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Granulicatella adiacens infections in children: a single-center retrospective study
Türkan Aydın Teke1, Ayşe Kaman2, Fatma Nur Öz2
1Department of Pediatric Infectious Disease, Ankara Etlik City Hospital, Ankara, Türkiye. turkanteke@gmail.com.
Insights
Granulicatella adiacens is a rare cause of severe pediatric infections, including bacteremia and endocarditis. Vigilance is crucial for early detection in children with underlying conditions, especially when slow-growing bacteria are found.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Pediatric Infectious Diseases
Background:
- Granulicatella species are rare but significant pathogens, often causing bacteremia and infective endocarditis.
- Identifying and treating Granulicatella presents challenges due to unique growth requirements and difficulties in antimicrobial susceptibility testing.
Purpose of the Study:
- To investigate the incidence and clinical characteristics of Granulicatella infections in pediatric patients.
- To highlight the diagnostic and therapeutic challenges associated with Granulicatella species.
Main Methods:
- A retrospective study was conducted at a tertiary care hospital in Ankara, Turkey, from January 2005 to January 2017.
- Blood cultures from 4125 patients were screened for Granulicatella species.
- Clinical and laboratory data of patients with positive cultures were analyzed.
Main Results:
- Granulicatella adiacens infection was diagnosed in seven pediatric patients (0.1% of positive blood cultures).
- Common underlying conditions included congenital heart disease, gastrointestinal diseases, malignancy, and neurological disorders.
- Infections ranged from bacteremia to infective endocarditis; all patients survived.
Conclusions:
- Granulicatella adiacens can cause severe infections in children, necessitating clinical vigilance.
- Early detection is critical in pediatric patients with cardiac disease, malignancy, or mucosal disruption.
- Consideration of Granulicatella is important when slow-growing gram-positive cocci are isolated from blood cultures.
Purpose:
Granulicatella spp. although rare, are notable pathogens in various infections, particularly in bacteraemia and infective endocarditis. Because of their unique growth requirements and difficulties in antimicrobial testing, identifying and treating these microorganisms poses significant challenges.
Methods:
This retrospective study was conducted at Dr. Sami Ulus Maternity and Children's Health and Diseases Research and Education Hospital, a tertiary care centre in Ankara, Turkey. Blood cultures were screened for Granulicatella spp. between January 2005 and January 2017. Clinical and laboratory features of the patients were documented.
Results:
During the 12-year study period, 4125 patients with positive blood culture results were investigated. No cases of G. para-adiacens or G. elegans infection were identified. G. adiacens infection was diagnosed in seven patients (five males and two females) representing 0.1%. The mean age of the patients was 79.5 ± 49.8 months (median: 96 months, range: 10-140 months). Six patients had underlying conditions, including congenital heart diseases (two patients), gastrointestinal diseases (two patients), haematological malignancy (one patient), and neurological disorders (one patient). Three patients had bacteraemia, two had central line-related bloodstream infection (CRBSI), one had bacteraemia and pneumonia, and one had infective endocarditis. Four infections were community-acquired and three were healthcare-associated. All patients survived.
Conclusion:
Although rare, G. adiacens can cause severe infections in children. Clinicians should be particularly vigilant for this pathogen, especially in children with cardiac disease, malignancy, or mucosal disruption, particularly when slow-growing gram-positive cocci are isolated from blood cultures or other sterile sites.
