Shongwe Nkosinathi S, Mabena Fikile C, Wadula Jeannette, Petersen Karen
Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
S Afr J Infect Dis. 2024 Apr 29;39(1):563. doi: 10.4102/sajid.v39i1.563. eCollection 2024.
Viridans Group Streptococci (VGS) are often considered organisms of low virulence; however, infection can result in clinically significant sepsis and life-threatening complications in paediatric patients.
This study aimed to describe the spectrum of clinical presentation of VGS bacteraemia in paediatric patients, to analyse risk factors, and to describe the antibiotics resistance patterns of VGS.
Cultures of VGS in paediatric patients admitted to Chris Hani Baragwanath Academic Hospital in 2019 were identified through National Health Laboratory Service. Data were extracted from archived clinical records and analysed. Sepsis scores were calculated at the time of bacteraemia.
A total of 133 cultures were identified; 64 (48.1%) polymicrobial cultures and no records 4 (0.03%) were excluded; 65 (48.9%) were analysed. The median age was 1.5 months (range 0.03 to 168, interquartile range [IQR]: 0.3-13.25), 27/65 (42%) were neonates. The median duration of hospitalisation was 7 days (IQR: 3-21). The commonest diagnoses were neonatal sepsis 30.8% ( = 20) and pneumonia 28% ( = 18). The systemic inflammatory response syndrome (SIRS) score was ≥ 2 in 57% (16/28) patients; paediatric sequential organ failure assessment (pSOFA) score was > 2 in 10/24 (42%). Fifty-seven (88%) patients were discharged; three (5%) required ICU admission and 8/65 (12.3%) died. Malnutrition was present in 50% of patients who died. Cephalosporins and penicillin had sensitivity of 89% and 55%, respectively.
Viridans Group Streptococci bacteraemia was common in neonates, and pneumonia was a common presentation in this cohort. The VGS bacteraemia was associated with morbidity and deaths in this cohort.
The VGS should be considered a significant organism when cultured from sterile sites and routine antibiotic susceptibility testing should be performed. Prospective studies are recommended.
草绿色链球菌（VGS）通常被认为是低毒力微生物；然而，感染可导致儿科患者发生具有临床意义的败血症和危及生命的并发症。
本研究旨在描述儿科患者VGS菌血症的临床表现谱，分析危险因素，并描述VGS的抗生素耐药模式。
通过国家卫生实验室服务机构对2019年入住克里斯·哈尼·巴拉格瓦纳特学术医院的儿科患者的VGS培养物进行鉴定。从存档的临床记录中提取数据并进行分析。在菌血症发生时计算败血症评分。
共鉴定出133份培养物；64份（48.1%）为混合菌培养物，4份（0.03%）无记录被排除；65份（48.9%）进行了分析。中位年龄为1.5个月（范围0.03至168个月，四分位间距[IQR]：0.3 - 13.25），27/65（42%）为新生儿。中位住院时间为7天（IQR：3 - 21）。最常见的诊断为新生儿败血症30.8%（n = 20）和肺炎28%（n = 18）。57%（16/28）的患者全身炎症反应综合征（SIRS）评分≥2；10/24（42%）的患者儿科序贯器官衰竭评估（pSOFA）评分>2。57名（88%）患者出院；3名（5%）需要入住重症监护病房，8/65（12.3%）死亡。50%的死亡患者存在营养不良。头孢菌素和青霉素的敏感性分别为89%和55%。
草绿色链球菌菌血症在新生儿中常见，肺炎是该队列中的常见表现。该队列中VGS菌血症与发病和死亡相关。
从无菌部位培养出VGS时应将其视为重要微生物，并应进行常规抗生素敏感性试验。建议进行前瞻性研究。
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