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Circulation May 2021In 2007, the American Heart Association published updated evidence-based guidelines on the recommended use of antibiotic prophylaxis to prevent viridans group... (Review)
Review
BACKGROUND
In 2007, the American Heart Association published updated evidence-based guidelines on the recommended use of antibiotic prophylaxis to prevent viridans group streptococcal (VGS) infective endocarditis (IE) in cardiac patients undergoing invasive procedures. The 2007 guidelines significantly scaled back the underlying conditions for which antibiotic prophylaxis was recommended, leaving only 4 categories thought to confer the highest risk of adverse outcome. The purpose of this update is to examine interval evidence of the acceptance and impact of the 2007 recommendations on VGS IE and, if needed, to make revisions based on this evidence.
METHODS AND RESULTS
A writing group was formed consisting of experts in prevention and treatment of infective endocarditis including members of the American Dental Association, the Infectious Diseases Society of America, and the American Academy of Pediatrics, in addition to the American Heart Association. MEDLINE database searches were done for English language articles on compliance with the recommendations in the 2007 guidelines and the frequency of and morbidity or mortality from VGS IE after publication of the 2007 guidelines. Overall, there was good general awareness of the 2007 guidelines but variable compliance with recommendations. There was no convincing evidence that VGS IE frequency, morbidity, or mortality has increased since 2007.
CONCLUSIONS
On the basis of a review of the available evidence, there are no recommended changes to the 2007 VGS IE prevention guidelines. We continue to recommend VGS IE prophylaxis only for categories of patients at highest risk for adverse outcome while emphasizing the critical role of good oral health and regular access to dental care for all. Randomized controlled studies to determine whether antibiotic prophylaxis is effective against VGS IE are needed to further refine recommendations.
Topics: American Heart Association; Endocarditis; Humans; United States; Viridans Streptococci
PubMed: 33853363
DOI: 10.1161/CIR.0000000000000969 -
The Pediatric Infectious Disease Journal Sep 2021Viridans group streptococci (VGS) are an important cause of sepsis in immunosuppressed children. We reviewed the effectiveness of risk-stratified addition of vancomycin... (Review)
Review
Viridans group streptococci (VGS) are an important cause of sepsis in immunosuppressed children. We reviewed the effectiveness of risk-stratified addition of vancomycin to empiric febrile neutropenia therapy among 107 children with leukemia or undergoing an allogeneic transplant. Of 19 VGS bacteremia episodes, 78.9% were susceptible to risk-stratified antibiotics including 100% from high-risk patients. All blood cultures were flagged positive within 24 hours.
Topics: Anti-Bacterial Agents; Child; Child, Preschool; Febrile Neutropenia; Female; Hematopoietic Stem Cell Transplantation; Humans; Leukemia; Male; Microbial Sensitivity Tests; Practice Guidelines as Topic; Prospective Studies; Streptococcal Infections; Vancomycin; Viridans Streptococci
PubMed: 34285167
DOI: 10.1097/INF.0000000000003210 -
Clinical Infectious Diseases : An... Jul 2014
Topics: Bacteremia; Decision Support Techniques; Female; Humans; Male; Neoplasms; Neutropenia; Streptococcal Infections; Viridans Streptococci; beta-Lactam Resistance
PubMed: 24755859
DOI: 10.1093/cid/ciu264 -
Journal of the Pediatric Infectious... Jul 2023
Topics: Humans; Child; Fluoroquinolones; Levofloxacin; Anti-Bacterial Agents; Viridans Streptococci; Sepsis
PubMed: 37490395
DOI: 10.1093/jpids/piad049 -
Biocontrol Science 2020Viridans group streptococci (VGS) are a common cause of infective endocarditis, and dental plaque is the major source of these bacteria. The present study examined the...
