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Streptococcus Group D Infections Treatment & Management

  • Author: Christian P Sinave, MD; Chief Editor: Michael Stuart Bronze, MD  more...
 
Updated: Oct 20, 2015
 

Medical Care

Most S bovis isolates are susceptible to penicillin (MIC ≤ 0.1 mg/L) and should be treated with intravenous penicillin G or ceftriaxone for 4 weeks. An alternative for only uncomplicated cases of native-valve endocarditis is a 2-week course of therapy with a combination of penicillin G or ceftriaxone and gentamicin. For moderately susceptible isolates (MIC >0.1 mg/L, MIC ≤ 0.5 mg/L), penicillin or ceftriaxone and gentamicin should be administered for 4 weeks and 2 weeks, respectively.[13]

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Surgical Care

Surgical valve replacement is indicated in some cases, particularly for heart failure or complications of endocarditis (see Complications).

Mycotic aneurysm clipping after cerebral arteriography may be indicated.

Based on the findings from the evaluation of the gastrointestinal tract, colon or hepatobiliary surgery may be indicated.

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Consultations

Consult an infectious diseases specialist to confirm the diagnosis of Streptococcus group D infection and to recommend treatment for endocarditis or bacteremia.

Consult a cardiologist to evaluate heart function, including echocardiography findings.

A cardiovascular surgeon can assist with valvular replacement, if indicated. Having the cardiac surgeon involved from the start is a good practice in case the patient's heart condition abruptly deteriorates.

Obtain a consultation with a neurosurgeon for possible clipping if mycotic aneurysms are present.

Obtain a consultation with a general surgeon or gastroenterologist to investigate and treat colonic or hepatobiliary disease.

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Contributor Information and Disclosures
Author

Christian P Sinave, MD Associate Professor, Department of Medical Microbiology and Infectious Diseases, University of Sherbrooke Faculty of Medicine, Canada

Christian P Sinave, MD is a member of the following medical societies: American Society for Microbiology, Association of Medical Microbiology and Infectious Disease Canada

Disclosure: Nothing to disclose.

Coauthor(s)

Tomas Michael Ferguson, MD Consulting Staff, Department of Internal Medicine, Division of Infectious Diseases, Tripler Army Medical Center

Tomas Michael Ferguson, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

John L Brusch, MD, FACP Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance

John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

Pranatharthi Haran Chandrasekar, MBBS, MD Professor, Chief of Infectious Disease, Program Director of Infectious Disease Fellowship, Department of Internal Medicine, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians, American Society for Microbiology, International Immunocompromised Host Society, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Acknowledgements

John W Downs, MD Resident Physician, Department of Medicine, Tripler Army Medical Center

John W Downs, MD is a member of the following medical societies: Alpha Omega Alpha and American College of Physicians

Disclosure: Nothing to disclose.

References
  1. Tripodi MF, Adinolfi LE, Ragone E, et al. Streptococcus bovis endocarditis and its association with chronic liver disease: an underestimated risk factor. Clin Infect Dis. 2004 May 15. 38(10):1394-400. [Medline].

  2. Montalto M, Izzi D, La Regina M, Nucera G, Manna R, Gasbarrini G. Non-life-threatening sepsis: report of two cases. Am J Med Sci. 2004 May. 327(5):275-7. [Medline].

  3. Biedenbach DJ, Moet GJ, Jones RN. Occurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997-2002). Diagn Microbiol Infect Dis. 2004 Sep. 50(1):59-69. [Medline].

  4. Pfaller MA, Jones RN, Marshall SA, et al. Nosocomial streptococcal blood stream infections in the SCOPE Program: species occurrence and antimicrobial resistance. The SCOPE Hospital Study Group. Diagn Microbiol Infect Dis. 1997 Dec. 29(4):259-63. [Medline].

  5. Hoen B, Chirouze C, Cabell CH, Selton-Suty C, Duchêne F, Olaison L, et al. Emergence of endocarditis due to group D streptococci: findings derived from the merged database of the International Collaboration on Endocarditis. Eur J Clin Microbiol Infect Dis. 2005 Jan. 24(1):12-6. [Medline].

