Article ID: JJID.2018.074
Viridans streptococci are still under investigation concerning epidemiology, pathogenesis and clinical presentations. We aimed to investigate the clinical presentations and outcomes of the pediatric patients infected with Streptococcus mitis/oralis. Based on accumulation of blood stream infections (BSI) caused by S. mitis /oralis in four patients in Hematology and Bone Marrow Transplantation Department in a particular time, review of medical and microbiological records of pediatric patients with positive blood cultures for S. mitis/oralis in whole hospital was performed. In addition, a retrospective case control study was conducted.
Pulse field gel electrophoresis of S. mitis /oralis in four patients displayed unrelatedness of the strains. A total of 53 BSI [42 BSI and 11 catheter related BSI] were analyzed. Thirty-four percent of patients with BSI caused by S. mitis/oralis had febrile neutropenia. Clinical and microbiological outcomes were favorable and infection related mortality was not observed. Although not significant previous antibiotic use and trimethoprim-sulfamethoxazole prophylaxis were more common in case group. S. mitis/oralis seems likely an important agent in bacteremic children who are particularly neutropenic because of the underlying hematologic and oncologic diseases. Prompt management of infections with accurate antimicrobials regarding to antibiotic susceptibilities of organism may facilitate favorable outcomes.