Viridans group streptococci (VGS) are a common cause of infective endocarditis, and dental plaque is the major source of these bacteria. The present study examined the antibiotic resistance of 635 VGS isolates obtained from dental plaques. Isolates from supragingival plaques were identified using the rapid ID 32 Strep and mini API reader (bioMérieux, France), and minimal inhibitory concentrations (MICs) were determined by a broth microdilution method. High rates of resistance to ampicillin and tetracycline were detected among the isolates. The most resistant species were Streptococcus sanguinis and Streptococcus salivarius. Among the 635 isolates, 9.1% were resistant to erythromycin, and 20.6% to tetracycline. All isolates were sensitive to vancomycin. Resistance to amoxicillin was observed in 0.2% of all isolates. In this study, we showed the incidence of antimicrobial resistance and the susceptibility patterns among 635 VGS isolates from dental plaque.
Topics: Anti-Bacterial Agents; Dental Plaque; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Viridans Streptococci
PubMed: 32938847
DOI: 10.4265/bio.25.173 -
Peritoneal Dialysis International :... 2015The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear.
BACKGROUND
The clinical courses and long-term outcomes of viridans streptococcus (VS) peritoneal dialysis (PD) peritonitis remain unclear.
METHODS
We conducted a retrospective analysis of all PD patients in a single center with gram-positive cocci (GPC) peritonitis between 2005 and 2011, and divided them into 3 groups: VS, other streptococci and other GPC (apart from VS). Clinical characteristics and outcomes of the VS group were compared with the other streptococci and other GPC groups, with prognostic factors determined.
RESULTS
A total of 140 patients with 168 episodes of GPC peritonitis (44% of all peritonitis) were identified over 7 years. Among these, 18 patients (13%) developed VS peritonitis, while 14 patients (10%) developed other streptococcal peritonitis. Patients with VS peritonitis had a high cure rate by antibiotic alone (94%), despite a high polymicrobial yield frequency (28%). We found that VS peritonitis carried a lower risk of Tenckhoff catheter removal and relapsing episodes than other GPC peritonitis (6% vs 11%), and a lower mortality than other streptococci peritonitis (0% vs 7%). However, after the index peritonitis episodes, VS, other streptococci, and other GPC group had a significantly increased peritonitis incidence compared with the period before the index peritonitis (all p < 0.01). Patients with VS peritonitis had a significantly higher incidence of refractory peritonitis compared with other streptococci or other GPC peritonitis in the long term (both p < 0.01).
CONCLUSIONS
VS poses a higher risk of subsequent refractory peritonitis after the index episode as compared with other streptococcal or GPC peritonitis. It might be prudent to monitor the technique of these patients with VS peritonitis closely to avoid further peritonitis episodes.
Topics: Female; Follow-Up Studies; Humans; Incidence; Kidney Failure, Chronic; Male; Middle Aged; Peritoneal Dialysis; Peritonitis; Retrospective Studies; Streptococcal Infections; Taiwan; Time Factors; Viridans Streptococci
PubMed: 24497584
DOI: 10.3747/pdi.2013.00108 -
Indian Journal of Medical Microbiology 2016The viridans group streptococci are a heterogeneous group of organisms which exist as commensals in the oropharynx and the gut. They cause serious infections when they... (Review)
Review
The viridans group streptococci are a heterogeneous group of organisms which exist as commensals in the oropharynx and the gut. They cause serious infections when they gain entry into sterile sites particularly in patients with predisposing conditions. Classification and species differentiation of these organisms has always been a challenge because of phenotypic differences between strains of the same species. Facklam's typing scheme based on six metabolic properties has been the most widely used and many commercial identification systems are based on it. Due to the ambiguity in species differentiation based on phenotypic tests, nucleic acid-based methods have been developed to improve the identification of these organisms. Results using genotypic methods such as 16S rRNA and sodA gene sequencing have been promising. Multilocus sequence analysis of seven house-keeping genes map, pfl, pyk, ppaC, rpoB, soda and tuf amplified by polymerase chain reaction was found to be an accurate alternative to other methods and could be useful in the characterisation of larger collections of isolates.
