PDF(Pubmed)
Abstract：
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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. Streptococcus mitis was the most common species isolated followed by S. gallolyticus and S. sanguinis. 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%.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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. Streptococcus mitis was the most common species isolated followed by S. gallolyticus and S. sanguinis. 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%.
UNASSIGNED: 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.
摘要：
■Viridans群链球菌（VGS）是一组可引起菌血症和其他侵袭性感染的独特物种。它们也是引起感染性心内膜炎的常见生物之一。VGS的流行病学和临床资料有限，尤其是来自印度。
■我们对2012年1月至2021年12月我院收治的VGS菌血症患者进行了基于电子病历的回顾性分析。血培养物用BacT/ALERT系统孵育，用VITEK2微生物鉴定系统进行细菌鉴定和药敏试验。药敏试验报告按照临床和实验室标准协会(CLSI)指南。发病率，临床资料,菌血症的来源，分析了VGS菌血症的共病和耐药性。
■在219例患者中分离出VGS，占研究期间血培养阳性的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％），其次是慢性肾脏疾病和慢性肝病。血液系统恶性肿瘤和中性粒细胞减少症的患者很少。腹腔内感染是最常见的感染源，占26％。仅在10％的病例中诊断出感染性心内膜炎。中炎链球菌是最常见的分离物种，其次是溶胆囊链球菌和血链球菌。9.58％的分离株无法达到物种水平。青霉素的总体敏感性为71％，头孢曲松的敏感性为92％，与个别物种的变异。住院死亡率为19%。
■VGS是菌血症的重要原因，在我们的研究中与19％的死亡率相关。青霉素和头孢曲松的高耐药率是令人担忧的原因。考虑到大量分离株未被鉴定到物种水平，必须越来越多地应用分子诊断，例如基质辅助激光解吸电离飞行时间（MALDI-TOF）鉴定。
■我们对2012年1月至2021年12月我院收治的VGS菌血症患者进行了基于电子病历的回顾性分析。血培养物用BacT/ALERT系统孵育，用VITEK2微生物鉴定系统进行细菌鉴定和药敏试验。药敏试验报告按照临床和实验室标准协会(CLSI)指南。发病率，临床资料,菌血症的来源，分析了VGS菌血症的共病和耐药性。
■在219例患者中分离出VGS，占研究期间血培养阳性的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％），其次是慢性肾脏疾病和慢性肝病。血液系统恶性肿瘤和中性粒细胞减少症的患者很少。腹腔内感染是最常见的感染源，占26％。仅在10％的病例中诊断出感染性心内膜炎。中炎链球菌是最常见的分离物种，其次是溶胆囊链球菌和血链球菌。9.58％的分离株无法达到物种水平。青霉素的总体敏感性为71％，头孢曲松的敏感性为92％，与个别物种的变异。住院死亡率为19%。
■VGS是菌血症的重要原因，在我们的研究中与19％的死亡率相关。青霉素和头孢曲松的高耐药率是令人担忧的原因。考虑到大量分离株未被鉴定到物种水平，必须越来越多地应用分子诊断，例如基质辅助激光解吸电离飞行时间（MALDI-TOF）鉴定。
