Streptococcus mitisStrains Causing Severe Clinical Disease in Cancer Patients

0301 basic medicine Bacteremia Streptococcus mitis Infectious and parasitic diseases RC109-216 Severity of Illness Index Cohort Studies Mice 03 medical and health sciences Neoplasms Streptococcal Infections neutropenia Animals Humans bacteremia Phylogeny 0303 health sciences Genes, Essential Virulence Research R viridans group streptococci 3. Good health Pitt bacteremia score Disease Models, Animal Genes, Bacterial 13. Climate action Medicine Female cancer patients Genome, Bacterial Multilocus Sequence Typing
DOI: 10.3201/eid2005.130953 Publication Date: 2014-03-26T18:03:55Z
ABSTRACT
The genetically diverse viridans group streptococci (VGS) are increasingly recognized as the cause of a variety of human diseases. We used a recently developed multilocus sequence analysis scheme to define the species of 118 unique VGS strains causing bacteremia in patients with cancer; Streptococcus mitis (68 patients) and S. oralis (22 patients) were the most frequently identified strains. Compared with patients infected with non-S. mitis strains, patients infected with S. mitis strains were more likely to have moderate or severe clinical disease (e.g., VGS shock syndrome). Combined with the sequence data, whole-genome analyses showed that S. mitis strains may more precisely be considered as >2 species. Furthermore, we found that multiple S. mitis strains induced disease in neutropenic mice in a dose-dependent fashion. Our data define the prominent clinical effect of the group of organisms currently classified as S. mitis and lay the groundwork for increased understanding of this understudied pathogen.
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