Topics: Bacterial Proteins; Bacterial Typing Techniques; Humans; Molecular Diagnostic Techniques; Multilocus Sequence Typing; RNA, Bacterial; RNA, Ribosomal, 16S; Streptococcal Infections; Viridans Streptococci
PubMed: 27934818
DOI: 10.4103/0255-0857.195371 -
Archives of Disease in Childhood Sep 2006In children under 5 years of age, presenting to the paediatric emergency room with clinical and radiological findings of pneumonia, viridans streptococci were isolated...
In children under 5 years of age, presenting to the paediatric emergency room with clinical and radiological findings of pneumonia, viridans streptococci were isolated in 10/33 positive haemocultures as the only microorganism. Viridans streptococci should therefore not be ruled out as a cause of pneumonia.
Topics: Brazil; Child, Preschool; Community-Acquired Infections; Cross-Sectional Studies; Developing Countries; Humans; Infant; Pleural Effusion; Pneumonia; Streptococcal Infections; Viridans Streptococci
PubMed: 16737994
DOI: 10.1136/adc.2006.094847 -
The Journal of Antimicrobial... May 2006In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to... (Review)
Review
In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to penicillin. Early treatment trials indicate that some patients with subacute endocarditis can be cured with shorter treatment duration than currently advised by international guidelines. Also, high-dose antibiotics, as recommended today, have a predominantly pharmacokinetic and pharmacodynamic rationale that is based mostly on experimental animal studies. Shortening antimicrobial treatment in select patients with endocarditis would be of great benefit. As yet there are no predictors of cure that can be used to individualize treatment duration in patients with bacterial endocarditis.
Topics: Anti-Bacterial Agents; Endocarditis, Subacute Bacterial; Humans; Penicillins; Streptococcal Infections; Treatment Outcome; Viridans Streptococci
PubMed: 16549513
DOI: 10.1093/jac/dkl087 -
Oral Health & Preventive Dentistry Jan 2021Purpose: The aim of this study was to verify how the prevalence of viridans-streptococci is changed by two appointments of professional prophylaxis and after the...
Purpose: The aim of this study was to verify how the prevalence of viridans-streptococci is changed by two appointments of professional prophylaxis and after the subgingival instrumentation via scaling and root planing (SRP). Material and Methods: Samples of the subgingival biofilm were collected from 19 individuals with periodontitis receiving two appointments of professional prophylaxis and SRP before and after the treatment procedures and the presence of viridans-streptococci was analysed by microbiological cultivation. Non-parametric statistical testing using Friedman/Wilcoxon tests and chi-square testing was used for statistical analysis. Results: No statistically significant changes over time were found for the mutans-group. The prevalence of Streptococcus mitis decreased after two appointments of professional prophylaxis (p = 0.013). The prevalence of S. mitis decreased again after SRP (p <0.001). The prevalence of Streptococcus anginosus decreased after two appointments of professional prophylaxis (p = 0.002). After SRP five positive results for S. anginosus were detected (p = 0.026). For Streptococcus oralis and Streptococcus gordonii tendencies to statistical significance were found. The number of positive results for S. oralis increased after the first appointment of professional oral prophylaxis (p = 0.055). The number of positive results for S. gordonii increased after the first appointment of professional oral prophylaxis (p = 0.055). Conclusion: The step-wise periodontal therapy influences the prevalence of viridans-streptococci, especially S. mitis and S. anginosus. No tremendous increase of streptococci especially related to the carious process occurs in the subgingival biofilm. Clinical Relevance: The study reveals knowledge on changes of the composition of the subgingival biofilm due to different steps of periodontal therapy.
Topics: Biofilms; Dental Scaling; Humans; Periodontitis; Root Planing; Streptococcus oralis
PubMed: 33491375
DOI: 10.3290/j.ohpd.b875517