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Anti-Infective Agents

Editor-in-Chief

ISSN (Print): 2211-3525
ISSN (Online): 2211-3533

Mini-Review Article

Nutritionally Variant Streptococci - Its Clinical Relevance and Treatment Options: A Mini-Review

Author(s): Ronni Mol Joji, Shahad Said Alsharji, Shahad Abdullah Alkiyumi, Kothar Ali Alsakiti, Mohd Shadab, Ali Al Mahmeed and Mohammad Shahid*

Volume 21, Issue 3, 2023

Published on: 13 March, 2023

Article ID: e010223213344 Pages: 8

DOI: 10.2174/2211352521666230201121402

Price: $65

Abstract

Nutritionally variant streptococci (NVS) were assumed to be nutritional mutants of the viridans group of streptococci, but they are now considered as other Streptococcus species. Due to their difficult nature, to date, the detection and treatment of NVS are challenging.

This review aims at a compilation of a comprehensive study on literature reporting the microbiological characteristics of NVS species, their detection, and treatment strategies with an emphasis on large-scale research experimentations.

According to the literature, the classification of these Streptococci has changed several times, interpreting the scientific literature of Abiotrophia and Granulicatella spp. NVS strains exhibit pleomorphic cellular morphologies, and they can be distinguished from other streptococci by their biochemical reactions and molecular tests. They have been isolated from clinical specimens including pus, synovial fluid, and blood, in addition to their involvement in endocarditis. Treatment of NVS is challenging due to its difficult nature and the complexity of antimicrobial susceptibility testing.

Early diagnosis is critical for initiating proper therapy and avoiding fatal consequences. Microbiologists and clinicians ought to be cautious of these isolates, which are easy to overlook due to their difficult nature and the challenges in retrieving from clinical samples. Hence largescale research is required to identify additional detection techniques, infrastructure, and treatment options.

