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Clinical Characteristics of Community-Acquired Viridans Streptococcal Pneumonia.

Choi SH, Cha SI, Choi KJ, Lim JK, Seo H, Yoo SS, Lee J, Lee SY, Kim CH, Park JY - Tuberc Respir Dis (Seoul) (2015)

Bottom Line: We compared various clinical parameters between the VS group and the control group.It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions.However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Background: Viridans streptococci (VS) are a large group of streptococcal bacteria that are causative agents of community-acquired respiratory tract infection. However, data regarding their clinical characteristics are limited. The purpose of the present study was to investigate the clinical and radiologic features of community-acquired pneumonia (CAP) with or without parapneumonic effusion caused by VS.

Methods: Of 455 consecutive CAP patients with or without parapneumonic effusion, VS were isolated from the blood or pleural fluid in 27 (VS group, 5.9%) patients. Streptococcus pneumoniae was identified as a single etiologic agent in 70 (control group) patients. We compared various clinical parameters between the VS group and the control group.

Results: In univariate analysis, the VS group was characterized by more frequent complicated parapneumonic effusion or empyema and bed-ridden status, lower incidences of productive cough, elevated procalcitonin (>0.5 ng/mL), lower age-adjusted Charlson comorbidity index score, and more frequent ground glass opacity (GGO) or consolidation on computed tomography (CT) scans. Multivariate analysis demonstrated that complicated parapneumonic effusion or empyema, productive cough, bed-ridden status, and GGO or consolidation on CT scans were independent predictors of community-acquired respiratory tract infection caused by VS.

Conclusion: CAP caused by VS commonly presents as complicated parapneumonic effusion or empyema. It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions. However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

No MeSH data available.


Related in: MedlinePlus

Viridans streptococcal isolates. Streptococcus mitis/oralis is the most common pathogen, followed by S. sanguis and S. constellatus (%, the number of each isolate per the number of total viridans streptococcal isolates): S. mitis/oralis is isolated from blood (n=8) and pleural fluid (n=2); S. sanguis is from blood (n=6); S. constellatus is from blood (n=2) and pleural fluid (n=2); S. intermedius is from pleural fluid (n=3) and blood (n=1); S. salivarius, S. parasanguinis, and S. anginosus is from blood (n=2, respectively).
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Figure 1: Viridans streptococcal isolates. Streptococcus mitis/oralis is the most common pathogen, followed by S. sanguis and S. constellatus (%, the number of each isolate per the number of total viridans streptococcal isolates): S. mitis/oralis is isolated from blood (n=8) and pleural fluid (n=2); S. sanguis is from blood (n=6); S. constellatus is from blood (n=2) and pleural fluid (n=2); S. intermedius is from pleural fluid (n=3) and blood (n=1); S. salivarius, S. parasanguinis, and S. anginosus is from blood (n=2, respectively).

Mentions: Causative microbes were identified in 455 from a total of 933 patients diagnosed with CAP with or without parapneumonic effusion. VS were isolated in 27 patients (5.9%), and S. pneumoniae were identified in 97 patients, 27 of whom were excluded from analysis owing to the presence of mixed infections. S. mitis/oralis were the most common VS species, followed by S. sanguis and S. constellatus (Figure 1). Only one VS species was isolated from each patient, except one patient in whom S. mitis/oralis and S. parasanguinis were cultured from the blood samples. We compared various parameters between the VS (n=27) and control groups (n=70).


Clinical Characteristics of Community-Acquired Viridans Streptococcal Pneumonia.

Choi SH, Cha SI, Choi KJ, Lim JK, Seo H, Yoo SS, Lee J, Lee SY, Kim CH, Park JY - Tuberc Respir Dis (Seoul) (2015)

Viridans streptococcal isolates. Streptococcus mitis/oralis is the most common pathogen, followed by S. sanguis and S. constellatus (%, the number of each isolate per the number of total viridans streptococcal isolates): S. mitis/oralis is isolated from blood (n=8) and pleural fluid (n=2); S. sanguis is from blood (n=6); S. constellatus is from blood (n=2) and pleural fluid (n=2); S. intermedius is from pleural fluid (n=3) and blood (n=1); S. salivarius, S. parasanguinis, and S. anginosus is from blood (n=2, respectively).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499586&req=5

Figure 1: Viridans streptococcal isolates. Streptococcus mitis/oralis is the most common pathogen, followed by S. sanguis and S. constellatus (%, the number of each isolate per the number of total viridans streptococcal isolates): S. mitis/oralis is isolated from blood (n=8) and pleural fluid (n=2); S. sanguis is from blood (n=6); S. constellatus is from blood (n=2) and pleural fluid (n=2); S. intermedius is from pleural fluid (n=3) and blood (n=1); S. salivarius, S. parasanguinis, and S. anginosus is from blood (n=2, respectively).
Mentions: Causative microbes were identified in 455 from a total of 933 patients diagnosed with CAP with or without parapneumonic effusion. VS were isolated in 27 patients (5.9%), and S. pneumoniae were identified in 97 patients, 27 of whom were excluded from analysis owing to the presence of mixed infections. S. mitis/oralis were the most common VS species, followed by S. sanguis and S. constellatus (Figure 1). Only one VS species was isolated from each patient, except one patient in whom S. mitis/oralis and S. parasanguinis were cultured from the blood samples. We compared various parameters between the VS (n=27) and control groups (n=70).

Bottom Line: We compared various clinical parameters between the VS group and the control group.It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions.However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.

ABSTRACT

Background: Viridans streptococci (VS) are a large group of streptococcal bacteria that are causative agents of community-acquired respiratory tract infection. However, data regarding their clinical characteristics are limited. The purpose of the present study was to investigate the clinical and radiologic features of community-acquired pneumonia (CAP) with or without parapneumonic effusion caused by VS.

Methods: Of 455 consecutive CAP patients with or without parapneumonic effusion, VS were isolated from the blood or pleural fluid in 27 (VS group, 5.9%) patients. Streptococcus pneumoniae was identified as a single etiologic agent in 70 (control group) patients. We compared various clinical parameters between the VS group and the control group.

Results: In univariate analysis, the VS group was characterized by more frequent complicated parapneumonic effusion or empyema and bed-ridden status, lower incidences of productive cough, elevated procalcitonin (>0.5 ng/mL), lower age-adjusted Charlson comorbidity index score, and more frequent ground glass opacity (GGO) or consolidation on computed tomography (CT) scans. Multivariate analysis demonstrated that complicated parapneumonic effusion or empyema, productive cough, bed-ridden status, and GGO or consolidation on CT scans were independent predictors of community-acquired respiratory tract infection caused by VS.

Conclusion: CAP caused by VS commonly presents as complicated parapneumonic effusion or empyema. It is characterized by less frequent productive cough, more frequent bed-ridden status, and less common CT pulmonary parenchymal lesions. However, its treatment outcome and clinical course are similar to those of pneumococcal pneumonia.

No MeSH data available.


Related in: MedlinePlus