Clinical and Laboratory Features of Streptococcus salivarius Meningitis: A Case Report and Literature Review

Wilson, Megan J.; Ryan, Martin; Walk, Seth T.; Young, Carol; Grossman, Sylvia; McKean, Erin Lin; Aronoff, David M.

doi:10.3121/cmr.2011.1001

Cited by 42 publications

(39 citation statements)

References 44 publications

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“…A few strains have also been associated with opportunistic infections, in particular, in cases of meningitis (17), endocarditis (18) and bacteremia in immunocompromised patients (19,20). Analyses of S. salivarius genomes pointed out the considerable variability of gene content and the differences in adaptive traits (21).…”

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confidence: 99%

Diversity of Integrative and Conjugative Elements of Streptococcus salivarius and Their Intra- and Interspecies Transfer

Dahmane

Libante

Charron-Bourgoin

et al. 2017

Appl Environ Microbiol

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Integrative and conjugative elements (ICEs) are widespread chromosomal mobile genetic elements which can transfer autonomously by conjugation in bacteria. Thirteen ICEs with a conjugation module closely related to that of ICESt3 of Streptococcus thermophilus were characterized in Streptococcus salivarius by wholegenome sequencing. Sequence comparison highlighted ICE evolution by shuffling of 3 different integration/excision modules (for integration in the 3= end of the fda, rpsI, or rpmG gene) with the conjugation module of the ICESt3 subfamily. Sequence analyses also pointed out a recombination occurring at oriT (likely mediated by the relaxase) as a mechanism of ICE evolution. Despite a similar organization in two operons including three conserved genes, the regulation modules show a high diversity (about 50% amino acid sequence divergence for the encoded regulators and presence of unrelated additional genes) with a probable impact on the regulation of ICE activity. Concerning the accessory genes, ICEs of the ICESt3 subfamily appear particularly rich in restriction-modification systems and orphan methyltransferase genes. Other cargo genes that could confer a selective advantage to the cell hosting the ICE were identified, in particular, genes for bacteriocin synthesis and cadmium resistance. The functionality of 2 ICEs of S. salivarius was investigated. Autonomous conjugative transfer to other S. salivarius strains, to S. thermophilus, and to Enterococcus faecalis was observed. The analysis of the ICE-fda border sequence in these transconjugants allowed the localization of the DNA cutting site of the ICE integrase.IMPORTANCE The ICESt3 subfamily of ICEs appears to be widespread in streptococci and targets diverse chromosomal integration sites. These ICEs carry diverse cargo genes that can confer a selective advantage to the host strain. The maintenance of these mobile genetic elements likely relies in part on self-encoded restrictionmodification systems. In this study, intra-and interspecies transfer was demonstrated for 2 ICEs of S. salivarius. Closely related ICEs were also detected in silico in other Streptococcus species (S. pneumoniae and S. parasanguinis), thus indicating that diffusion of ICESt3-related elements probably plays a significant role in horizontal gene transfer (HGT) occurring in the oral cavity but also in the digestive tract, where S. salivarius is present.

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confidence: 99%

Diversity of Integrative and Conjugative Elements of Streptococcus salivarius and Their Intra- and Interspecies Transfer

Dahmane

Libante

Charron-Bourgoin

et al. 2017

Appl Environ Microbiol

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“…S. salivarius is also commonly detected as an inhabitant of the gastrointestinal tracts of healthy humans and has been described as a typical small intestine commensal species (8). However, some strains have been associated with opportunistic infections: a growing number of meningitis cases (9,10), several cases of endocarditis (11), bacteremia in immunocompromised patients (12,13), and invasion of the guts of patients with liver cirrhosis (14).…”

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confidence: 99%

Resistance Genes and Genetic Elements Associated with Antibiotic Resistance in Clinical and Commensal Isolates of Streptococcus salivarius