Graphical Abstract

[1]
Frenkel, A.; Hirsch, W. Spontaneous development of L forms of streptococci requiring secretions of other bacteria or sulphydryl compounds for normal growth. Nature, 1961, 191(4789), 728-730.
[http://dx.doi.org/10.1038/191728a0] [PMID: 13701753]
[2]
Sinner, S.W.; Tunkel, A.R. 204 - Viridans streptococci ,nutritionally variant streptococci , groups c and g streptococci , and other related organisms. Mandell, Douglas, and Bennett’s principlesand practice of infectious diseases, 8th ed; Bennett, J.E.; Dolin, R.; Blaser, M.J., Eds.; W.B. Saunders: Philadelphia, 2015, pp. 2349-61.e2.
[http://dx.doi.org/10.1016/B978-1-4557-4801-3.00204-6]
[3]
Bouvet, A.; Grimont, F.; Grimont, P.A.D. Streptococcus defectivus sp. nov. and Streptococcus adjacens sp. nov., nutritionally variant streptococci from human clinical specimens. Int. J. Syst. Evol. Microbiol., 1989, 39(3), 290-294.
[4]
Bouvet, A. Human endocarditis due to nutritionally variant streptococci: Streptococcus adjacens and Streptococcus defectivus. Eur. Heart J., 1995, 16(Suppl. B), 24-27.
[http://dx.doi.org/10.1093/eurheartj/16.suppl_B.24] [PMID: 7671920]
[5]
Kawamura, Y.; Hou, X.G.; Sultana, F.; Liu, S.; Yamamoto, H.; Ezaki, T. Transfer of Streptococcus adjacens and Streptococcus defectivus to Abiotrophia gen. nov. as Abiotrophia adiacens comb. nov. and Abiotrophia defectiva comb. nov., Respectively. Int. J. Syst. Bacteriol., 1995, 45(4), 798-803.
[http://dx.doi.org/10.1099/00207713-45-4-798] [PMID: 7547302]
[6]
Roggenkamp, A.; Abele-Horn, M.; Trebesius, K.H.; Tretter, U.; Autenrieth, I.B.; Heesemann, J. Abiotrophia elegans sp. nov., a possible pathogen in patients with culture-negative endocarditis. J. Clin. Microbiol., 1998, 36(1), 100-104.
[http://dx.doi.org/10.1128/JCM.36.1.100-104.1998] [PMID: 9431929]
[7]
Lawson, P.A.; Foster, G.; Falsen, E.; Sjödén, B.; Collins, M.D. Abiotrophia balaenopterae sp. nov., isolated from the minke whale (Balaenoptera acutorostrata). Int. J. Syst. Evol. Microbiol., 1999, 49(2), 503-506.
[http://dx.doi.org/10.1099/00207713-49-2-503] [PMID: 10319470]
[8]
Collins, M.D.; Lawson, P.A. The genus Abiotrophia (Kawamura et al.) is not monophyletic: proposal of Granulicatella gen. nov., Granulicatella adiacens comb. nov., Granulicatella elegans comb. nov. and Granulicatella balaenopterae comb. nov. Int. J. Syst. Evol. Microbiol., 2000, 50(1), 365-369.
[http://dx.doi.org/10.1099/00207713-50-1-365] [PMID: 10826824]
[9]
Centers for Disease Control and Prevention. Identification of Other Streptococcus Species: Streptococcus General Methods; U.S. Department of Health & Human Services, 2006. [Available from: https://www.cdc.gov/streplab/other-strep/general-methods-section2.html]
[10]
Christensen, J.J.; Gruhn, N.; Facklam, R.R. Endocarditis caused by Abiotrophia species. Scand. J. Infect. Dis., 1999, 31(2), 210-212.
[http://dx.doi.org/10.1080/003655499750006335] [PMID: 10447338]
[11]
Christensen, J.J.; Facklam, R.R. Granulicatella and Abiotrophia species from human clinical specimens. J. Clin. Microbiol., 2001, 39(10), 3520-3523.
[http://dx.doi.org/10.1128/JCM.39.10.3520-3523.2001] [PMID: 11574566]
[12]
Ruoff, K.L. Nutritionally variant streptococci. Clin. Microbiol. Rev., 1991, 4(2), 184-190.
[http://dx.doi.org/10.1128/CMR.4.2.184] [PMID: 2070344]
[13]
