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Frontiers in Microbiology 2022Three distinct streptococcal species: , and , belonging to the group (SAG), also known as group, have been attracting clinicians and microbiologists, not only as oral... (Review)
Review
Three distinct streptococcal species: , and , belonging to the group (SAG), also known as group, have been attracting clinicians and microbiologists, not only as oral commensals but also as opportunistic pathogens. For years they have been simply classified as so called viridans streptococci, and distinct species were not associated with particular clinical manifestations. Therefore, description of SAG members are clearly underrepresented in the literature, compared to other medically relevant streptococci. However, the increasing number of reports of life-threatening infections caused by SAG indicates their emerging pathogenicity. The improved clinical data generated with the application of modern molecular diagnostic techniques allow for precise identification of individual species belonging to SAG. This review summarizes clinical reports on SAG infections and systematizes data on the occurrence of individual species at the site of infection. We also discuss the issue of proper microbiological diagnostics, which is crucial for further clinical treatment.
PubMed: 35898914
DOI: 10.3389/fmicb.2022.956677 -
Cureus Apr 2021The group (SAG) consists of three bacteria (, , and ) that are known commensals of the upper respiratory, digestive, and reproductive tracts. While a rare occurrence,...
The group (SAG) consists of three bacteria (, , and ) that are known commensals of the upper respiratory, digestive, and reproductive tracts. While a rare occurrence, these bacteria have the capability of causing devastating pyogenic infections and ensuing abscess formations. It is often difficult to distinguish this group as a contaminant or the offending organism (as it is often cultured in respiratory specimens); therefore, it is important to understand the risk factors, clinical presentation, and diagnostic findings that can provide a more accurate picture to identify the organism. Published literature pertaining to the SAG group has rarely documented any invasive surgical intervention that was undertaken for treatment. We describe a case of a 59-year-old male who presented for persistent chest pain and profuse productive cough weeks after he was diagnosed with a left lower extremity deep vein thrombosis and right-sided pulmonary embolism. The patient was found to have a rapidly evolving right middle lobe lung abscess complicated by a right hemithorax empyema. Management included an exploration of the right chest, decortication, parietal pleurectomy, and partial excision of the right middle lobe. Subsequently, the patient completed four weeks of antibiotics with ertapenem.
PubMed: 34017651
DOI: 10.7759/cureus.14534 -
Infection and Drug Resistance 2022, a commensal, plays an important role in purulent infections. It has been reported as aggressive pathogen causing pleural empyema. But the role of in empyema has not...
BACKGROUND
, a commensal, plays an important role in purulent infections. It has been reported as aggressive pathogen causing pleural empyema. But the role of in empyema has not been taken seriously. There are no studies about clinical characteristics of empyema caused by domestically and abroad. This study aimed to explore the clinical features and management of empyema caused by .
METHODS
A retrospective review of 9 patients diagnosed with empyema caused by in a hospital between January 2010 and August 2021 was performed.
RESULTS
empyema were mostly seen in old males (66.7%) with comorbid diseases. The high-risk factors include diabetes mellitus, oral infection, and oral surgery. All were unilateral encapsulated empyema (right-side, 55.6%), diagnosed with pneumonia (bilateral pneumonia, 88.9%; ipsilateral lung abscess, 44.4%). 33.3% of patients had and anaerobes co-isolated. were sensitive to penicillin G, linezolid, levofloxacin, vancomycin, ceftriaxone, and chloramphenicol, resistant to erythromycin, tetracycline, and clindamycin. 33.3% of the patients needed ventilator support. The primary treatment to empyema was timely pus drainage, intravenous antibiotics, and enough nutrition support, intrapleural fibrinolytics and surgery (VAST recommended first) in necessity.
CONCLUSION
may cause pneumonia and lung abscess first and then spread to cause empyema mainly in old males with comorbid diseases. often co-isolated with anaerobes in empyema. Antibiotics should cover simultaneously both and anaerobes.
PubMed: 36329986
DOI: 10.2147/IDR.S382484 -
Cureus Aug 2023A 60-year-old male presented to our institution for abdominal pain and was later admitted to the intensive care unit for shock, acute hypoxemic respiratory failure, and...
A 60-year-old male presented to our institution for abdominal pain and was later admitted to the intensive care unit for shock, acute hypoxemic respiratory failure, and acute kidney injury. He was subsequently found to have a large left-sided pleural effusion with empyema secondary to . With the emerging threat and growing prevalence of group pathogens, there is now greater clinical importance in identifying viridans streptococci at the species level. While immunosuppressed individuals are at greater risk of opportunistic pathogens, this case presentation demonstrated that can remain a serious community-acquired pathogen for the non-immunosuppressed. Continued interprofessional team care management and a greater look into the reasons for greater pathogenicity may be indicated.
PubMed: 37711946
DOI: 10.7759/cureus.43468 -
BMC Infectious Diseases Dec 2021Streptococcus constellatus is a member of Streptococcus anginosus group (SAG) that tends to cause pyogenic infections in various sites. However, Streptococcus... (Review)
Review
BACKGROUND
Streptococcus constellatus is a member of Streptococcus anginosus group (SAG) that tends to cause pyogenic infections in various sites. However, Streptococcus constellatus is easily ignored by routine clinical laboratory tests for its prolonged anaerobic culture environment.
