Granulicatella adiacens isolated from sterile body fluids: A case series from India

Abstract

The genera Abiotrophia and Granulicatella spp. (previously known as nutritionally variant Streptococcus) are infrequently isolated from clinical specimens. Literature quotes that they account for about 56% of the infective endocarditis and bacteremia, and lesser in CNS infections (post instrumentation) and others. The objective of the study was to assess the clinical significance and outcome of the patients with laboratory isolations of <i>Granulicatella adiacens</i>. Case Series: We reviewed the clinical records from 201112 noting down the demographic details, identifiable risk factors, management of patients in whom <i>Granulicatella adiacens</i> was isolated. Seven cases of <i>Granulicatella adiacens</i> were reported. Five were children (<2 years) and two were male adults. Six strains were from blood and one was isolated from cerebrospinal fluid shunt fluid and were regarded as clinically significant. Pre-existing co-morbidities like nephrotic syndrome, premature birth and dysmorphism were noted in almost all the children. One of the patients had undergone invasive ventriculoperitoneal shunt insertion. All the patients except one (discharged against medical advice) recovered. Conclusion: The study describes the spectrum of infections by <i>Granulicatella adiacens</i>. <i>G. adiacens</i> can grow on routine sheep blood agar without pyridoxal supplementation in CO2 incubator when sub-cultured from automated blood culture bottles. This is one of the largest study from India.