Clark, R.B.; Gordon, R.E.; Bottone, E.J.; Reitano, M. Morphological aberrations of nutritionally deficient streptococci: Association with pyridoxal (vitamin B6) concentration and potential role in antibiotic resistance. Infect. Immun., 1983, 42(1), 414-417.
[http://dx.doi.org/10.1128/iai.42.1.414-417.1983] [PMID: 6618670]
[14]
Zierdt, C.H. Light-microscopic morphology, ultrastructure, culture, and relationship to disease of the nutritional and cell-wall-deficient α-hemolytic streptococci. Diagn. Microbiol. Infect. Dis., 1992, 15(3), 185-194.
[http://dx.doi.org/10.1016/0732-8893(92)90112-7] [PMID: 1582162]
[15]
Stein, D.S.; Nelson, K.E. Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma. Clin. Infect. Dis., 1987, 9(5), 908-916.
[http://dx.doi.org/10.1093/clinids/9.5.908] [PMID: 3317735]
[16]
Bottone, E.J.; Thomas, C.A.; Lindquist, D.; Janda, J.M. Difficulties encountered in identification of a nutritionally deficient streptococcus on the basis of its failure to revert to streptococcal morphology. J. Clin. Microbiol., 1995, 33(4), 1022-1024.
[http://dx.doi.org/10.1128/jcm.33.4.1022-1024.1995] [PMID: 7790428]
[17]
Al-Tawfiq, J.A.; Kiwan, G.; Murrar, H. Granulicatella elegans native valve infective endocarditis: Case report and review. Diagn. Microbiol. Infect. Dis., 2007, 57(4), 439-441.
[http://dx.doi.org/10.1016/j.diagmicrobio.2006.10.005] [PMID: 17188448]
[18]
Cargill, J.S.; Scott, K.S.; Gascoyne-Binzi, D.; Sandoe, J.A.T. Granulicatella infection: diagnosis and management. J. Med. Microbiol., 2012, 61(6), 755-761.
[http://dx.doi.org/10.1099/jmm.0.039693-0] [PMID: 22442291]
[19]
Holler, J.G.; Pedersen, L.K.; Calum, H.; Nielsen, J.B.; Tvede, M.; Schønning, K.; Knudsen, J.D. Using MALDI-TOF mass spectrometry as a rapid and accurate diagnostic tool in infective endocarditis: A case report of a patient with mitral valve infective endocarditis caused by Abiotrophia defectiva. Scand. J. Infect. Dis., 2011, 43(3), 234-237.
[http://dx.doi.org/10.3109/00365548.2010.535559] [PMID: 21091125]
[20]
Perera, Y.L.C.P.; Galagedara, W.D.; Gunasekara, S.P.; Wijekoon, S.; Chandrasiri, N.S. Granulicatella elegans: A rare cause of infective endocarditis A case report. Sri Lankan. J. Infecti. Dis., 2021, 11(2), 121-125.
[http://dx.doi.org/10.4038/sljid.v11i2.8397]
[21]
Ohara-Nemoto, Y.; Kishi, K.; Satho, M.; Tajika, S.; Sasaki, M.; Namioka, A.; Kimura, S. Infective endocarditis caused by Granulicatella elegans originating in the oral cavity. J. Clin. Microbiol., 2005, 43(3), 1405-1407.
[http://dx.doi.org/10.1128/JCM.43.3.1405-1407.2005] [PMID: 15750118]
[22]
Casalta, J.P.; Habib, G.; La Scola, B.; Drancourt, M.; Caus, T.; Raoult, D. Molecular diagnosis of Granulicatella elegans on the cardiac valve of a patient with culture-negative endocarditis. J. Clin. Microbiol., 2002, 40(5), 1845-1847.
[http://dx.doi.org/10.1128/JCM.40.5.1845-1847.2002] [PMID: 11980974]
[23]
Perkins, A.; Osorio, S.; Serrano, M.; del Ray, M.C.; Sarriá, C.; Domingo, D.; López-Brea, M. A case of endocarditis due to Granulicatella adiacens. Clin. Microbiol. Infect., 2003, 9(6), 576-577.
[http://dx.doi.org/10.1046/j.1469-0691.2003.00646.x] [PMID: 12848740]
[24]
Altay, M.; Akay, H.; Yildiz, E.; Duranay, M. A novel agent of peritoneal dialysis-related peritonitis: Granulicatella adiacens. Perit. Dial. Int., 2008, 28(1), 96-97.
[http://dx.doi.org/10.1177/089686080802800116] [PMID: 18178954]
[25]
Ohara-Nemoto, Y.; Tajika, S.; Sasaki, M.; Kaneko, M. Identification of Abiotrophia adiacens and Abiotrophia defectiva by 16S rRNA gene PCR and restriction fragment length polymorphism analysis. J. Clin. Microbiol., 1997, 35(10), 2458-2463.
