Streptococcus bovis Bacteremia in Neonates in a Predominantly Hispanic Population

Abstract

BackgroundStreptococcus bovis bacteremia has been associated with gastrointestinal diseases, especially colon cancer, neoplastic colon polyps, and other malignancies of the GI tract in adults. Sporadic cases of S. bovis disease have also been reported in neonates and young infants. Although uncommon, S. bovis infection can cause fulminant neonatal sepsis and meningitis.ObjectivesWe report a series of pediatric patients with S. bovis bacteremia in a county hospital in a United States–Mexico border city in order to examine the demographic and clinical associations.MethodsWe characterized the demographic and clinical features in all pediatric patients with blood cultures positive for S. bovis at University Medical Center in El Paso, TX, USA between January 2000 and December 2010. Hospital records were systematically reviewed by using a standardized protocol.ResultsA total of seven episodes of S. bovis bacteremia were documented in seven pediatric patients (four female and three male). Mean age was 1.2 days (range 1–3 days), all were Hispanic, average birth weight (3.25 kg). Mode of delivery was spontaneous vaginal delivery (five) and Caesarian section (two). All of our patients developed early (<1 week) onset disease and presented with signs of respiratory distress. Five out of seven babies presented with abdominal distention and diarrhea. Six had clinical evidence of sepsis at presentation. Respiratory distress was the most common manifestation of sepsis (seven). Aspiration pneumonia was diagnosed in two of them. Most patients were treated with a combination of antibiotics (six), either ampicillin and gentamicin or ampicillin and cefotaxime, and one with ampicillin alone. None of the pediatric patients had endoscopy and none of them died.ConclusionStreptococcus bovis is considered as an uncommon pathogen in the newborn, but can be associated with substantial morbidity and mortality if not identified and treated early. Physicians should be alert to the less common presentation of neonatal bacteremia due to S. bovis.

Bacteremia with the bovis group streptococci: species identification and association with infective endocarditis and with gastrointestinal disease

“…In this study 21 (39.6%) died within the first year after their episode of bovis group streptococci bacteremia. There are not many studies to compare these data with but one study found a mortality rate among patients with bovis group streptococci bacteremia of 19% (Alvarez et al 2015). Similar to our study one third had colonoscopy and 19% were diagnosed with colorectal neoplasia.…”

Pattern of Antibiotics Utilization in Neonatal Septicemia: A Cross-Sectional Study From Rural Tertiary Care Hospital Western Maharashtra, India

“…Another study reported respiratory distress (100%) followed by abdominal distension (71.42%) and signs of pneumonia (28.57%) of neonatal sepsis [11]. Unusual presentation of generalised neonatal seizures was seen in a study [12].…”

Streptococcus bovis – unusual etiology of meningitis in a neonate with Down syndrome: a case report

“…Streptococcus bovis is a Gram-positive, Lancefield group D Streptococcus which is found in the pharynx, nose, and gastrointestinal tract of healthy humans [ 3 ]. It is an unusual etiology of human diseases; however, it is known to cause infective endocarditis in hosts with predisposing cardiac defects [ 4 ].…”