD) analyses. Amplification of five virulence genes ( sicG , prtF1 , prtF2 , lmb , and cbp ), biofilm formation (BF), and cell invasion abilities (CIAs) were measured as virulent phenotypes. We observed close genetic similarities in the data obtained by emm typing, MLST, PFGE, and RAPD in four isolates from two patients, suggesting recurrence, whereas two isolates from one patient indicated genetic differences in these data, suggesting re-infection. The presence of the five virulence genes and the BF and CIA measurements appeared not to contribute to repetitive infections, compared with isolates causing single-episode infection. In conclusion, clinicians encountering patients with repetitive infections should be aware of both possibilities: recurrence with closely related strains and reinfection with different strains.

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Recurrent bacteremia with Streptococcus dysgalactiae: a case–control study

Abstract: Abstract

Cited by 17 publications

References 22 publications

Septicemia due to Streptococcus dysgalactiae subspecies dysgalactiae in vampire bats (Desmodus rotundus)

Septicemia due to Streptococcus dysgalactiae subspecies dysgalactiae in vampire bats (Desmodus rotundus)

Age-related differences in clinical characteristics of invasive group G streptococcal infection: Comparison with group A and group B streptococcal infections

Comparison of Characteristics of Streptococcus dysgalactiae subsp. equisimilis Isolates Causing Repetitive vs Single Infections

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