[http://dx.doi.org/10.1128/jcm.35.10.2458-2463.1997] [PMID: 9316889]
[26]
Drancourt, M.; Roux, V.; Fournier, P.E.; Raoult, D. rpoB gene sequence-based identification of aerobic Gram-positive cocci of the genera Streptococcus, Enterococcus, Gemella, Abiotrophia, and Granulicatella. J. Clin. Microbiol., 2004, 42(2), 497-504.
[http://dx.doi.org/10.1128/JCM.42.2.497-504.2004] [PMID: 14766807]
[27]
Tung, S.K.; Teng, L.J.; Vaneechoutte, M.; Chen, H.M.; Chang, T.C. Array-based identification of species of the genera Abiotrophia, Enterococcus, Granulicatella, and Streptococcus. J. Clin. Microbiol., 2006, 44(12), 4414-4424.
[http://dx.doi.org/10.1128/JCM.01712-06] [PMID: 17065265]
[28]
Giuliano, S; Caccese, R; Carfagna, P; Vena, A; Falcone, M; Venditti, M Endocarditis caused by nutritionally variant streptococci: a case report and literature review. sepsis, 2012, 1(2), 67-74.
[29]
Stein, A.; Raoult, D. Q fever endocarditis. Eur. Heart J., 1995, 16(Suppl. B), 19-23.
[http://dx.doi.org/10.1093/eurheartj/16.suppl_B.19] [PMID: 7671918]
[30]
Roberts, R.B.; Krieger, A.G.; Schiller, N.L.; Gross, K.C. Viridans streptococcal endocarditis: the role of various species, including pyridoxal-dependent streptococci. Clin. Infect. Dis., 1979, 1(6), 955-966.
[http://dx.doi.org/10.1093/clinids/1.6.955] [PMID: 551516]
[31]
Brouqui, P.; Raoult, D. Endocarditis due to rare and fastidious bacteria. Clin. Microbiol. Rev., 2001, 14(1), 177-207.
[http://dx.doi.org/10.1128/CMR.14.1.177-207.2001] [PMID: 11148009]
[32]
Gupta, S.; Garg, M.; Misra, S.; Singhal, S. Granulicatella adiacens abscess: Two rare cases and review. J. Lab. Physicians, 2018, 10(1), 121-123.
[http://dx.doi.org/10.4103/JLP.JLP_58_17] [PMID: 29403221]
[33]
Téllez, A.; Ambrosioni, J.; Llopis, J.; Pericàs, J.M.; Falces, C.; Almela, M.; Garcia de la Mària, C.; Hernandez-Meneses, M.; Vidal, B.; Sandoval, E.; Quintana, E.; Fuster, D.; Tolosana, J.M.; Marco, F.; Moreno, A.; Miro, J.M.; Miró, J.M.; Ambrosioni, J.; Pericàs, J.M.; Téllez, A.; Hernandez-Meneses, M.; Moreno, A.; Garcia de la Mària, C.; Garcia-Gonzalez, J.; Marco, F.; Almela, M.; Vila, J.; Quintana, E.; Sandoval, E.; Paré, J.C.; Falces, C.; Pereda, D.; Cartañá, R.; Ninot, S.; Azqueta, M.; Sitges, M.; Vidal, B.; Pomar, J.L.; Castella, M.; Tolosana, J.M.; Ortiz, J.; Fita, G.; Rovira, I.; Fuster, D.; Ramírez, J.; Brunet, M.; Soy, D.; Castro, P.; Llopis, J. Epidemiology, Clinical Features, and Outcome of Infective Endocarditis due to Abiotrophia Species and Granulicatella Species: Report of 76 Cases, 2000–2015. Clin. Infect. Dis., 2018, 66(1), 104-111.
[http://dx.doi.org/10.1093/cid/cix752] [PMID: 29020360]
[34]
Baddour, L.M.; Wilson, W.R.; Bayer, A.S.; Fowler, V.G., Jr; Tleyjeh, I.M.; Rybak, M.J.; Barsic, B.; Lockhart, P.B.; Gewitz, M.H.; Levison, M.E.; Bolger, A.F.; Steckelberg, J.M.; Baltimore, R.S.; Fink, A.M.; O’Gara, P.; Taubert, K.A. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation, 2015, 132(15), 1435-1486.
[http://dx.doi.org/10.1161/CIR.0000000000000296] [PMID: 26373316]
[35]
Okada, Y.; Kitada, K.; Takagaki, M.; Ito, H.O.; Inoue, M. Endocardiac infectivity and binding to extracellular matrix proteins of oral Abiotrophia species. FEMS Immunol. Med. Microbiol., 2000, 27(3), 257-261.
[http://dx.doi.org/10.1111/j.1574-695X.2000.tb01438.x] [PMID: 10683471]
[36]
