Antibiotic susceptibility, cytotoxicity, and protease activity of viridans group streptococci causing endophthalmitis

Marquart, Mary E.; Benton, Angela H.; Galloway, Regina; Stempak, Lisa

doi:10.1371/journal.pone.0209849

Cited by 14 publications

(10 citation statements)

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“…All of these manifestations were attributed to end-organ hypoperfusion (MODS) due to sepsis. S. pseudoporcinus in our case could have been acquired by the consumption of contaminated dairy products, since the pathogen has been previously recovered from them [ 10 ], with subsequent colonization of the gastrointestinal tract. Colonization of the gut lumen could traverse the intestinal wall and colonize mesenteric lymph nodes (bacterial translocation).…”

Section: Discussionmentioning

confidence: 99%

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Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

2021

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Background Streptococcus pseudoporcinus (S. pseudoporcinus) was first identified in 2006. It cross-reacts with Lancefield group B antigen agglutination reagents and has been misidentified as S. agalactiae. Sites of S. pseudoporcinus isolation include the female genitourinary tract, urine, wounds, and dairy products. The prevalence of vaginal colonization is reportedly between 1 and 5.4%. Two uneventful cases of soft tissue infection caused by S. pseudoporcinus were reported in the past. However, since late 2019, six cases of invasive S. pseudoporcinus infections have emerged in the literature, one of which was fatal. Case presentation We describe a fatal case of a Caucasian male with spontaneous bacterial peritonitis associated with bacteremia due to a multidrug-resistant S. pseudoporcinus strain in a patient with decompensated liver cirrhosis. Despite the patient’s good general condition and stable blood test results when he had visited the outpatient clinic for large-volume paracentesis a few days before admission, this time he presented to the emergency department with a rapidly worsening clinical condition and with laboratory features consistent with multiple-organ dysfunction syndrome, and succumbed within a short period. Conclusions Contrary to what was thought until recently, multidrug-resistant S. pseudoporcinus may cause invasive, disseminated, fatal disease in humans. According to current limited data, vancomycin, linezolid, daptomycin, levofloxacin, clindamycin, and tetracycline seem to be the most effective antimicrobial agents against multidrug-resistant strains, and should be the empirical choice in cases of disseminated S. pseudoporcinus infection until laboratory antimicrobial susceptibility results are available. Improvements and new approaches for bacterial identification in routine clinical microbiology laboratories may reveal the real spectrum of S. pseudoporcinus infections in humans, which is currently believed to be underestimated. SS. pseudoporcinus could emerge as a serious medical problem in the near future, similar to other β-hemolytic streptococci.

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Section: Discussionmentioning

confidence: 99%

“…Risk factors for Streptococcus pseudoporcinus acquisition and subsequent vaginal-rectal colonization[1][2][3][4][5][6][7][8][9][10] …”

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confidence: 99%

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

2021

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“…However, at least 3 intravitreal antibiotics injections were required to control the infection. It is reported that viridans streptococci has cytotoxicity to retinal pigment epithelial cells 16 . One of our patients with polymicrobial infections received 3 intravitreal antibiotics injections.…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors associated with visual outcome of salvageable eyes with posttraumatic endophthalmitis

Jin

et al. 2019

Sci Rep

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The purpose of this study is to evaluate the prognostic factors associated with visual outcomes in the salvageable eyes with posttraumatic endophthalmitis. We retrospectively reviewed the medical records of all patients diagnosed with posttraumatic endophthalmitis in our hospital between 2008 and 2015. The following information was collected: age, sex, etiology, past medical history, clinical manifestations, wound location, microbiology, blood leukocyte counts, types of interventions, initial visual acuities and final visual acuities. Univariate and multivariate analyses were used to explore the factors associated with final best-corrected visual acuity. In total, 98 eyes of 98 patients were included in our study. Fifty-seven eyes underwent vitrectomy, 27 of them had silicone oil tamponade, 38 eyes received intravitreal ceftazidime only and 3 eyes received intracameral ceftazidime. In univariate analysis, poor initial visual acuity, presence of intraocular foreign body, number of intravitreal injections, retinal detachment and Zone 3 injury were associated with poor visual outcome. In multivariable analysis, poor initial visual acuity, presence of intraocular foreign body and number of intravitreal injections were independently associated with poor visual outcome. The silicone oil group had fewer repeated intravitreal injections than the group without oil tamponade. We concluded that the visual outcome of salvageable eyes with posttraumatic endophthalmitis is associated with initial visual acuity, presence of intraocular foreign body and number of intravitreal antibiotic injections.

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“…Vancomycin and ceftazidime were the most commonly used intravitreal treatment in our cohort. This regimen potentially covers 100% of the bacterial infections documented but the microbiology e cacy of ceftazidime is reduced in streptococcal cases in comparison to ceftriaxone [19]. Seven isolates of different streptococci species in the present study would have been treated more e ciently had ceftriaxone been used instead of ceftazidime.…”

Section: Discussionmentioning

confidence: 97%

Endophthalmitis Panorama in The Jerusalem Area

Sánchez

Elinav

Tiosano

et al. 2021

Preprint

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Purpose: The spectrum of microbial infections and the pattern of their susceptibility is variable among communities. Researching this data will lead to the establishment of the most appropriate national management strategies. The purpose of this study was to analyze the epidemiological, clinical, microbial spectrum and antibiotic susceptibility of endophthalmitis cases in a tertiary referral center in Jerusalem.Methods: Retrospective review of medical charts of patients presenting with endophthalmitis over a 12-year-period.Results: Included were 74 eyes of 70 patients (males 56%). Mean age±SD at presentation was 60±19.5 years. Exogenous endophthalmitis accounted for 78% of cases; of which, 62% followed an intraocular surgery, 21% occurred after intravitreal injections, 10% followed infectious keratitis and 7% were post-traumatic. Endogenous cases were predominantly observed in diabetic patients. Microbial isolates were identified in 44 samples. Of them, gram-positive bacteria were the predominant microorganisms detected in 33 samples (75%); Staphylococcus epidermidis and Enterococcus faecalis were the most commonly detected pathogens. Mean presenting±SD LogMAR visual acuity (VA) was 2.38±1.21 and it improved at last follow-up to 1.7±1.37 (p=0.004, paired t-test). Cases secondary to gram-positive microbes were associated with improved VA during the follow-up while cases secondary to gram-negative microbes was correlated with poor final VA (p=0.046, r2=0.4). There was no evidence of bacterial resistance in the antibiograms for either vancomycin, ceftazidime, ceftriaxone or amikacin.Conclusions: Intraocular surgery remains the most common event preceding endophthalmitis with coagulase-negative staphylococci being the most frequently detected microorganisms. The microbial spectrum of endophthalmitis is similar to that in the western world.

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Antibiotic susceptibility, cytotoxicity, and protease activity of viridans group streptococci causing endophthalmitis

Cited by 14 publications

References 50 publications

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

Fatal Streptococcus pseudoporcinus disseminated infection in decompensated liver cirrhosis: a case report

Prognostic factors associated with visual outcome of salvageable eyes with posttraumatic endophthalmitis

Endophthalmitis Panorama in The Jerusalem Area

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