Strepotococcus gallolyticus infections at a community hospital

Authors:
Saron Araya, Sridha Gona, Ifeanyi Chinedozi, Aaron George, Hugo Bonatti

Body of Abstract:
Background: Streptococcus gallolyticus – previously part of the Streptococcus bovis group – was identified and first described by Osawa et al. in 1995. While bacteremia and endocarditis remain the most frequent manifestations, Streptococcus gallolyticus may also cause other infections such as septic arthritis, osteomyelitis and intra-abdominal infections amongst others. Its presence in the microbiome has been linked to the development of colonic malignancies.

Methods: This is a retrospective analysis of all invasive infections involving Streptococcus gallolyticus between 9/2018 and 12/2022 at a rural hospital in the Appalachian region of the United States.

Results: Twenty-seven isolates of Streptococcus gallolyticus in 13 patients were identified. Median age of the seven male and six female patients was 73.2 (range 52.2 – 91.1) years. Median BMI was 32 (range 21.1 – 52.3) kg/m2; 64% were obese. 62% of patients were diabetic, 62% had hyperlipidemia. 23% were active smokers and 8% had COPD; only 15% had malignancies. Bacteremia was the most common infection with 77%, two patients had lower extremity soft tissue infections and one had intraabdominal infection. 31% of infections were polymicrobial with Gram-negative rods accounting for 4 isolates (E. coli and Klebsiella spp 2 each) and anaerobes for 2 (Corynebacterium spp and Peptoniphilus asaccharolyticus). Demographic, clinical and microbiology data are shown in Table 1.

Conclusion: Streptococcus gallolyticus mainly causes bacteremia but may also cause intraabdominal and soft tissue infections. In contrast to other studies, our observed infections were not significantly associated with presence of colorectal cancer. On the other hand, strong association with obesity, metabolic syndrome and heart disease was found and patients were older than those presenting with infections with other streptococci.