Amado Cristina, Hidalgo M José, Sedano Cecilia, Hebel Allan, Porte Lorena, Braun Stephanie, Dabanch Jeannette, Fica Alberto
Rev Chilena Infectol. 2015 Aug;32(4):430-4. doi: 10.4067/S0716-10182015000500009.
Bacteremia due to Streptococcus bovis (now S. gallolyticus) has been traditionally associated to colon or hepatobiliar disease and endocarditis but there is no information on this matter in Chile.
To describe clinical features of adult patients suffering bacteremia by S. bovis/S. gallolyticus, identify the source of the bacteremia and the frequency of endocarditis.
Retrospective-descriptive study using laboratory records.
Between January 2003 and August 2014, 23 S. bovis/S. gallolyticus bacteremic events were identified among 22 patients. Mean age was 72.7 years (range 46-96). Co-morbidities were frequent (9.1 to 47.6%). The primary source of bacteremia was intestinal in 52.2%; hepatobiliar in 17.4% and in 34.8% it was not elucidated. Six patients had infective endocarditis (26.1%) and one patient had espondylodiscitis (4.3%). S. bovis represented 39.1% of isolates (all until 2008), S. gallolyticus subsp pasteurianus 39.1% and, S. gallolyticus subsp infantarius and S. gallolyticus subsp gallolyticus 8.7% each one, respectively. Association studies between the bacteremic source or endocarditis with specific S. gallolyticus subspecies were limited by the small number of isolates. Seven patients (30.4%) underwent surgical interventions. In-hospital mortality reached 21.7% (n=5).
Although infrequent, bacteremic events by S. gallolyticus/S. bovis have increased in-hospital mortality, require surgical intervention and affect older patients with co-morbidities. Near two-thirds suffer from colonic or hepatobiliary disease that act as the primary source of bacteremia. In addition, near one fourth is affected by infective endocarditis. Detection of S. gallolyticus/S. bovis in blood cultures prompts a thorough clinical evaluation in order to clarify the source of the bloodstream infection and the presence of complications.
牛链球菌（现称解脲链球菌）所致菌血症传统上与结肠或肝胆疾病及心内膜炎相关，但智利尚无关于此问题的信息。
描述成人解脲链球菌/牛链球菌所致菌血症患者的临床特征，确定菌血症来源及心内膜炎发生率。
采用实验室记录进行回顾性描述性研究。
2003年1月至2014年8月期间，在22例患者中确定了23次解脲链球菌/牛链球菌菌血症事件。平均年龄为72.7岁（范围46 - 96岁）。合并症常见（9.1%至47.6%）。菌血症的主要来源为肠道占52.2%；肝胆占17.4%，34.8%未明确。6例患者患有感染性心内膜炎（26.1%），1例患者患有脊椎盘炎（4.3%）。牛链球菌占分离株的39.1%（均为2008年以前），解脲亚种巴氏亚种占39.1%，解脲亚种婴儿亚种和解脲亚种解脲亚种各占8.7%。由于分离株数量少，菌血症来源或心内膜炎与特定解脲链球菌亚种之间的关联研究受限。7例患者（30.4%）接受了手术干预。住院死亡率达21.7%（n = 5）。
尽管不常见，但解脲链球菌/牛链球菌所致菌血症事件增加了住院死亡率，需要手术干预，并影响有合并症的老年患者。近三分之二患有结肠或肝胆疾病，这些疾病是菌血症的主要来源。此外，近四分之一受感染性心内膜炎影响。血培养中检测到解脲链球菌/牛链球菌提示进行全面临床评估，以明确血流感染的来源及并发症的存在。
