Abstract
The viridans group streptococci (VGS) are a diverse group of organisms that form the microbiota of the gastrointestinal tract. There are over 30 recognized species of VGS with varied microbiologic and pathologic properties. They are typically classified into six major groups including the S. mutans group, S. salivarius group, S. mitis group, S. sanguinis group, S. anginosus group, and S. bovis group. While relatively avirulent compared to other forms of streptococci, they may act as opportunistic organisms causing infections of various body sites that may have damaged tissue. The most common infection caused by nutritionally variant streptococci (NVS) remains native valve subacute bacterial endocarditis (SBE). The S. anginosis group may cause abscesses of the brain, liver, and abdomen. Groups C and G streptococci may cause pharyngitis or cellulitis in elderly, diabetic, or cirrhotic patients. VGS remain highly susceptible to β-lactam antibiotics and when resistance is present, it is a “relative resistance” that can be overcome with higher doses of β-lactams.
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