Chaffanel

Charron-Bourgoin

Libante

et al. 2015

Appl Environ Microbiol

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The diversity of clinical (n ‫؍‬ 92) and oral and digestive commensal (n ‫؍‬ 120) isolates of Streptococcus salivarius was analyzed by multilocus sequence typing (MLST). No clustering of clinical or commensal strains can be observed in the phylogenetic tree. Selected strains (92 clinical and 46 commensal strains) were then examined for their susceptibilities to tetracyclines, macrolides, lincosamides, aminoglycosides, and phenicol antibiotics. The presence of resistance genes tet(M), tet(O), erm(A), erm(B), mef(A/ E), and catQ and associated genetic elements was investigated by PCR, as was the genetic linkage of resistance genes. High rates of erythromycin and tetracycline resistance were observed among the strains. Clinical strains displayed either the erm(B) (macrolide-lincosamide-streptogramin B [MLS B ] phenotype) or mef(A/E) (M phenotype) resistance determinant, whereas almost all the commensal strains harbored the mef(A/E) resistance gene, carried by a macrolide efflux genetic assembly (MEGA) element. A genetic linkage between a macrolide resistance gene and genes of Tn916 was detected in 23 clinical strains and 5 commensal strains, with a predominance of Tn3872 elements (n ‫؍‬ 13), followed by Tn6002 (n ‫؍‬ 11) and Tn2009 (n ‫؍‬ 4) elements. Four strains harboring a mef(A/E) gene were also resistant to chloramphenicol and carried a catQ gene. Sequencing of the genome of one of these strains revealed that these genes colocalized on an IQ-like element, as already described for other viridans group streptococci. ICESt3-related elements were also detected in half of the isolates. This work highlights the potential role of S. salivarius in the spread of antibiotic resistance genes both in the oral sphere and in the gut. Streptococcus salivarius is a Gram-positive commensal bacterium that is a major bacterial constituent of saliva and of biofilms found on the human tongue dorsum (1). It belongs to the early microbial community that colonizes the oral cavities of newborns (2) and persists in the adult oral flora (3). This species is considered to contribute to oral health by preventing the colonization of mucosal surfaces with pathogens involved in upper respiratory tract infections (4). For instance, S. salivarius strains have been reported to inhibit biofilm formation by Streptococcus pyogenes (5) and Streptococcus mutans (6) as well as adherence by Candida albicans (7). S. salivarius is also commonly detected as an inhabitant of the gastrointestinal tracts of healthy humans and has been described as a typical small intestine commensal species (8). However, some strains have been associated with opportunistic infections: a growing number of meningitis cases (9, 10), several cases of endocarditis (11), bacteremia in immunocompromised patients (12, 13), and invasion of the guts of patients with liver cirrhosis (14).Macrolides and tetracyclines are commonly used for the treatment of streptococcal infections, but high rates of resistance to these antibiotics have been observed among pathogenic and commensal strept...

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“…Acute bacterial meningitis remains an important cause of morbidity and mortality worldwide, despite advances in prophylactic vaccination and pharmacotherapy [5]. Bacterial meningitis can be a serious and devastating illness.…”

Section: Resultsmentioning

confidence: 99%

Streptococcus salivarius Meningitis in Immunocompetent: A Case Report

M¹,

S²,

M³

2018

Int Arch Med Microbiol

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Streptococcus salivarius (S. salivarius) is a rare cause of purulent meningitis. We report a case of meningitis due to S. salivarius in 15-years-old Sudanese boy. Diagnosis was established based on Cerebrospinal fluid (CSF) findings. The patient responded well to systemic antibiotics and recovered completely without any neurological complications after proper supportive measures. In this patient the meningitis caused by S. salivarius was thought to be spontaneous. The importance of bacteriological diagnosis and proper antibiotic treatment for S. salivarius meningitis is discussed. KeywordsStreptococcus salivarius, Meningitis, Immunocompetent, Cerebrospinal fluid is a Joint commission international (JCI) accredited, with a history of high grade of fever 2 days ago, intermittent, relieved by paracetamol, severe headache and generalized fatigability. On day of admission, he developed one episode of tonic clonic convulsion at home and three times in emergency room. He was intubated and admitted in ICU.Assessment of vital signs on presentation revealed a temperature of 39.2 °C, pulse of 112 beats per minute, and blood pressure of 88/50 mmHg. The physical examination revealed that the patient was toxic, and irritable. Cardiovascular and respiratory systems were normal. Laboratory investigations revealed hemoglobin 13.4 g/dl, total leukocyte count 26.400 cells per cubic millimeter. Liver and renal function, serum electrolytes, calcium and magnesium were within normal limits.The patient have no history of epidural anesthesia, spinal myelography, post-traumatic cerebrospinal fluid leaks, brain abscesses, pericranial fistulas or other procedures associated with S. salivarius contamination and also have no recent contact with meningitis patients.In view of suspected central nervous system infection, lumbar puncture was done. Cerebrospinal fluid (CSF) analysis showed an elevated protein level of 169 mg/dl (reference range, 15 to 45) and decrease glucose concentration of 5.8 mg/dl (reference range of 40 to 70 mg/dl). Gram stain of CSF showed no bacteria, but white blood cells were increased 16 cells/cm, with 56% neutrophils and 44% lymphocytes. With the conclusion of pyogenic meningitis, patient was started on intravenous ceftriaxone (2 gm/12 h), vancomycin (1 gm/12 h)

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Clinical and Laboratory Features of Streptococcus salivarius Meningitis: A Case Report and Literature Review

Cited by 42 publications

References 44 publications

Diversity of Integrative and Conjugative Elements of Streptococcus salivarius and Their Intra- and Interspecies Transfer

Diversity of Integrative and Conjugative Elements of Streptococcus salivarius and Their Intra- and Interspecies Transfer

Resistance Genes and Genetic Elements Associated with Antibiotic Resistance in Clinical and Commensal Isolates of Streptococcus salivarius

Streptococcus salivarius Meningitis in Immunocompetent: A Case Report

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