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Emerging group C and group G streptococcal endocarditis: A Canadian perspective
Sylvain A Lother1, Davinder S Jassal2, Philippe Lagacé-Wiens3
1Section of Internal Medicine, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, BMSB 507, Department of Medical Microbiology, 745 Bannatyne Ave, Winnipeg, Manitoba R3E0J9, Canada.
Summary
Infective endocarditis (IE) from group C and G streptococci (GCGS) bacteremia is common, often leading to severe illness and death. Prompt investigation for IE is crucial in patients with GCGS bacteremia.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Group C and G streptococci (GCGS) can cause bacteremia.
- The incidence and characteristics of infective endocarditis (IE) due to GCGS are not well-defined.
Purpose of the Study:
- To determine the incidence of IE in patients with GCGS bacteremia.
- To characterize the clinical features, disease burden, and outcomes of GCGS IE.
Main Methods:
- Retrospective case series of patients with GCGS bacteremia in Manitoba, Canada (2012-2015).
- Inclusion criteria: blood cultures positive for GCGS.
- IE diagnosis based on modified Duke criteria; echocardiography performed in 33%.
Main Results:
- 6% of patients with GCGS bacteremia developed IE (18% of those with echocardiography).
- Native valve infections predominated (75%); metastatic infections occurred in 64% (lungs, skin, osteoarticular, CNS).
- High rates of sepsis (58%), streptococcal toxic shock syndrome (50%), and 17% mortality were observed in GCGS IE patients.
Conclusions:
- Infective endocarditis is a frequent and severe complication of GCGS bacteremia.
- GCGS IE is associated with significant morbidity, including metastatic infections and high mortality.
- Clinicians should consider IE in patients presenting with GCGS bacteremia.
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