Infectious Disease Unit, Hospital Lucus Augusti, Lugo, Spain.
Clin Microbiol Infect. 2014 May;20(5):405-9. doi: 10.1111/1469-0691.12333. Epub 2013 Aug 30.
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).
牛链球菌是一种众所周知的心内膜炎病因，但它在其他感染中的作用尚未得到充分描述。我们前瞻性分析了 1988 年至 2011 年期间所有由牛链球菌群引起的胆道感染患者。我们选择了那些符合东京指南定义的伴有胆管炎和胆囊炎的病例。使用 API 20 Strep 和 Vitek 2 系统的 GP 卡进行菌株鉴定，并通过分子方法确认。我们的系列包括 51 例（30 例胆管炎和 21 例胆囊炎）。相关的微生物有：29 例（57%）为婴儿链球菌（生物型 II/1），20 例（39%）为结肠链球菌亚种。巴氏亚种（生物型 II/2）和 2 例（4%）为结肠链球菌亚种。在婴儿链球菌和结肠链球菌亚种之间发现的唯一区别是前者与恶性胆管狭窄的相关性更大：48%（14/29）与 5%（1/20），p<0.001。37 例病例也伴有菌血症，导致 20%（37/185）的所有牛链球菌菌血症，结肠链球菌亚种。加利福尼亚亚种（2/112；2%）与其他两种微生物（婴儿链球菌和结肠链球菌亚种。巴氏亚种）之间存在差异：35/73；48%；p<0.001）。牛链球菌群引起的胆道感染绝大多数是由婴儿链球菌和结肠链球菌亚种引起的。巴氏亚种（牛链球菌生物型 II），而这两种物种引起的菌血症中近一半（婴儿链球菌的 43%和结肠链球菌亚种。巴氏亚种的 56%）有胆道来源。
