Senn Laurence, Entenza José M, Greub Gilbert, Jaton Katia, Wenger Aline, Bille Jacques, Calandra Thierry, Prod'hom Guy
Infectious Diseases Service, University Hospital, Lausanne, Switzerland.
BMC Infect Dis. 2006 Jan 20;6:9. doi: 10.1186/1471-2334-6-9.
Abiotrophia and Granulicatella species, previously referred to as nutritionally variant streptococci (NVS), are significant causative agents of endocarditis and bacteraemia. In this study, we reviewed the clinical manifestations of infections due to A. defectiva and Granulicatella species that occurred at our institution between 1998 and 2004.
The analysis included all strains of NVS that were isolated from blood cultures or vascular graft specimens. All strains were identified by 16S rRNA sequence analysis. Patients' medical charts were reviewed for each case of infection.
Eleven strains of NVS were isolated during the 6-year period. Identification of the strains by 16S rRNA showed 2 genogroups: Abiotrophia defectiva (3) and Granulicatella adiacens (6) or "para-adiacens" (2). The three A. defectiva strains were isolated from immunocompetent patients with endovascular infections, whereas 7 of 8 Granulicatella spp. strains were isolated from immunosuppressed patients, mainly febrile neutropenic patients. We report the first case of "G. para-adiacens" bacteraemia in the setting of febrile neutropenia.
We propose that Granulicatella spp. be considered as a possible agent of bacteraemia in neutropenic patients.
过去被称为营养变异型链球菌（NVS）的乏养菌属和颗粒链菌属菌种是心内膜炎和菌血症的重要病原体。在本研究中，我们回顾了1998年至2004年间在我们机构发生的因缺陷乏养菌和颗粒链菌属菌种引起的感染的临床表现。
分析包括从血培养或血管移植标本中分离出的所有NVS菌株。所有菌株均通过16S rRNA序列分析进行鉴定。对每例感染患者的病历进行了回顾。
在这6年期间共分离出11株NVS。通过16S rRNA对菌株进行鉴定显示有2个基因组：缺陷乏养菌（3株）和毗邻颗粒链菌（6株）或“副毗邻颗粒链菌”（2株）。3株缺陷乏养菌菌株是从患有血管内感染的免疫功能正常的患者中分离出来的，而8株颗粒链菌属菌株中的7株是从免疫抑制患者中分离出来的，主要是发热性中性粒细胞减少患者。我们报告了第一例在发热性中性粒细胞减少背景下发生的“副毗邻颗粒链菌”菌血症病例。
我们建议将颗粒链菌属菌种视为中性粒细胞减少患者菌血症的可能病原体。
