Arjun Rajalakshmi, Niyas Vettakkara Kandy Muhammed, Hussain Febeena, Surendran Sandeep, Mohan Viji
Department of Infectious Diseases, Kimshealth, Thiruvananthapuram, Kerala, India.
Hospital Epidemiology, Kimshealth, Thiruvananthapuram, Kerala, India.
Infez Med. 2024 Mar 1;32(1):37-44. doi: 10.53854/liim-3201-5. eCollection 2024.
Viridans Group Streptococci (VGS) are a group of distinct species that can cause bacteraemia and other invasive infections. They are also among the common organisms causing infective endocarditis. Data on the epidemiology and clinical profile of VGS is limited, especially from India.
We conducted an electronic medical record-based retrospective analysis of patients with VGS bacteraemia admitted to our hospital between January 2012 to December 2021. Blood cultures were incubated by BacT/ALERT system and bacterial identification and susceptibility testing were done by using the VITEK 2 microbial identification system. Susceptibility test reporting was as per Clinical and Laboratory Standards Institute (CLSI) guidelines. The incidence, clinical profile, source of bacteraemia, co-morbidities and antimicrobial resistance among VGS bacteraemia were analyzed.
VGS were isolated in 219 patients, accounting for 3.2% of positive blood cultures during the period studied. The median age of the patients was 58 years and 69% were males. Diabetes mellitus was the most common co-morbidity (55%) followed by chronic kidney disease and chronic liver disease. Patients with haematological malignancy and neutropenia were few. Intra-abdominal infections were the most common source of infection and was noted in 26%. Infective endocarditis was diagnosed in only 10% of the cases. was the most common species isolated followed by and . 9.58% of the isolates could not be identified up to the species level. Overall penicillin susceptibility was 71% and ceftriaxone susceptibility was 92%, with individual species variation. In-hospital mortality was 19%.
VGS are an important cause of bacteraemia and was associated with 19% mortality in our study. High rates of penicillin and ceftriaxone resistance are a reason of concern. Molecular diagnostics like matrix assisted laser desorption ionization-time of flight (MALDI-TOF) identification must be increasingly applied for species identification considering that a substantial number of isolates were not identified to species level.
草绿色链球菌（VGS）是一组不同的菌种，可引起菌血症及其他侵袭性感染。它们也是引起感染性心内膜炎的常见病原体之一。关于VGS的流行病学和临床特征的数据有限，尤其是来自印度的数据。
我们对2012年1月至2021年12月期间我院收治的VGS菌血症患者进行了基于电子病历的回顾性分析。血培养采用BacT/ALERT系统进行孵育，细菌鉴定和药敏试验采用VITEK 2微生物鉴定系统。药敏试验报告按照临床和实验室标准协会（CLSI）指南进行。分析了VGS菌血症的发病率、临床特征、菌血症来源、合并症及抗菌药物耐药情况。
在所研究期间，219例患者分离出VGS，占阳性血培养的3.2%。患者的中位年龄为58岁，69%为男性。糖尿病是最常见的合并症（55%），其次是慢性肾脏病和慢性肝病。血液系统恶性肿瘤和中性粒细胞减少的患者较少。腹腔内感染是最常见的感染源，占26%。仅10%的病例诊断为感染性心内膜炎。 是最常分离出的菌种，其次是 和 。9.58%的分离株无法鉴定到种水平。总体青霉素敏感性为71%，头孢曲松敏感性为92%，各菌种存在差异。院内死亡率为19%。
VGS是菌血症的重要病因，在我们的研究中死亡率为19%。青霉素和头孢曲松的高耐药率令人担忧。鉴于大量分离株未鉴定到种水平，必须越来越多地应用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）等分子诊断方法进行菌种鉴定。