CASE PRESENTATION
A 71-year-old man was admitted to our hospital due to productive cough, fever, chest pain and shortness of breath for 3 weeks. Chest computed tomography showed patchy opacities and right-sided pleural effusion, so a chest tube was inserted and purulent and hemorrhagic fluid was aspirated. The routine etiological examinations of the pleural effusion were all negative, and next-generation sequencing (NGS) detected Streptococcus constellatus. Intravenous piperacillin-tazobactam 4.5 g every 8 h was used accordingly. The patient recovered and subsequent chest computed tomography confirmed the improvement.
CONCLUSIONS
We reported a case of empyema secondary to Streptococcus constellatus infection, which was identified by NGS, instead of bacterial culture. This case highlights the utility of NGS in detecting pathogens negative in traditional bacterial tests.
Topics: Aged; Empyema; Fever; Humans; Laboratories, Clinical; Male; Streptococcal Infections; Streptococcus constellatus
PubMed: 34930151
DOI: 10.1186/s12879-021-06955-2 -
Journal of Oral Microbiology 2023The current study aimed to test the hypothesis that Parkinson's disease exacerbates periodontitis by altering its microbiome.
AIM
The current study aimed to test the hypothesis that Parkinson's disease exacerbates periodontitis by altering its microbiome.
MATERIALS AND METHODS
Clinical periodontal parameters were recorded. Subgingival samples from healthy controls, periodontitis patients (PD), and Parkinson's patients with periodontitis (PA+PD) were analyzed using the checkerboard DNA-DNA hybridization technique for targeting 40 bacterial species typically associated with periodontal disease and health. Next-generation sequencing (NGS) of the 16S ribosomal RNA gene (V1-V3 regions) was performed to analyze the microbiome comprehensively.
RESULTS
Parkinson's patients had mild-to-moderate motor dysfunctions. Bleeding on probing was significantly increased in the PA+PD group compared to PD ( < 0.05). With checkerboard analysis, PA was associated with increased ( = 0.0062), ( = 0.0439), ( < 0.0001), ( = 0.0002), ( < 0.0001), and ( = 0.0020). ( = 0.0042), ( = 0.0022), ( = 0.0002), ( = 0.0045), ( = 0.0267), ( = 0.0017), ( = 0.0020), and ( = 0.0002) were higher; ( = 0.0072) was lower in deep pockets in the PA+PD compared to PD. ( = 0.0351) and ( = 0.002) were lower; ( = 0.0002), ( = 0065), ( = 0.0151), ( = 0.0141), ( = 0.0057), and ( = 0.0316) were higher in shallow pockets in the PA+PD. Diversity decreased in PD ( = 0.001) and PA+PD ( = 0.026) compared to control, with minimal differences in alpha and beta diversities among PD and PA+PD based on NGS results.
CONCLUSION
These data demonstrated that Parkinson's disease modifies PD-associated subgingival microbiome.
PubMed: 37649970
DOI: 10.1080/20002297.2023.2250650 -
Cureus Dec 2023Lemierre syndrome is characterized by thrombophlebitis of the internal jugular vein (IJV) secondary to bacterial pharyngitis or tonsillitis. Though antibiotic use has...
Lemierre syndrome is characterized by thrombophlebitis of the internal jugular vein (IJV) secondary to bacterial pharyngitis or tonsillitis. Though antibiotic use has made this a rarer syndrome, it can nevertheless manifest in patients presenting with pharyngitis. Herein, we describe a 20-year-old male patient with no relevant medical history presenting with signs concerning for pneumonia and was ultimately diagnosed with Lemierre syndrome with bacteremia. Complications included IJV thrombus with presumed septic emboli to the lungs. The patient was discharged on ampicillin/sulbactam with plans to transition to amoxicillin/clavulanate.
PubMed: 38222167
DOI: 10.7759/cureus.50580 -
Frontiers in Microbiology 2022together with and constitute the group (SAG), until recently considered to be benign commensals of the human mucosa isolated predominantly from oral cavity, but also... (Review)
Review
together with and constitute the group (SAG), until recently considered to be benign commensals of the human mucosa isolated predominantly from oral cavity, but also from upper respiratory, intestinal, and urogenital tracts. For years the virulence potential of SAG was underestimated, mainly due to complications in correct species identification and their assignment to the physiological microbiota. Still, SAG representatives have been associated with purulent infections at oral and non-oral sites resulting in abscesses formation and empyema. Also, life threatening blood infections caused by SAG have been reported. However, the understanding of SAG as potential pathogen is only fragmentary, albeit certain aspects of SAG infection seem sufficiently well described to deserve a systematic overview. In this review we summarize the current state of knowledge of the pathogenicity factors and their mechanisms of action.
PubMed: 36386673
DOI: 10.3389/fmicb.2022.1025136 -
Cureus Jul 2022The authors present the case of a 29-year-old female diagnosed with acute appendicitis who underwent an uneventful laparoscopic appendectomy. Three weeks later, she...
The authors present the case of a 29-year-old female diagnosed with acute appendicitis who underwent an uneventful laparoscopic appendectomy. Three weeks later, she returned to the emergency department with fevers, abdominal pain, chills, and nausea. Laboratory analysis revealed elevated liver enzymes and leukocytosis, and a computed tomography scan of the abdomen revealed a liver abscess. Interventional radiology placed an 8 French drainage catheter in the hepatic abscess and drained 40cc of purulent fluid. A culture of the abscess fluid revealed Streptococcus constellatus, Bacteroides fragilis, and Bacteroides ovatus. We believe appendicitis causes hematogenous spreading of bowel organisms along the portal vein, which is seeded to the liver.
PubMed: 35978753
DOI: 10.7759/cureus.26867