Basaranoglu Sevgen Tanır, Ozsurekci Yasemin, Aykac Kubra, Aycan Ahmet Emre, Bıcakcigil Asiye, Altun Belgin, Sancak Banu, Cengiz Ali Bülent, Kara Ates, Ceyhan Mehmet
Department of Pediatric Infectious Diseases, Hacettepe University Faculty of Medicine.
Department of Microbiology, Hacettepe University Faculty of Medicine.
Jpn J Infect Dis. 2019 Jan 23;72(1):1-6. doi: 10.7883/yoken.JJID.2018.074. Epub 2018 Aug 31.
Viridans streptococci are still under investigation concerning epidemiology, pathogenesis and clinical presentations. We aimed to investigate the clinical presentations and outcomes of pediatric patients infected with Streptococcus mitis/oralis. Based on the accumulation of bloodstream infections (BSI) caused by S. mitis/oralis in 4 patients in our Hematology and Bone Marrow Transplantation Department at a particular time, a review of the medical and microbiological records of pediatric patients with positive blood cultures for S. mitis/oralis in the entire hospital was performed. In addition, a retrospective case-control study was conducted. Pulsed-field gel electrophoresis of S. mitis/oralis in 4 patients displayed unrelatedness of the strains. A total of 53 BSI (42 BSI and 11 catheter-related BSI) were analyzed. Thirty-four percent of patients with BSI caused by S. mitis/oralis had febrile neutropenia. Clinical and microbiological outcomes were favorable and infection-related mortality was not observed. Although not significant, previous antibiotic use and trimethoprim-sulfamethoxazole prophylaxis were more common in the case group. S. mitis/oralis seems likely an important agent in bacteremic children who are particularly neutropenic because of the underlying hematologic and oncologic diseases. Prompt management of infections with appropriate antimicrobials, regarding antibiotic susceptibilities of organisms, may facilitate favorable outcomes.
关于草绿色链球菌的流行病学、发病机制和临床表现仍在研究中。我们旨在调查感染缓症链球菌/口腔链球菌的儿科患者的临床表现和结局。基于我们血液学和骨髓移植科在特定时间4例由缓症链球菌/口腔链球菌引起的血流感染（BSI）病例的积累，我们对全院缓症链球菌/口腔链球菌血培养阳性的儿科患者的医疗和微生物学记录进行了回顾。此外，还进行了一项回顾性病例对照研究。4例患者的缓症链球菌/口腔链球菌脉冲场凝胶电泳显示菌株不相关。共分析了53例BSI（42例BSI和11例导管相关BSI）。由缓症链球菌/口腔链球菌引起的BSI患者中，34%有发热性中性粒细胞减少症。临床和微生物学结局良好，未观察到感染相关死亡。虽然差异无统计学意义，但病例组中既往使用抗生素和复方新诺明预防更为常见。由于潜在的血液学和肿瘤性疾病，缓症链球菌/口腔链球菌似乎可能是菌血症患儿尤其是中性粒细胞减少患儿的重要病原体。根据病原体的抗生素敏感性，及时使用适当的抗菌药物治疗感染可能有助于取得良好结局。
