Yacoub Abraham T, Krishnan Jayasree, Acevedo Ileana M, Halliday Joseph, Greene John N
H. Lee Moffitt Cancer Center and Research Institute. 12902 Magnolia Drive. Tampa, Florida 33612-9497.
University of South Florida, Morsani College of Medicine, Division of Infectious Disease and International Medicine, 1 Tampa General Circle, G323.
Mediterr J Hematol Infect Dis. 2015 Apr 20;7(1):e2015030. doi: 10.4084/MJHID.2015.030. eCollection 2015.
Nutritionally variant Streptococci (NVS), Abiotrophia and Granulicatella are implicated in causing endocarditis and blood stream infections more frequently than other sites of infection. Neutropenia and mucositis are the most common predisposing factors for infection with other pathogens in cancer patients. In this study, we investigated the clinical characteristics of NVS bacteremia in cancer patients and identified risk factors and outcomes associated with these infections.
We retrospectively reviewed all cases of NVS bacteremia occurring from June 1999 to April 2014 at H. Lee Moffitt Cancer Center and Research Institute. The computerized epidemiology report provided by the microbiology laboratory identified thirteen cancer patients with NVS bacteremia. We collected data regarding baseline demographics and clinical characteristics such as age, sex, underlying malignancy, neutropenic status, duration of neutropenia, treatment, and outcome.
Thirteen patients were identified with positive NVS blood stream infection. Ten patients (77%) had hematologic malignancies, including chronic lymphocytic leukemia (CLL)(1), multiple myeloma (MM)(1), acute myelogenous leukemia (AML)(4), and non-Hodgkin's lymphoma (NHL)(4). The non-hematologic malignancies included esophageal cancer(2) and bladder cancer (1).
NVS should be considered as a possible agent of bacteremia in cancer patients with neutropenia and a breach in oral, gastrointestinal and genitourinary mucosa (gingivitis/mucositis).
营养变异型链球菌（NVS）、乏养菌属和颗粒链菌属比其他感染部位更常引发心内膜炎和血流感染。中性粒细胞减少和粘膜炎是癌症患者感染其他病原体最常见的诱发因素。在本研究中，我们调查了癌症患者中NVS菌血症的临床特征，并确定了与这些感染相关的危险因素和结局。
我们回顾性分析了1999年6月至2014年4月在H. Lee Moffitt癌症中心和研究所发生的所有NVS菌血症病例。微生物实验室提供的计算机化流行病学报告确定了13例患有NVS菌血症的癌症患者。我们收集了有关基线人口统计学和临床特征的数据，如年龄、性别、潜在恶性肿瘤、中性粒细胞减少状态、中性粒细胞减少持续时间、治疗和结局。
确定了13例NVS血流感染阳性患者。10例患者（77%）患有血液系统恶性肿瘤，包括慢性淋巴细胞白血病（CLL）（1例）、多发性骨髓瘤（MM）（1例）、急性髓细胞白血病（AML）（4例）和非霍奇金淋巴瘤（NHL）（4例）。非血液系统恶性肿瘤包括食管癌（2例）和膀胱癌（1例）。
对于患有中性粒细胞减少症且口腔、胃肠道和泌尿生殖黏膜（牙龈炎/粘膜炎）有破损的癌症患者，应将NVS视为菌血症的可能病原体。
