Juan Corredoira1, Imma Grau2, Jose F Garcia-Rodriguez3, Pilar Alonso-Garcia4, M J Garcia-Pais5, Ramon Rabuñal6, Fernando Garcia-Garrote7, Carmen Ardanuy8, Amparo Coira9, M J Lopez-Alvarez10, Roman Pallares11. 1. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: juan.corredoira.sanchez@sergas.es. 2. Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain. Electronic address: igrau@idibell.cat. 3. Infectious Disease Unit, Hospital Ferrol "Arquitecto Macide", Ferrol, Spain. Electronic address: Jose.Francisco.Garcia.Rodriguez@sergas.es. 4. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: Pilar.Alonso.Garcia@sergas.es. 5. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: Maria.Jose.Garcia.Pais@sergas.es. 6. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: Ramon.Rabunal.Rey@sergas.es. 7. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: garciagarrote@yahoo.es. 8. Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain. Electronic address: c.ardanuy@bellvitgehospital.cat. 9. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: amparo.coira.nieto@sergas.es. 10. Infectious Disease Unit and Microbiology Departments, Hospital Lugo "Lucus Augusti", Lugo, Spain. Electronic address: Maria.Jose.Lopez.Alvarez@sergas.es. 11. Infectious Disease and Microbiology Departments, Hospital Bellvitge, Ciberes, Idibell, University of Barcelona, L'Hospitalet, Barcelona, Spain. Electronic address: rpallares@ub.edu.
Abstract
OBJECTIVES: To determine the incidence of Streptococcus bovis (Sb) biotypes causing bacteraemia and associated malignancies. METHODS: This is a retrospective analysis of patients with Sb bacteraemia, pulled out from a prospective surveillance protocol of bacteraemia cases, in three areas of Spain (1990-2013): a cattle area (Lugo), a fishing area (Ferrol) and an urban area (Barcelona). Colonoscopy and Sb biotypes (Sb-I and Sb-II) were determined in most cases. RESULTS: 506 patients with Sb bacteraemia; mean age 68.1 (±14.1) years, and 66.2% were males. The cattle area, compared with the fishing and urban areas, had higher incidence of bacteraemia by SbI (40.29 vs 9.38 vs 6.15 cases/10(6) person-years, P < 0.001) and bacteraemia by Sb-II (29.07 vs 9.84 vs 13.37 cases/10(6) person-years, P < 0.001). The Sb-I cases (n = 224), compared with Sb-II cases (n = 270), had greater rates of endocarditis (77.6% vs 9.6%, P < 0.001) and colorectal neoplasm (CRN) (50.9% vs 16.6%, P < 0.001), and smaller rates of biliary tract infection (2.2% vs 29.6%, P < 0.001) and non-colorectal malignancy (8.9% vs 31.4%, P < 0.001). CONCLUSION: There was a link between the cattle area and higher incidence of Sb bacteraemia. Sb-I differed from Sb-II cases in clinical findings and associated malignancies. Colonoscopy is mandatory in cases of endocarditis or bacteraemia caused by Sb-I.
OBJECTIVES: To determine the incidence of Streptococcus bovis (Sb) biotypes causing bacteraemia and associated malignancies. METHODS: This is a retrospective analysis of patients with Sb bacteraemia, pulled out from a prospective surveillance protocol of bacteraemia cases, in three areas of Spain (1990-2013): a cattle area (Lugo), a fishing area (Ferrol) and an urban area (Barcelona). Colonoscopy and Sb biotypes (Sb-I and Sb-II) were determined in most cases. RESULTS: 506 patients with Sb bacteraemia; mean age 68.1 (±14.1) years, and 66.2% were males. The cattle area, compared with the fishing and urban areas, had higher incidence of bacteraemia by SbI (40.29 vs 9.38 vs 6.15 cases/10(6) person-years, P < 0.001) and bacteraemia by Sb-II (29.07 vs 9.84 vs 13.37 cases/10(6) person-years, P < 0.001). The Sb-I cases (n = 224), compared with Sb-II cases (n = 270), had greater rates of endocarditis (77.6% vs 9.6%, P < 0.001) and colorectal neoplasm (CRN) (50.9% vs 16.6%, P < 0.001), and smaller rates of biliary tract infection (2.2% vs 29.6%, P < 0.001) and non-colorectal malignancy (8.9% vs 31.4%, P < 0.001). CONCLUSION: There was a link between the cattle area and higher incidence of Sb bacteraemia. Sb-I differed from Sb-II cases in clinical findings and associated malignancies. Colonoscopy is mandatory in cases of endocarditis or bacteraemia caused by Sb-I.
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