Yang, S.; Wu, L.; Xu, L.; Huang, X.; Sun, X.; Yang, L.; Xu, L. Lung abscess secondary to lung cancer with a coinfection of Granulicatella adiacens and other bacteria: a case report. BMC Infect. Dis., 2021, 21(1), 662.
[http://dx.doi.org/10.1186/s12879-021-06191-8] [PMID: 34238251]
[37]
Podgórska, A.; Kordybach-Prokopiuk, M.; Jaworska-Wilczyńska, M.; Hoffman, P.; Biernacka, K.; Kuśmierski, K.; Kuthan, R.; Hryniewiecki, T.; Lutyńska, A. The First Case of Granulicatella adiacens identified from a resected heart valve by next generation sequencing (NGS) in Poland. Pathogens, 2022, 11(3), 295.
[http://dx.doi.org/10.3390/pathogens11030295] [PMID: 35335619]
[38]
Badrick, T.C.; Nusem, I.; Heney, C.; Sehu, M. Granulicatella adiacens: An uncommon diagnosis of prosthetic hip joint infection. A case report with review of the literature. IDCases, 2021, 25, e01204.
[http://dx.doi.org/10.1016/j.idcr.2021.e01204] [PMID: 34258223]
[39]
Tang, M; Zhou, H; Zhang, J; Peng, F; Sumayyah, G; Jia, B. Granulicatella adiacens infective endocarditis treated with teicoplanin and ceftriaxone: A case report. Infectious Microbes & Diseases, 2021, 3(3)
[http://dx.doi.org/10.1097/IM9.0000000000000059]
[40]
Quénard, F.; Seng, P.; Lagier, J.C.; Fenollar, F.; Stein, A. Prosthetic joint infection caused by Granulicatella adiacens: A case series and review of literature. BMC Musculoskelet. Disord., 2017, 18(1), 276.
[http://dx.doi.org/10.1186/s12891-017-1630-1] [PMID: 28645272]
[41]
Sim, B.W.C.; Koo, R.M.; Hawkins, C.; Bowden, F.; Watson, A. Granulicatella adiacens subacute bacterial endocarditis as the underlying cause of type II mixed cryoglobulinaemia. BMJ Case Rep., 2015, 2015(jan07 1), bcr2014206091.
[http://dx.doi.org/10.1136/bcr-2014-206091] [PMID: 25568266]
[42]
Gonzales-Marin, C.; Spratt, D.A.; Millar, M.R.; Simmonds, M.; Kempley, S.T.; Allaker, R.P. Levels of periodontal pathogens in neonatal gastric aspirates and possible maternal sites of origin. Mol. Oral Microbiol., 2011, 26(5), 277-290.
[http://dx.doi.org/10.1111/j.2041-1014.2011.00616.x] [PMID: 21896155]
[43]
Yamamoto, T.; Zhou, X.; Williams, C.J.; Hochwalt, A.; Forney, L.J. Bacterial populations in the vaginas of healthy adolescent women. J. Pediatr. Adolesc. Gynecol., 2009, 22(1), 11-18.
[http://dx.doi.org/10.1016/j.jpag.2008.01.073] [PMID: 19232297]
[44]
Farid, S.; Esquer Garrigos, Z.; Sohail, M.R. Infective endocarditis due to Granulicatella elegans presenting with musculoskeletal symptoms. BMJ Case Rep., 2019, 12(8), e229294.
[http://dx.doi.org/10.1136/bcr-2019-229294] [PMID: 31466970]
[45]
Patri, S.; Agrawal, Y. Granulicatella elegans endocarditis: a diagnostic and therapeutic challenge. BMJ Case Rep., 2016, 2016, bcr2015213987.
[http://dx.doi.org/10.1136/bcr-2015-213987] [PMID: 26921367]
[46]
Wang, M.; Lin, J.; Sun, S.; Yuan, X. Identification of Granulicatella elegans from a case of infective endocarditis, based on the phenotypic characteristics and 16S rRNA gene sequence. J. Cardiovasc. Med. (Hagerstown), 2015, 16(Suppl. 2), S138-S140.
[http://dx.doi.org/10.2459/JCM.0b013e328356a471] [PMID: 22772601]
[47]
Chowdhury, S.; German, M.L. Rare but Not Infrequent: Infective Endocarditis Caused by Abiotrophia defectiva. Case Rep. Infect. Dis., 2018, 2018, 1-3.
[http://dx.doi.org/10.1155/2018/5186520] [PMID: 29780647]
[48]
Park, S.; Ann, H.W.; Ahn, J.Y.; Ku, N.S.; Han, S.H.; Hong, G.R.; Choi, J.Y.; Song, Y.G.; Kim, J.M. A Case of Infective Endocarditis caused by Abiotrophia defectiva in Korea. Infect. Chemother., 2016, 48(3), 229-233.
