Association between Clostridium septicum and Streptococcus gallolyticus bacteremia and colorectal neoplasms

Colorectal cancer (CRC) is associated with Clostridium septicum (CS), Streptococcus gallolyticus (SG), and Fusobacterium nucleatum (FN) bacteremia. Further investigation of the mechanism of translocation and the time interval between bacteremia and a CRC diagnosis is required.

Patients with bacteremia caused by the three organisms were studied. The organisms were identified using MALDI-TOF mass spectrometry.

Fourteen patients (CS [n = 1], SG [n = 11], and FN [n = 2]) were included among 2866 patients with bacteremia. Colorectal neoplasms were detected in two patients at the onset of bacteremia (advanced CRC in patient CS and carcinoma in adenoma in patient SG). Rectal cancer developed 31 months after incidental bacteremia in another patient with SG. Colonoscopy was not performed in 10 of 14 patients, including two patients with FN at the onset of bacteremia and during the follow-up period.

Consistent with previous reports, we found three typical patterns associated with CRC in patients with CS and SG bacteremia. Because routine colonoscopy was not performed, the true association with CRC could not be determined for these organisms.