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Colomba C, Garbo V, Boncori G, Albano C, Bagarello S, Condemi A, Giordano S, Canduscio LA, Gallo C, Parrinello G, Cascio A. Streptococcus mitis as a New Emerging Pathogen in Pediatric Age: Case Report and Systematic Review. Antibiotics (Basel) 2023; 12:1222. [PMID: 37508318 PMCID: PMC10376791 DOI: 10.3390/antibiotics12071222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/20/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
Streptococcus mitis, a normal inhabitant of the oral cavity, is a member of Viridans Group Streptococci (VGS). Generally recognized as a causative agent of invasive diseases in immunocompromised patients, S. mitis is considered to have low pathogenic potential in immunocompetent individuals. We present a rare case of sinusitis complicated by meningitis and cerebral sino-venous thrombosis (CSVT) caused by S. mitis in a previously healthy 12-year-old boy with poor oral health status. With the aim of understanding the real pathogenic role of this microorganism, an extensive review of the literature about invasive diseases due to S. mitis in pediatric patients was performed. Our data define the critical role of this microorganism in invasive infections, especially in immunocompetent children and in the presence of apparently harmful conditions such as sinusitis and caries. Attention should be paid to the choice of therapy because of VGS's emerging antimicrobial resistance patterns.
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Affiliation(s)
- Claudia Colomba
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
- Division of Pediatric Infectious Diseases, "G. Di Cristina" Hospital, ARNAS Civico Di Cristina Benfratelli, 90100 Palermo, Italy
| | - Valeria Garbo
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Giovanni Boncori
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Chiara Albano
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Sara Bagarello
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Anna Condemi
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Salvatore Giordano
- Division of Pediatric Infectious Diseases, "G. Di Cristina" Hospital, ARNAS Civico Di Cristina Benfratelli, 90100 Palermo, Italy
| | - Laura A Canduscio
- Division of Pediatric Infectious Diseases, "G. Di Cristina" Hospital, ARNAS Civico Di Cristina Benfratelli, 90100 Palermo, Italy
| | - Cristina Gallo
- Division of Radiology, "G. Di Cristina" Hospital, ARNAS Civico Di Cristina Benfratelli, 90100 Palermo, Italy
| | - Gaspare Parrinello
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
| | - Antonio Cascio
- Department of Health Promotion, Maternal and Infant Care, Internal Medicine and Medical Specialties, University of Palermo, 90100 Palermo, Italy
- Infectious and Tropical Diseases Unit, AOU Policlinico "P. Giaccone", 90100 Palermo, Italy
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Franchetti L, Schumann DM, Tamm M, Jahn K, Stolz D. Multiplex bacterial polymerase chain reaction in a cohort of patients with pleural effusion. BMC Infect Dis 2020; 20:99. [PMID: 32007106 PMCID: PMC6995182 DOI: 10.1186/s12879-020-4793-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/14/2020] [Indexed: 12/25/2022] Open
Abstract
Background The identification of the pathogens in pleural effusion has mainly relied on conventional bacterial culture or single species polymerase chain reaction (PCR), both with relatively low sensitivity. We investigated the efficacy of a commercially available multiplex bacterial PCR assay developed for pneumonia to identify the pathogens involved in pleural infection, particularly empyema. Methods A prospective, monocentric, observational study including 194 patients with pleural effusion. Patients were evaluated based on imaging, laboratory values, pleura ultrasound and results of thoracentesis including conventional microbiology studies during hospitalisation. Multiplex bacterial PCR (Curetis Unyvero p55) was performed in batch and had no influence on therapeutic decisions. Results Overall, there were 51/197 cases with transudate and 146/197 with exudate. In 42% (n = 90/214) there was a clinical suspicion of parapneumonic effusion and the final clinical diagnosis of empyema was made in 29% (n = 61/214) of all cases. The most common microorganisms identified in the cases diagnosed with empyema were anaerobes [31] followed by gram-positive cocci [10] and gram-negative rods [4]. The multiplex PCR assay identified more of the pathogens on the panel than the conventional methods (23.3% (7/30) vs. 6.7% (2/30), p = 0.008). Conclusion The multiplex PCR-based assay had a higher sensitivity and specificity than conventional microbiology when only the pathogens on the pneumonia panel were taken into account. A dedicated pleural empyema multiplex PCR panel including anaerobes would be needed to cover most common pathogens involved in pleural infection.
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Affiliation(s)
- Léo Franchetti
- Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland
| | - Desiree M Schumann
- Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland.
| | - Michael Tamm
- Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland
| | - Kathleen Jahn
- Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland
| | - Daiana Stolz
- Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Petersgraben 4, 4031, Basel, CH, Switzerland
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Michos A, Palili A, Koutouzis EI, Sandu A, Lykopoulou L, Syriopoulou VP. Detection of bacterial pathogens in synovial and pleural fluid with the FilmArray Blood Culture Identification System. IDCases 2016; 5:27-8. [PMID: 27419071 PMCID: PMC4936597 DOI: 10.1016/j.idcr.2016.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/26/2016] [Accepted: 05/31/2016] [Indexed: 12/25/2022] Open
Abstract
We report the use of FilmArray Blood Culture Identification (BCID) multiplex PCR system for pathogen detection from a child with septic arthritis that Streptococcus pyogenes was identified directly from synovial fluid and a child with complicated pneumonia with pleural effusion that Streptococcus pneumoniae was identified from pleural fluid.
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Affiliation(s)
- Athanasios Michos
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Alexandra Palili
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Emmanouil I Koutouzis
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Adina Sandu
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Lilia Lykopoulou
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Vassiliki P Syriopoulou
- First Department of Pediatrics, University of Athens, "Aghia Sophia" Children's Hospital, Athens, Greece
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