Geographical difference of disease association in Streptococcus bovis bacteraemia

• Published in: Journal of medical microbiology Vol. 52; no. 10; pp. 903 - 908
• Main Authors: Lee, Rodney A, Woo, Patrick C.Y, To, Amanda P.C, Lau, Susanna K.P, Wong, Samson S.Y, Yuen, Kwok-Yung
• Format: Journal Article
• Language: English
• Published: Reading Soc General Microbiol 01-10-2003; Society for General Microbiology
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacteremia - epidemiology; Bacteremia - microbiology; Bacterial diseases; Bacterial sepsis; Bacteriology; Biological and medical sciences; Child; Child, Preschool; clindamycin; DNA, Bacterial - chemistry; DNA, Bacterial - genetics; ermB gene; ermT gene; erythromycin; Female; Fundamental and applied biological sciences. Psychology; Hong Kong - epidemiology; Human bacterial diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Phylogeny; Polymerase Chain Reaction; Retrospective Studies; RNA, Ribosomal, 16S - chemistry; RNA, Ribosomal, 16S - genetics; Sequence Alignment; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcus bovis; Streptococcus bovis - classification; Streptococcus bovis - genetics; Hong Kong; Infection; Streptococcaceae; Microbiology; Bacteriosis; Bacteria; Micrococcales; Bacteremia; Streptococcus bovis
• ISSN: 0022-2615; 1473-5644
• DOI: 10.1099/jmm.0.05199-0

1 Department of Microbiology, The University of Hong Kong, University Pathology Building, Queen Mary Hospital, Hong Kong 2 HKU-Pasteur Research Centre, Hong Kong
Correspondence Kwok-Yung Yuen hkumicro{at}hkucc.hku.hk
Received January 29, 2003
Accepted July 1, 2003
From 1996 to 2001, 48 Streptococcus bovis strains were isolated from blood cultures of 37 patients in one hospital. Median patient age was 68 years (range: 1 day–88 years). The male : female ratio was 23 : 14. Most patients (97 %) had underlying diseases, including biliary tract disease in 14 (38 %), diabetes mellitus in 12 (32 %), liver parenchymal disease in seven (19 %), carcinoma of the colon in four (11 %) and other malignancies in four (11 %). No infective foci (indicative of primary bacteraemia) were identified in 15 patients (40 %) and 14 (38 %) had acute cholangitis/cholecystitis, but only four (11 %) had infective endocarditis. Two (5 %), three (8 %) and 32 (87 %) patients had S. bovis of biotypes I, II/1 and II/2, respectively, and three (8 %), two (5 %) and 32 (87 %) patients had S. bovis of genotypes 1, 2a and 2b, respectively. All isolates were sensitive to penicillin, cephalothin and vancomycin, 24 (65 %) were resistant to erythromycin and 15 (41 %) were resistant to clindamycin (these strains were also resistant to erythromycin). Thirteen isolates that were erythromycin- and clindamycin-resistant possessed the ermB gene, 10 possessed the ermT gene and one possessed both the ermB and ermT genes. Overall, seven patients (19 %) died. In contrast to most other reports from western countries, where carcinoma of the colon and infective endocarditis were the major underlying disease and infective focus associated with S. bovis bacteraemia, biliary tract disease and acute cholangitis and/or cholecystitis were the major underlying diseases associated with S. bovis bacteraemia in our locality.