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Updated: Jul 9, 2026
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Hospital-based study of viridans streptococcal bacteraemia in children and adults
Lionel K K Tan1, Sandra Lacey, Sundhiya Mandalia
1Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. lionel.tan@nhs.net
Insights
Viridans streptococci (VS) bloodstream infections are uncommon in immunocompetent individuals but can cause significant illness, including infective endocarditis in adults. Mortality directly from VS infection is rare, despite 20% penicillin resistance.
Area of Science:
- Clinical microbiology
- Infectious diseases
- Epidemiology
Background:
- Viridans streptococci (VS) are a common cause of bloodstream infections.
- Understanding the clinical significance of VS bacteraemia in immunocompetent populations is crucial.
Purpose of the Study:
- To determine the incidence and clinical importance of viridans streptococci bacteraemia in immunocompetent adults and children.
- To identify risk factors and outcomes associated with VS bacteraemia.
Main Methods:
- A 25-month prospective data collection of all patients with VS bacteraemia at a UK district general hospital.
- Review of patient records to assess clinical significance, comorbidities, and outcomes.
- Analysis of antimicrobial resistance patterns, particularly penicillin resistance.
Main Results:
- VS accounted for 6.9% of adult and 12.3% of pediatric community-acquired bacteraemias.
- Nearly half (47.3%) of reviewed cases were deemed clinically significant.
- Infective endocarditis occurred in 11.6% of adults; penicillin resistance was 20%.
Conclusions:
- Viridans streptococci bacteraemia is generally associated with low mortality in immunocompetent individuals.
- Despite rare cases of infective endocarditis and notable penicillin resistance, VS infections are rarely fatal.
- Seizure history was more prevalent in children with non-significant VS cultures.
Objectives:
To assess the proportion and clinical significance of bacteraemia caused by viridans streptococci (VS) in immunocompetent adults and children.
Methods:
Over a 25-month period, we collected data on all patients with VS bacteraemia at a UK district general hospital.
Results:
VS caused 50/723 (6.9%) adult and 13/106 (12.3%) paediatric community-acquired bacteraemias. Of the 43 adult and 12 paediatric patient notes reviewed, 26 (47.3%) cultures were of 'definite' or 'probable' clinical significance. No patients were neutropenic and overall penicillin resistance was 11/55 (20.0%). Amongst adults, there were five (11.6%) confirmed or suspected cases of infective endocarditis compared to none in the paediatric cohort. Similar proportions of adults (16.3%) and children (16.7%) had lower respiratory tract infections. Among non-significant cultures, a history of seizures was observed in one (1.3%) adult and four (33.3%) children (p=0.008). Thirty-day mortality was 7.3%. No children and four adults died, one directly attributable to infection. Median adult inpatient stay was 11 days compared to 2 days in the paediatric population (p=0.003).
Conclusion:
Despite cases of infective endocarditis and an incidence of penicillin resistance of 20%, mortality directly attributable to VS infection in immunocompetent adults and children was rare.
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