[Clinical significance of bacteremia caused by streptococci of the viridans group].

BACKGROUND

The viridans group Streptococcus (SVG) include species which may have different pathogenic capacity. This study was aimed at evaluating the clinical significance of bacteremia by different species of SVG.

PATIENTS AND

METHODS

One hundred ninety-four clinical records of patients with blood culture(s) isolation (Hémoline/BioMérieux) of SVG (Api 20 STREP/BioMérieux) over 9 years were reviewed with criteria of clinical significance being established and the results analyzed by the chi square test.

RESULTS

The most frequent species of SVG isolated were: S. sanguis II (29.4%), S. mitis (27.3%) and S. anginosus (12.9%). With regard to the criteria established, 36% of the isolates were clinically significant, associating S. anginosus with significant bacteremia (p = 0.001) and S. mitis with non significant bacteremia (p = 0.04). More than half of the isolations of S. anginosus, S. bovis, S. mutans and S. adjacens were clinically significant with this rate being lower in the remaining species (S. sanguis I, S. sanguis II, S. mitis, S. salivarius and S. acidominimus). The significant isolations correspond with endocarditis (S. sanguis II being responsible for 44%; p = 0.05). In 54.3% of the cases followed by abscesses or other localized infections and severe sepsis in patients with a solid or hematologic tumor with a mortality of 20%. The endocarditis/other disease relation was: greater for the existence of endocarditis for S. sanguis II, S. sanguis I, S. mutans, S. bovis and S. adjacens; similar in both diseases for S. mitis, and greater for the existence of a non endocardic disease for S. anginosus.

CONCLUSIONS

In this series the isolation of SVG group was clinically significant in 36% of cases with a probability of clinical significance and disease association related to the species isolated of SVG.