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Whether cirrhotic patients with Streptococcus bovis bacteremia have an increased risk of colorectal neoplasm is uncertain. A multicentric retrospective cohort study was conducted investigating associations between S. bovis biotype and species, cirrhosis, and colorectal neoplasm. Out of 779 patients with S. bovis bacteremia, 69 (8.7%) had cirrhosis. No differences were found in the prevalence of colorectal neoplasm between cirrhotic and non-cirrhotic patients undergoing colonoscopy. Among cirrhotic patients, prevalence of colorectal neoplasms was higher in S. bovis biotype I (S. gallolyticus) bacteremia (80%) than in S. bovis biotype II (33.3%; p < 0.007). In conclusion, risk of colorectal neoplasm is high among cirrhotic patients with S. gallolyticus bacteremia. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the clinical significance ofStreptococcus salivariusisolates recovered from blood cultures and compare them with isolates ofStreptococcus bovisbiotypes I and II. Seventeen of the 52 (32%)S. salivariusisolates recovered were considered clinically significant, compared with 62 of the 64 (97%)S. bovisisolates (p<0.0001). Bacteremia caused byS. salivariusoccurred mostly in patients who showed relevant disruption of the mucous membranes and/or serious underlying diseases. Patients withS. salivariusbacteremia were younger than those withS. bovisbacteremia (57 vs. 67 years;p<0.01). Patients withS. salivariusbacteremia and patients withS. bovisII bacteremia had similar rates of endocarditis, colon tumors, and noncolon cancer. On the other hand, when compared withS. bovisI bacteremia,S. salivariusbacteremia was associated with lower rates of endocarditis (18% vs. 74%, respectively) (p<0.01) and colon tumors (0% vs. 57%, respectively) (p<0.005) and higher rates of noncolon cancer (53% vs. 9.5%, respectively) (p<0.01). Bacteremia caused byS. bovisII had a hepatobiliary origin in 50% of the patients, while, in contrast, that due toS. salivariusorS. bovisI was less frequently associated with a hepatobiliary origin (12% and 5%, respectively) (p<0.00001). The rate of penicillin resistance was 31% amongS. salivariusisolates and 0% amongS. bovisisolates (p<0.0001). In conclusion, the clinical characteristics ofS. salivariusbacteremia andS. bovisII bacteremia are similar, and the isolation ofS. salivariusin blood should not be systematically regarded as contamination. [ABSTRACT FROM AUTHOR]

In a prospective study of bacteremia caused by organisms of the Streptococcus milleri group a total of 32 adult patients were observed over a seven-year period. These patients accounted for 1.6% of all patients diagnosed as having significant bacteremia and 17% of all cases of streptococcal (nonpneumococcal) bacteremia diagnosed during the study period. Only five patients had polymicrobic bacteremia. In 31 cases, a presumed origin of infection was identified, generally oral or gastrointestinal disease. There were only six cases of nosocomial acquisition. The most common presenting symptom was prolonged fever. The following forms of presentation were documented: bacteremia with local suppurative infection (56%), bacteremia without local suppurative infection (25%), and endocarditis (19%). An associated focus of infection was found in the abdominal cavity in 20 cases (62%). The mortality rate was 12.5%. All isolates were susceptible to penicillin. Caution is necessary in interpreting a blood culture positive for Streptococcus milleri group organisms, since, unlike other viridans streptococci, they are rarely contaminants. For this reason patients with suppurative processes and/or digestive tract disease must be carefully investigated. [ABSTRACT FROM AUTHOR]