Streptococcus bovis group and biliary tract infections: an analysis of 51 cases

Abstract

Streptococcus bovis is a well-known cause of endocarditis, but its role in other infections has not been well described. We analysed prospectively all patients with biliary tract infections caused by S. bovis group during the period 1988-2011. We selected those cases associated with cholangitis and cholecystitis, defined according to Tokyo guidelines. Identification of the strains was performed using the API 20 Strep and the GP card of the Vitek 2 system, and was confirmed by molecular methods. Our series included 51 cases (30 cholangitis and 21 cholecystitis). The associated microorganisms were: Streptococcus infantarius (biotype II/1) 29 cases (57%), Streptococcus gallolyticus subsp. pasteurianus (biotype II/2) 20 cases (39%) and Streptococcus gallolyticus subsp. gallolyticus (biotype I) two cases (4%). The only difference found between S. infantarius and S. gallolyticus subsp. pasteurianus was a greater association of the first with malignant strictures of the bile ducts: 48% (14/29) versus 5% (1/20), p <0.001. Thirty-seven of the cases also had bacteraemia, causing 20% (37/185) of all S. bovis bacteraemia, with differences between S. gallolyticus subsp. gallolyticus (2/112; 2%) and the other two microorganisms: S. infantarius and S. gallolyticus subsp. pasteurianus (35/73; 48%; p <0.001). The vast majority of biliary tract infections due to S. bovis group are caused by S. infantarius and S. gallolyticus subsp. pasteurianus (S. bovis biotype II), and nearly half of the bacteraemia due to these two species has a biliary source (43% of the S. infantarius and 56% of S. gallolyticus subsp. pasteurianus).

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

“…The non-colonic cancers were more often found in the pancreas or biliary tract. In a later study Corredoira et al (2014b) even found that the prevalence of colorectal neoplasia in patients infected with SB II does not appear to be higher than the prevalence among the general population and therefore suggested that colonoscopy should not routinely be performed in these patients. We found a statistically significant association between S. gallolyticus subsp.…”

Streptococcus bovis Bacteremia in Neonates in a Predominantly Hispanic Population

“…Different microbiological classification of S. bovis subspecies may have various relationships to colorectal neoplasia in adults ( 8 , 18 , 19 ). Patients infected with S. gallolyticus subsp gallolyticus (biotype I) were noted to have an increased rate of colorectal neoplasia and infective endocarditis ( 8 ).…”

Inducible Expression of both ermB and ermT Conferred High Macrolide Resistance in Streptococcus gallolyticus subsp. pasteurianus Isolates in China

“…In humans, it is increasingly recognized as a cause of infant meningitis and bacteremia [9,10,11,12], and 58.7% of mortality rate has been observed with one-year neonates relating to this subspecies [13]. In adults, it is linked to a wide spectrum of diseases, including meningitis [14], endocarditis [15,16,17], splenic abscess [18], biliary and urinary tract infection [15,19,20,21], as well as gastric, pancreatic, hepatobiliary and colorectal cancers [16,22]. Death cases in adults were also reported in association with infections by this subspecies.…”