[http://dx.doi.org/10.3947/ic.2016.48.3.229] [PMID: 27659438]
[49]
Pinkney, JA; Nagassar, RP; Roye-Green, KJ; Ferguson, T Abiotrophia defectiva endocarditis. Case Reports, 2014, 2014, bcr2014207361.
[http://dx.doi.org/10.1136/bcr-2014-207361]
[50]
Stemberger Marić, L.K.N.; Tešović, G. Abiotrophia defectiva endocarditis in a child – a case report. Infektol. Glas., 2018, 38(1), 22-24.
[51]
Chang, H.H.; Lu, C.Y.; Hsueh, P.R.; Wu, M.H.; Wang, J.K.; Huang, L.M. Endocarditis caused by Abiotrophia defectiva in children. Pediatr. Infect. Dis. J., 2002, 21(7), 697-700.
[http://dx.doi.org/10.1097/00006454-200207000-00018] [PMID: 12237606]
[52]
Je, H.; Song, D.; Chang, C.L. Bacterial endocarditis caused by Abiotrophia defectiva in a healthy adult: A case report with literature review. Ann. Clin. Microbiol., 2019, 22(1), 23.
[http://dx.doi.org/10.5145/ACM.2019.22.1.23]
[53]
Birlutiu, V.; Birlutiu, R.M. Endocarditis due to Abiotrophia defectiva, a biofilm-related infection associated with the presence of fixed braces. Medicine (Baltimore), 2017, 96(46), e8756.
[http://dx.doi.org/10.1097/MD.0000000000008756] [PMID: 29145328]
[54]
Jorgensen, J.H.; Hindler, J.F.; Reller, L.B.; Weinstein, M.P. New consensus guidelines from the clinical and laboratory standards institute for antimicrobial susceptibility testing of infrequently isolated or fastidious bacteria. Clin. Infect. Dis., 2007, 44(2), 280-286.
[http://dx.doi.org/10.1086/510431] [PMID: 17173232]
[55]
Jeng, A.; Chen, J.; Katsivas, T. Prosthetic valve endocarditis from Granulicatella adiacens (nutritionally variant streptococci). J. Infect., 2005, 51(3), e125-e129.
[http://dx.doi.org/10.1016/j.jinf.2004.10.017] [PMID: 16230190]
[56]
Alberti, M.O.; Hindler, J.A.; Humphries, R.M. Antimicrobial Susceptibilities of Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans. Antimicrob. Agents Chemother., 2016, 60(3), 1411-1420.
[http://dx.doi.org/10.1128/AAC.02645-15] [PMID: 26666926]
[57]
Karched, M.; Bhardwaj, R.G.; Asikainen, S.E. Coaggregation and biofilm growth of Granulicatella spp. with Fusobacterium nucleatum and Aggregatibacter actinomycetemcomitans. BMC Microbiol., 2015, 15(1), 114.
[http://dx.doi.org/10.1186/s12866-015-0439-z] [PMID: 26025449]
[58]
Tuohy, M.J.; Procop, G.W.; Washington, J.A. Antimicrobial susceptibility of Abiotrophia adiacens and Abiotrophia defectiva. Diagn. Microbiol. Infect. Dis., 2000, 38(3), 189-191.
[http://dx.doi.org/10.1016/S0732-8893(00)00194-2] [PMID: 11109021]
[59]
Kanamoto, T.; Terakubo, S.; Nakashima, H. Antimicrobial Susceptibilities of Oral Isolates of Abiotrophia and Granulicatella according to the consensus guidelines for fastidious bacteria. Medicines (Basel), 2018, 5(4), 129.
[http://dx.doi.org/10.3390/medicines5040129] [PMID: 30514000]
[60]
De Luca, M.; Amodio, D.; Chiurchiù, S.; Castelluzzo, M.A.; Rinelli, G.; Bernaschi, P.; Calò Carducci, F.I.; D’Argenio, P. Granulicatella bacteraemia in children: two cases and review of the literature. BMC Pediatr., 2013, 13(1), 61.
[http://dx.doi.org/10.1186/1471-2431-13-61] [PMID: 23607627]
[61]
Gul, M; Reshma, G; Priyanka, B. Endocarditis caused by abiotrophia and granulicatella species. In: Advanced concepts in Endocarditis; Intech Open: London. UK, 2018; pp. 41-58.
[http://dx.doi.org/10.5772/intechopen.74252]

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