  6. Kupferwasser I, Darius H, Muller AM, et al. Clinical and morphological characteristics in Streptococcus bovis endocarditis: a comparison with other causative microorganisms in 177 cases. Heart. 1998 Sep. 80(3):276-80. [Medline].

  7. Giannitsioti E, Chirouze C, Bouvet A, Béguinot I, Delahaye F, Mainardi JL, et al. Characteristics and regional variations of group D streptococcal endocarditis in France. Clin Microbiol Infect. 2007 Aug. 13(8):770-6. [Medline].

  8. Corredoira J, Alonso MP, Coira A, Casariego E, Arias C, Alonso D, et al. Characteristics of Streptococcus bovis endocarditis and its differences with Streptococcus viridans endocarditis. Eur J Clin Microbiol Infect Dis. 2008 Apr. 27(4):285-91. [Medline].

  9. Karchmer AW. Infective endocarditis. Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Saunders; 2007. 1713.

  10. van't Wout JW, Bijlmer HA. Bacteremia due to Streptococcus gallolyticus, or the perils of revised nomenclature in bacteriology. Clin Infect Dis. 2005 Apr 1. 40(7):1070-1. [Medline].

  11. Ruoff KL, Miller SI, Garner CV, et al. Bacteremia with Streptococcus bovis and Streptococcus salivarius: clinical correlates of more accurate identification of isolates. J Clin Microbiol. 1989 Feb. 27(2):305-8. [Medline].

  12. Mouton JW, Endtz HP, den Hollander JG, et al. In-vitro activity of quinupristin/dalfopristin compared with other widely used antibiotics against strains isolated from patients with endocarditis. J Antimicrob Chemother. 1997 May. 39 Suppl A:75-80. [Medline].

  13. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Bolger AF, Levison ME, et al. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation. 2005 Jun 14. 111(23):e394-434. [Medline].

  14. Bayer AS, Scheld WM. Endocarditis and intravascular infections. Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease. 5th ed. Philadelphia, Pa: Churchill Livingstone; 2000. Vol 1: 857-902.

  15. Burns CA, McCaughey R, Lauter CB. The association of Streptococcus bovis fecal carriage and colon neoplasia: possible relationship with polyps and their premalignant potential. Am J Gastroenterol. 1985 Jan. 80(1):42-6. [Medline].

  16. Corredoira J, Alonso MP, Coira A, Varela J. Association between Streptococcus infantarius (formerly S. bovis II/1) bacteremia and noncolonic cancer. J Clin Microbiol. 2008 Apr. 46(4):1570. [Medline].

  17. Cunha BA. Antibiotic Essentials. 7th ed. Royal Oak, Mich: Physicians Press; 2008.

  18. Cunha BA. Antimicrobial therapy of multidrug-resistant Streptococcus pneumoniae, vancomycin-resistant enterococci, and methicillin-resistant Staphylococcus aureus. Med Clin North Am. 2006 Nov. 90(6):1165-82. [Medline].

  19. Cunha BA. New uses for older antibiotics: nitrofurantoin, amikacin, colistin, polymyxin B, doxycycline, and minocycline revisited. Med Clin North Am. 2006 Nov. 90(6):1089-107. [Medline].

  20. Cunha BA. Oral antibiotic therapy of serious systemic infections. Med Clin North Am. 2006 Nov. 90(6):1197-222. [Medline].

  21. Diekema DJ, Pfaller MA, Jones RN, et al. Trends in antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections in the USA, Canada and Latin America. SENTRY Participants Group. Int J Antimicrob Agents. 2000 Feb. 13(4):257-71. [Medline].

  22. Diekema DJ, Pfaller MA, Jones RN; SENTRY Participants Group. Age-related trends in pathogen frequency and antimicrobial susceptibility of bloodstream isolates in North America: SENTRY Antimicrobial Surveillance Program, 1997-2000. Int J Antimicrob Agents. 2002 Dec. 20(6):412-8. [Medline].

  23. García-Porrúa C, González-Gay MA, Monterroso JR, Sánchez-Andrade A, González-Ramirez A. Septic arthritis due to Streptococcus bovis as presenting sign of 'silent' colon carcinoma. Rheumatology (Oxford). 2000 Mar. 39(3):338-9. [Medline].

