Viridans Streptococcal Endocarditis: The Role of Various Species, Including Pyridoxal-Dependent Streptococci

Roberts, Richard B.; Krieger, Arlene G.; Schiller, Neal L.; Gross, Katharine C.

doi:10.1093/clinids/1.6.955

Cited by 225 publications

(178 citation statements)

References 30 publications

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“…They have also been isolated from pleural fluid (26), otitis (15, 16), conjunctivitis (l), pancreatic and brain abcesses (8, 17), wounds (16, 17), and the blood of patients with intestinal or postpartum sepsis, pneumonia, osteomyelitis, and cancer (17, 23,26,29). They are part of the normal throat flora and of the urogenital and intestinal flora (16,26).A taxonomic relationship between NVS and Streptococcus mitis and Streptococcus sanguis I1 ("Streptococcus mitior" in British papers [ll]) was suggested following several physiological studies (4, 8, 12,26) and by the presence of a red chromophore (4, 5, 28). However, it has been shown that NVS differ from these two species in their enzymatic activities and penicillin-binding proteins (PBPs) (5, 19).…”

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“…More recently, growth of NVS was obtained in a semisynthetic medium with or without vitamin B, and cysteine (4). In various publications these organisms have been referred to as satellite streptococci (25), satelliting streptococci (23), symbiotic streptococci (16), thiol-requiring mutants (lo), vitamin B,-dependent streptococci (8), pyridoxal-dependent streptococci (26), nutritionally deficient streptococci (3,29), and nutritionally variant streptococci (4, 12, 17, 21). NVS are responsible for 5% of streptococcal endocarditis (26).…”

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“…In various publications these organisms have been referred to as satellite streptococci (25), satelliting streptococci (23), symbiotic streptococci (16), thiol-requiring mutants (lo), vitamin B,-dependent streptococci (8), pyridoxal-dependent streptococci (26), nutritionally deficient streptococci (3,29), and nutritionally variant streptococci (4, 12, 17, 21). NVS are responsible for 5% of streptococcal endocarditis (26). They have also been isolated from pleural fluid (26), otitis (15, 16), conjunctivitis (l), pancreatic and brain abcesses (8, 17), wounds (16, 17), and the blood of patients with intestinal or postpartum sepsis, pneumonia, osteomyelitis, and cancer (17, 23,26,29).…”

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Streptococcus defectivus sp. nov. and Streptococcus adjacens sp. nov., Nutritionally Variant Streptococci from Human Clinical Specimens

Bouvet

Grimont

1989

International Journal of Systematic Bacteriology

108

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Nutritionally variant streptococci (12 strains) formed two deoxyribonucleic acid hybridization groups (as determined by the S1 nuclease method) that were distinct from 39 Streptococcus spp. type and reference strains. These two groups differed by their penicillin-binding protein patterns and biochemical properties. Streptococcus defectivus sp. nov. (with type strain SC10) and Streptococcus adjacens sp. nov. (with type strain GaD) are the names proposed for these species.Nutritionally variant streptococci (NVS) were originally described by Frenkel and Hirsch (15) as fastidious streptococci that grow as satellite colonies around other microorganisms or in complex media enriched with sulfydryl compounds, such as cysteine. Further studies also demonstrated a vitamin B,-requirement for growth in complex media (8, 16). More recently, growth of NVS was obtained in a semisynthetic medium with or without vitamin B, and cysteine (4). In various publications these organisms have been referred to as satellite streptococci (25), satelliting streptococci (23), symbiotic streptococci (16), thiol-requiring mutants (lo), vitamin B,-dependent streptococci (8), pyridoxal-dependent streptococci (26), nutritionally deficient streptococci (3, 29), and nutritionally variant streptococci (4, 12, 17, 21). NVS are responsible for 5% of streptococcal endocarditis (26). They have also been isolated from pleural fluid (26), otitis (15, 16), conjunctivitis (l), pancreatic and brain abcesses (8, 17), wounds (16, 17), and the blood of patients with intestinal or postpartum sepsis, pneumonia, osteomyelitis, and cancer (17, 23,26,29). They are part of the normal throat flora and of the urogenital and intestinal flora (16,26).A taxonomic relationship between NVS and Streptococcus mitis and Streptococcus sanguis I1 ("Streptococcus mitior" in British papers [ll]) was suggested following several physiological studies (4, 8, 12,26) and by the presence of a red chromophore (4, 5, 28). However, it has been shown that NVS differ from these two species in their enzymatic activities and penicillin-binding proteins (PBPs) (5, 19). Furthermore, three different biotypes of NVS and two different PBP patterns have been described (5). A comparison between biotypes and PBP patterns allowed distinction between the following two groups of NVS: group I, including strains with PBP pattern I and biotype 1, and group 11, including strains with PBP pattern I1 and biotypes 2 and 3 (5).The uncertainty of the taxonomic position of NVS among viridans streptococci and the phenotypic heterogeneity of NVS prompted us to study the levels of deoxyribonucleic acid (DNA) relatedness of the three NVS biotypes to 39 different species or biotypes of the genus Streptococcus. The outcome of this study is a proposal for two new species, Streptococcus defectivus and Streptococcus adjacens.(Some of the results were presented at the International Lancefield Society Meeting, Cologne, Federal Republic of Germany, 1987.) MATERIALS AND METHODSBacterial strains. The 12 NVS strains and 39 refe...

