Community-acquired Streptococcus mitis meningitis: a case report

Kutlu, Selda Sayın; Saçar, Suzan; Cevahir, Nural; Turgut, Hüseyin

doi:10.1016/j.ijid.2008.01.003

Cited by 35 publications

(34 citation statements)

References 13 publications

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“…For example, we identified S. mitis, a ubiquitous oral species, in the mouse placenta. This organism, associated with various infections such as endocarditis and meningitis (14,35), was recently identified in amniotic fluid from three cases of PTB (17). Similarly, Veillonella is also a well-recognized oral commensal species.…”

Section: Discussionmentioning

confidence: 99%

Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection

et al. 2010

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Microbial infection of the intrauterine environment is a major cause of preterm birth. The current paradigm indicates that intrauterine infections predominantly originate from the vaginal tract, with the organisms ascending into the sterile uterus. With the improvements in technology, an increasing number of bacterial species have been identified in intrauterine infections that do not belong to the vaginal microflora. We have demonstrated previously that intrauterine infections can originate from the oral cavity following hematogenous transmission. In this study, we begin to systemically examine what proportion of the oral microbiome can translocate to the placenta. Pooled saliva and pooled subgingival plaque samples were injected into pregnant mice through tail veins to mimic bacteremia, which occurs frequently during periodontal infections. The microbial species colonizing the murine placenta were detected using 16S rRNA gene-based PCR and clone analysis. A diverse group of bacterial species were identified, many of which have been associated with adverse pregnancy outcomes in humans although their sources of infection were not determined. Interestingly, the majority of these species were oral commensal organisms. This may be due to a dose effect but may also indicate a unique role of commensal species in intrauterine infection. In addition, a number of species were selectively "enriched" during the translocation, with a higher prevalence in the placenta than in the pooled saliva or subgingival plaque samples. These observations indicate that the placental translocation was species specific. This study provides the first insight into the diversity of oral bacteria associated with intrauterine infection.Preterm birth (PTB) is a significant public health concern, affecting 12.7% of births in the United States. This rate reflects a 36% increase in the past 25 years. Among these, the very preterm births, i.e., those occurring before 32 weeks of gestation, are the most costly and medically relevant group, accounting for approximately 2% of all deliveries. Intrauterine infection has been recognized as a major cause of PTB. The infection rate is inversely related to the gestational age and is highly prevalent among the very preterm deliveries (24). Intrauterine infection has also been implicated in other adverse pregnancy outcomes, such as late miscarriage and stillbirth (25). A wide variety of bacterial species have been identified in the infections, with Ureaplasma urealyticum, Mycoplasma hominis, Bacteroides spp., Gardnerella vaginalis, and Fusobacterium nucleatum (24, 31) as the most prevalent. It has been suggested that the majority of these bacterial species are of relatively low virulence. However, once inside the uterus, they stimulate the synthesis and release of proinflammatory cytokines, neutrophil infiltration and activation, and prostaglandin and metalloprotease synthesis and release, leading to cervical ripening, membrane weakening and rupture, uterine contractions, and PTB (24).The current paradigm ind...

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Section: Discussionmentioning

confidence: 99%

Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection

et al. 2010

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“…However, those microorganisms can occur endocarditis and life-threatening infections resulting in viridans-related septic shock in children, especially, with malignancy or bane marrow transplantation (3)(4)(5). Although Streptococcus mitis (S. mitis) is a VGS, few reports have described severe infections caused by S. mitis in adults (6). Here, we report a case of fulminant PD-related peritonitis caused by S. mitis in an adult PD patient.…”

Section: Introductionmentioning

confidence: 99%

A Case of Fulminant Peritonitis Caused by Streptococcus mitis in a Patient on Peritoneal Dialysis

et al. 2011

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A 54-year-old woman on peritoneal dialysis (PD) was hospitalized with peritonitis with a high body temperature, abdominal pain and cloudy peritoneal fluid. She progressively fell into septic-like shock within only 6 hours after onset. The causative bacteria were Streptococcus mitis (S. mitis), part of the normal flora of oral cavity, intestine, female genial tract and upper respiratory tract. S. mitis shows pathogenicity for diseases such as endocarditis, brain abscesses and sepsis in children with malignancy or transplantation. However, S. mitis rarely shows severe pathogenic responses in adults. We report herein a case of fulminant peritonitis caused by S. mitis in an adult PD patient.

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“…Viridans streptococci are commonly found in the oropharanyx, gastrointestinal tract, skin and female genital tract, and are documented to be the third most frequent cause of bacterial endocarditis. S. mitis is considered to have low virulence and pathogenicity but may cause life-threatening infections, particularly endocarditis and meningitis (Pelletier & Petersdorf, 1977;Kutlu et al, 2008). Patients presenting with subacute bacterial endocarditis usually have an indolent start with non-specific signs and symptoms; ocular findings without fever can be the only herald symptoms, as in our patient's presentation.…”

Section: Discussionmentioning

confidence: 60%

Levofloxacin-resistant-Streptococcus mitis endophthalmitis: a unique presentation of bacterial endocarditis

Dinani

Ktaich

Urban

et al. 2009

Journal of Medical Microbiology

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Endogenous endophthalmitis is a rare complication of infective endocarditis and has been decreasing due to the availability of effective antibiotics. We highlight a case of endogenous endophthalmitis due to levofloxacin-resistant Streptococcus mitis presenting as infective endocarditis. Endogenous endophthalmitis should be considered as a manifestation of an underlying systemic disease, especially in patients who present with non-specific signs and symptoms with no obvious source of precipitating infection.

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Community-acquired Streptococcus mitis meningitis: a case report

Abstract: The purpose of this report is to emphasize the importance of the occurrence of S. mitis meningitis in patients with concomitant factors such as older age (>50 years), alcoholism, poor oral hygiene, and maxillary sinusitis.

Cited by 35 publications

References 13 publications

Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection

Transmission of Diverse Oral Bacteria to Murine Placenta: Evidence for the Oral Microbiome as a Potential Source of Intrauterine Infection

A Case of Fulminant Peritonitis Caused by Streptococcus mitis in a Patient on Peritoneal Dialysis

Levofloxacin-resistant-Streptococcus mitis endophthalmitis: a unique presentation of bacterial endocarditis

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