  24. Gavin PJ, Thomson RB Jr, Horng SJ, Yogev R. Neonatal sepsis caused by Streptococcus bovis variant (biotype II/2): report of a case and review. J Clin Microbiol. 2003 Jul. 41(7):3433-5. [Medline].

  25. Gonzlez-Quintela A, Martinez-Rey C, Castroagudín JF, et al. Prevalence of liver disease in patients with Streptococcus bovis bacteraemia. J Infect. 2001 Feb. 42(2):116-9. [Medline].

  26. Grant RJ, Whitehead TR, Orr JE. Streptococcus bovis meningitis in an infant. J Clin Microbiol. 2000 Jan. 38(1):462-3. [Medline].

  27. Hechmann Wittrup I, Chenoufi Schaadt ML, Arpi M, Danneskiold-Samsoe B. Bacteremia complicated by vertebral osteomyelitis due to Streptococcus bovis. Eur J Clin Microbiol Infect Dis. 1999 May. 18(5):365-7. [Medline].

  28. Klein RS, Catalano MT, Edberg SC, et al. Streptococcus bovis septicemia and carcinoma of the colon. Ann Intern Med. 1979 Oct. 91(4):560-2. [Medline].

  29. Klein RS, Recco RA, Catalano MT, et al. Association of Streptococcus bovis with carcinoma of the colon. N Engl J Med. 1977 Oct 13. 297(15):800-2. [Medline].

  30. Moellering RC Jr. Enterococcus species, Streptococcus bovis, and Leuconostoc species. Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease. 6th ed. Philadelphia, Pa: Churchill Livingstone; 2005.

  31. Moellering RC Jr, Watson BK, Kunz LJ. Endocarditis due to group D streptococci. Comparison of disease caused by streptococcus bovis with that produced by the enterococci. Am J Med. 1974 Aug. 57(2):239-50. [Medline].

  32. Murray HW, Roberts RB. Streptococcus bovis bacteremia and underlying gastrointestinal disease. Arch Intern Med. 1978 Jul. 138(7):1097-9. [Medline].

  33. Pfaller MA, Jones RN, Doern GV, et al. Survey of blood stream infections attributable to gram-positive cocci: frequency of occurrence and antimicrobial susceptibility of isolates collected in 1997 in the United States, Canada, and Latin America from the SENTRY Antimicrobial Surveillance Progr. Diagn Microbiol Infect Dis. 1999 Apr. 33(4):283-97. [Medline].

  34. Rehm SJ. Outpatient intravenous antibiotic therapy for endocarditis. Infect Dis Clin North Am. 1998 Dec. 12(4):879-901, vi. [Medline].

  35. Reynolds JG, Silva E, McCormack WM. Association of Streptococcus bovis bacteremia with bowel disease. J Clin Microbiol. 1983 Apr. 17(4):696-7. [Medline].

  36. Selton-Suty C, Hoen B, Grentzinger A, et al. Clinical and bacteriological characteristics of infective endocarditis in the elderly. Heart. 1997 Mar. 77(3):260-3. [Medline].

  37. Siegman-Igra Y, Schwartz D. Streptococcus bovis revisited: a clinical review of 81 bacteremic episodes paying special attention to emerging antibiotic resistance. Scand J Infect Dis. 2003. 35(2):90-3. [Medline].

  38. Terpenning MS, Buggy BP, Kauffman CA. Infective endocarditis: clinical features in young and elderly patients. Am J Med. 1987 Oct. 83(4):626-34. [Medline].

  39. Vilaichone RK, Mahachai V, Kullavanijaya P, Nunthapisud P. Spontaneous bacterial peritonitis caused by Streptococcus bovis: case series and review of the literature. Am J Gastroenterol. 2002 Jun. 97(6):1476-9. [Medline].

  40. Wilson WR, Karchmer AW, Dajani AS, et al. Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci, and HACEK microorganisms. American Heart Association. JAMA. 1995 Dec 6. 274(21):1706-13. [Medline].

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