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Streptococcus defectivus sp. nov. and Streptococcus adjacens sp. nov., Nutritionally Variant Streptococci from Human Clinical Specimens

Bouvet

Grimont

1989

International Journal of Systematic Bacteriology

108

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“…The viridans group includes several strains of streptococci, most of which are part of the normal microbiota of the upper respiratory tract and of the oropharynx (16) . They are observed in 30%-40% of the cases of infectious endocarditis (39) , but are also responsible for transient bacteremias, i.e., those that do not result in infection. These bacteria are observed after endoscopic procedures such as EGD (5,31,46,51) , esophageal dilation (51) , endoscopic retrograde cholangiopancreatography (ERCP), endoscopic mucosal resection (23) , EVS (12,40,46,50,52) and EVL (24) .…”

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Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

Maulaz

Mattos

Pereira-Lima

et al. 2003

Arq. Gastroenterol.

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-Background -Endoscopic procedures can develop bacteremia. Patients with chronic liver disease are more predisposed to undergo bacteremia and infections because they are immunocompromised. Aims -The purpose of this study was to determine the incidence of bacteremia in cirrhotics submitted to endoscopic variceal ligation. Methods -Three groups of 40 patients each were studied. One group was made up of patients with cirrhosis who were submitted to ligation, a second group was composed of cirrhotics who underwent esophagogastroduodenoscopy only, and a third group was composed of patients without liver disease who underwent esophagogastroduodenoscopy. Blood was sampled from all patients for culture, both in aerobic and in anaerobic mediums, immediately before endoscopy and at 5 and 30 minutes after its completion. Results -Blood culture was positive in 6 samples. In 4 of these, the bacteria (Staphylococcus hominis hominis, Staphylococcus auricularis, Acinetobacter lwoffii, and coagulase-negative staphylococcus) were isolated before the endoscopic procedure and thus were considered as contamination. In the ligation group, a streptococcus of the viridans group was isolated 5 minutes after the procedure, and in the cirrhosis without ligation group, a Staphylococcus epidermidis was isolated at 30 minutes. None of the patients showed clinical evidence of infection. Conclusions -The bacteremia incidence in cirrhotic patients submitted to variceal ligation was 2.5%, showing no difference from the control groups.

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“…In a large series study, streptococcal species accounted for morethan one half of documented IE (4). This group included a variety of species, such as S. mitior (25% of causes ofIE on native valve), S. sangius (-20%), S. mutans (-10%), S. anginosus (-5%), and S. salivarius (-1%) (4,5). These organisms are normal inhabitants of oropharinx.…”

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confidence: 99%

Multiple Myeloma Complicated with Streptococcal Endocarditis Successfully Treated by Mitral Valve Replacement.

et al. 1994

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A 63-year-old male patient with multiple myeloma developed congestive heart failure due to streptococcus endocarditis prior to the initiation of chemotherapy. Doppler echocardiographical examination revealed the presence of a large vegetation on the anterior mitral leaflet as well as the association of severe mitral regurgitation. Surgical repair (mitral valve replacement) was urgently undertaken and the postoperative course resulted in uneventful recovery. In immunodeficient patients with such a streptococcus sepsis, the possibility of infectious endocarditis should be taken into consideration and proper managementis mandatory in these circumstances. (Internal Medicine 33: 13-17, 1994)

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Viridans Streptococcal Endocarditis: The Role of Various Species, Including Pyridoxal-Dependent Streptococci

Cited by 225 publications

References 30 publications

Streptococcus defectivus sp. nov. and Streptococcus adjacens sp. nov., Nutritionally Variant Streptococci from Human Clinical Specimens

Streptococcus defectivus sp. nov. and Streptococcus adjacens sp. nov., Nutritionally Variant Streptococci from Human Clinical Specimens

Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

Multiple Myeloma Complicated with Streptococcal Endocarditis Successfully Treated by Mitral Valve Replacement.

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