In my lab results, i have encountered a patient diagnosed with endocarditis due to an infection with S. dysgalactiae subsp. equisimilis, an organism that many of us probably don't know a lot about, so i thought i could just elaborate a little bit about it and add some information about it.
S. dysgalactiae subsp. Equisimilis (SDSE) is a sub-specie of Group G Streptococcus (GGS) species, which were first isolated in patients with puerperal sepsis in 1935. GGS are known to be commensals and pathogens in domestic animals. In humans, they may colonize the pharynx, skin, gastrointestinal and female genital tract. It has been increasingly reported in human infections such as pharyngitis, cellulitis, meningitis, endocarditis, and sepsis. S. dysgalactiae subsp. equisimilis is the most common species of GGS that is β-hemolytic on sheep blood agar.
The pathogenicity of S. dysgalactiae subsp. equisimilis has a wide spectrum of disease similar to that caused by Streptococcus pyogenes. Invasive infections with SDSE comprise arthritis, osteomyelitis, pleuropulmonary infections, peritonitis, intra-abdominal and epidural abscesses, meningitis, endocarditis, puerperal septicemia, neonatal infections, necrotizing fascitis, myositis, and streptococcal toxic-like syndrome. The invasive infections caused by SDSE has been found to be due to a rare mutation of the emm gene, which encodes for the M protein, which is a major virulence factor is SDSE (also present in S. pyogenes).
SDSE is susceptible to penicillin and other β-lactam agents, and penicillin is considered the drug of choice. The addition of an aminoglycoside to the cell wall-active agent is granted in serious infections. Also the Quinolone drugs have shown to have very good coverage for the eradication of the organism and treatment of invasive infections.
In conclusion, SDSE has many times been overlooked as a potential for invasive infections, and physicians and microbiologists are learning to look for this organism more, in order to provide the patient with optimized antimicrobial regimen.
S. dysgalactiae subsp. Equisimilis (SDSE) is a sub-specie of Group G Streptococcus (GGS) species, which were first isolated in patients with puerperal sepsis in 1935. GGS are known to be commensals and pathogens in domestic animals. In humans, they may colonize the pharynx, skin, gastrointestinal and female genital tract. It has been increasingly reported in human infections such as pharyngitis, cellulitis, meningitis, endocarditis, and sepsis. S. dysgalactiae subsp. equisimilis is the most common species of GGS that is β-hemolytic on sheep blood agar.
The pathogenicity of S. dysgalactiae subsp. equisimilis has a wide spectrum of disease similar to that caused by Streptococcus pyogenes. Invasive infections with SDSE comprise arthritis, osteomyelitis, pleuropulmonary infections, peritonitis, intra-abdominal and epidural abscesses, meningitis, endocarditis, puerperal septicemia, neonatal infections, necrotizing fascitis, myositis, and streptococcal toxic-like syndrome. The invasive infections caused by SDSE has been found to be due to a rare mutation of the emm gene, which encodes for the M protein, which is a major virulence factor is SDSE (also present in S. pyogenes).
SDSE is susceptible to penicillin and other β-lactam agents, and penicillin is considered the drug of choice. The addition of an aminoglycoside to the cell wall-active agent is granted in serious infections. Also the Quinolone drugs have shown to have very good coverage for the eradication of the organism and treatment of invasive infections.
In conclusion, SDSE has many times been overlooked as a potential for invasive infections, and physicians and microbiologists are learning to look for this organism more, in order to provide the patient with optimized antimicrobial regimen.
No comments:
Post a Comment