Nutritionally Variant Streptococcal Bacteremia in the 21st Century

Abstract

Abstract We report the results of a 12-year retrospective study of nutritionally variant streptococcal (NVS) bacteremia in a 510-bed, a large medical school-affiliated teaching hospital. Twenty-six episodes of NVS bacteremia were identified in this institutional review board—approved study of all positive blood cultures for NVS from January 1, 2006, to December 31, 2017. Most patients with NVS bacteremia were 50 years and older. Detection of bacteremia in the microbiology laboratory took from 2 to 11 days of incubation with an average of 4.65 days. Endocarditis was the most common source of bacteremia (7 patients), followed by primary bacteremia, skin and soft tissue infections, bone and joint infections, and device-associated infections. The mortality of patients in the study was 15% despite all but 1 patient who died receiving appropriate antimicrobial therapy immediately upon hospital admission. Nutritionally variant streptococcal bacteremia is uncommon, is frequently associated with infective endocarditis, is often detected late in the hospital course because of delayed growth of NVS organisms in blood culture media, and had a 15% mortality rate.