Korean J Clin Microbiol.  2011 Dec;14(4):144-147. 10.5145/KJCM.2011.14.4.144.

First Isolation of Streptococcus gallolyticus subsp. pasteurianus from a Korean Patient with Severe Septic Shock

• Jeong S
• Park JY
• Han SH
• Lee Y
• Yong D
• Lee K
• Chong Y

• KMID: 1476036
• DOI: http://doi.org/10.5145/KJCM.2011.14.4.144

Abstract

A 60-year-old man presented with a 1-day history of fever, vomiting, and diarrhea. He was diagnosed with severe septic shock on the basis of a body temperature of 38.9degrees C, heart rate of 92/min, respiratory rate of 25/min, WBC count of 22,970/microL, C-reactive protein (CRP) level of 136 mg/L, blood urea nitrogen (BUN) of 34.0 mg/dL, and creatinine of 2.98 mg/dL. On blood culture, Gram-positive cocci were detected in all 6 bottles. Small grayish non-hemolytic colonies were found on blood agar plates after incubation at 37degrees C for 2 days. The isolates were negative for catalase and L-pyrrolidonyl-beta-naphthylamide hydrolysis, and positive for bile-esculin and leucine aminopeptidase activity. The strain was identified as Streptococcus gallolyticus subsp. pasteurianus using Vitek 2 GP II systems. We performed 16S rRNA gene sequencing and detected 100% identity with S. gallolyticus subsp. pasteurianus strain CIP 107122T (1,345/1,345-bp). The patient recovered after receiving ampicillin-sulbactam. This is the first report of phenotypic and genetic identification of S. gallolyticus subsp. pasteurianus causing severe septic shock in a Korean patient.

Keyword

Streptococcus gallolyticus subsp. pasteurianus; Septic shock; 16S rRNA gene sequencing

MeSH Terms

Agar
Ampicillin
Blood Urea Nitrogen
Body Temperature
C-Reactive Protein
Catalase
Creatinine
Diarrhea
Fever
Genes, rRNA
Gram-Positive Cocci
Heart Rate
Humans
Hydrolysis
Leucyl Aminopeptidase
Middle Aged
Pyrrolidinones
Respiratory Rate
Shock, Septic
Sprains and Strains
Streptococcus
Sulbactam
Vomiting
Agar
Ampicillin
C-Reactive Protein
Catalase
Creatinine
Leucyl Aminopeptidase
Pyrrolidinones
Sulbactam

Reference

1. Herrera P, Kwon YM, Ricke SC. Ecology and pathogenicity of gastrointestinal Streptococcus bovis. Anaerobe. 2009; 15:44–54.

2. Murray PR.Baron EJ, et al. eds. Manual of clinical microbiology. 9th ed.Washington D.C.: ASM Press;2006. p. 416–25.

3. Sturt AS, Yang L, Sandhu K, Pei Z, Cassai N, Blaser MJ. Streptococcus gallolyticus subspecies pasteurianus (biotype II/2), a newly reported cause of adult meningitis. J Clin Microbiol. 2010; 48:2247–9.

4. Onoyama S, Ogata R, Wada A, Saito M, Okada K, Harada T. Neonatal bacterial meningitis caused by Streptococcus gallolyticus subsp. pasteurianus. J Med Microbiol. 2009; 58:1252–4.

5. Floret N, Bailly P, Thouverez M, Blanchot C, Alez-Martin D, Menget A, et al. A cluster of bloodstream infections caused by Streptococcus gallolyticus subspecies pasteurianus that involved 5 preterm neonates in a university hospital during a 2-month period. Infect Control Hosp Epidemiol. 2010; 31:194–6.

6. Cockerill FR III, Wikler MA. et al. eds. CLSI Documents M100-S20 Performance standards for antimicrobial susceptibility testing; Approved Guildeline. 20th ed.Wayne, PA: Clinical and Laboratory Standards Institute;2006. p. 96–8.

7. Beck M, Frodl R, Funke G. Comprehensive study of strains previously designated Streptococcus bovis consecutively isolated from human blood cultures and emended description of Streptococcus gallolyticus and Streptococcus infantarius subsp. coli. J Clin Microbiol. 2008; 46:2966–72.

8. Coykendall AL. Classification and identification of the viridans streptococci. Clin Microbiol Rev. 1989; 2:315–28.

9. Schlegel L, Grimont F, Ageron E, Grimont PA, Bouvet A. Reappraisal of the taxonomy of the Streptococcus bovis/Streptococcus equinus complex and related species: description of Streptococcus gallolyticus subsp. gallolyticus subsp. nov., S. gallolyticus subsp. macedonicus subsp. nov. and S. gallolyticus subsp. pasteurianus subsp. nov. Int J Syst Evol Microbiol. 2003; 53:631–45.

10. Ballet M, Gevigney G, Garé JP, Delahaye F, Etienne J, Delahaye JP. Infective endocarditis due to Streptococcus bovis. A report of 53 cases. Eur Heart J. 1995; 16:1975–80.

11. Smith AH, Sra HK, Bawa S, Stevens R. Streptococcus bovis meningitis and hemorrhoids. J Clin Microbiol. 2010; 48:2654–5.

12. Zarkin BA, Lillemoe KD, Cameron JL, Effron PN, Magnuson TH, Pitt HA. The triad of Streptococcus bovis bacteremia, colonic pathology, and liver disease. Ann Surg. 1990; 211:786–91.

13. Alazmi W, Bustamante M, O'Loughlin C, Gonzalez J, Raskin JB. The association of Streptococcus bovis bacteremia and gastrointestinal diseases: a retrospective analysis. Dig Dis Sci. 2006; 51:732–6.

14. Vilarrasa N, Prats A, Pujol M, Gason A, Viladrich PF. Streptococcus bovis meningitis in a healthy adult patient. Scand J Infect Dis. 2002; 34:61–2.

15. Kim SY, Joo SI, Yi J, Kim EC. A case of Streptococcus gallolyticus subsp. gallolyticus infective endocarditis with colon cancer: identification by 16S ribosomal DNA sequencing. Korean J Lab Med. 2010; 30:160–5.