Streptococcus Intermedius Research Articles

Primary ventriculitis caused by Streptococcus intermedius - a rare case and challenge with uncertain clinical outcome. Case report.

To present a case of primary ventriculitis in a 53-year-old patient caused by Streptococcus intermedius, emphasizing the rarity of the condition and the challenges in achieving clinical improvement despite targeted therapy. The patient underwent clinical evaluation, including CT and MRI imaging, as well as CSF analysis. Empirical antibiotic therapy was initiated with cefotaxime and metronidazole, followed by targeted therapy based on CSF culture results. External ventricular drainage was performed surgically. No predisposing factors were identified in the patient. Initial imaging showed no acute changes, but follow-up imaging revealed significant ventricular inflammation. CSF analysis confirmed the presence of Streptococcus intermedius. Despite early and targeted antibiotic therapy, and surgical intervention, the patient's clinical condition did not improve. This case highlights the rarity of primary ventriculitis caused by Streptococcus intermedius and the challenges in managing it. The lack of clinical improvement despite prompt and targeted treatment underscores the need for further research to develop more effective therapeutic strategies for such infections.

Microbiology and Epidemiology of Orbital Cellulitis in Pediatric and Young Adult Patients.

Using data from the large and geographically diverse Military Health System (MHS) beneficiary population, we aimed to characterize and update the epidemiology and microbiology of pediatric orbital cellulitis given previous data are limited to small, single-center studies. Following institutional review board approval, we performed a retrospective analysis using the Military Health System admissions, microbiology, and pharmacy data between June 2009 and September 2019. Patients less than 22 years of age with radiological confirmation of orbital cellulitis were included. Demographic data, presence of sinusitis, advanced imaging reports, blood and wound culture results with antibiotic susceptibilities, and antibiotic prescriptions were collected. Descriptive statistics were used to summarize demographic characteristics. Imaging findings were grouped by Chandler's stage (CS), an imaging-based measure of the progressive severity of orbital involvement. A Cochran-Armitage trend test was used to evaluate the relationship between CS and likelihood of positive confirmatory culture. There was a male predominance (66.9%) and 55.5% of subjects had comorbid sinusitis. Of the 130 subjects included, 33.8% had one or more positive cultures, 30.8% had a positive wound culture, and 4.6% had a positive blood culture. The most identified organism was coagulase-negative staphylococci (23.3%), followed by Staphylococcus aureus (18.9%), Streptococcus intermedius (17.8%), and strict anaerobes as a group (13.3%). Gram-negative organisms were rare. Twenty-five percent of S. aureus were methicillin-resistant. Clindamycin resistance was identified in 9% of all S. aureus, 50% of coagulase-negative staphylococci, and 25% of S. intermedius. Clindamycin plus ceftriaxone was the most prescribed empiric antibiotic regimen (36.2%). Likelihood of a positive culture significantly increased with advancing CS. Orbital cellulitis occurs most frequently in males with sinusitis. Likelihood of positive wound culture is increased with a more advanced CS. Staphylococcus and Streptococcus spp. and anaerobes are the most identified pathogens in orbital cellulitis, while gram-negative organisms are rare. Empiric antibiotic selection should include an anti-methicillin-resistant S. aureus agent combined with a broad-spectrum beta-lactam and anaerobic coverage.

Complete genome sequence of Streptococcus intermedius strain XH2169.

Here, we report the complete genome sequence of Streptococcus intermedius strain XH2169 isolated from a blood sample in China. The genome comprises a single circular chromosome with a length of 1,944,282 bp. It harbored 1,891 coding gene sequences, 16 rRNA genes, 60 tRNA genes, and 3 noncoding RNA genes.

Effectiveness of therapy of complicated forms of dental caries using an Er,Cr:YSGG laser with a wavelength of 2780 nm

BACKGROUND: The use of laser technologies in the treatment of complicated forms of dental caries is promising in dentistry. However, the available literature does not fully cover the use of the Er,Cr:YSGG laser (wavelength: 2780 nm) in the treatment of purulent pulpitis and pulp necrosis. AIM: To determine the effectiveness of therapy for complicated forms of dental caries using an erbium–chromium laser with a wavelength of 2780 nm for biomechanical treatment of root canals. MATERIALS AND METHODS: Overall, 106 patients were examined and divided into three groups: group 1 (control), 15 patients whose treatment was performed using a generally accepted method; group 2, 50 patients who were treated with erbium–chromium laser radiation at the second visit, immediately before root canal obturation; and group 3, 41 patients who were treated in one visit and divided into two subgroups. In group 3-A (n=18), the root canal was irradiated with a laser with factory settings, and in group 3-B (n=23), the frequency and power of the laser were increased from 20 to 40 Hz and from 1.25 to 1.5 Watts, respectively. RESULTS: In group 1, 59 microorganisms from all 17 strains were seeded before the treatment of the root canal system of teeth with chlorine-containing disinfectants. Moreover, the proportion of seeded microorganisms in each strain was 6.6%–40% (average value: 23.1%). After treatment, the seeding rate of Streptococcus mitis decreased from 40% to 13%, Streptococcus intermedius from 20% to 6.6%, Enterococcus spp. from 33.3% to 13.3%, and Candida spp. from 33.3% to 20%. In group 2, after complex biomechanical treatment of root canals and the use of a hydrokinetic laser, none of the 17 strains sown before treatment were observed. The Candida spp. (5.5%) were not neutralized due to the use of a hydrokinetic laser with a wavelength of 2780 nm in the factory settings in group 3-A (power, 1.25 W; pulse frequency, 20 Hz; air, 10%; water, off). The combined use of the traditional protocol and hydrokinetic Er,Cr:YSGG laser in group 3B enabled complete elimination of microorganisms from those sown before treatment (p 0.001). CONCLUSION: Treatment of purulent pulpitis and pulp necrosis in one visit using a hydrokinetic Er,Cr:YSGG laser with a wavelength of 2780 nm with increased parameters (i.e., power, 1.5 W; frequency, 40 Hz; air, 35%; water, 25%) is recommended.

The hidden threat: subdural empyema strikes a healthy teen

BackgroundThe incidence estimates for intracranial subdural empyema are 0.1 per 100,000 individuals, making it a rare clinical condition. It is a highly morbid and fatal illness that is most commonly the result of a primary infection somewhere else.Case presentationThe authors present a young male patient 15 years presented with 1 week history of headache, fever, confusion and seizure attack with initial negative CT head and nearly negative CSF analysis. With few days he developed left sided weakness. MRI brain showed right temporoparietal subdural fluid collection with midline shift. Urgent neurosurgical evacuation was made and revealed subdural empyema. The boy received combination therapy of vancomycin, ceftriaxone, and metronidazole. The culture of the pus was negative but 16S rRNA gene sequencing (bacterial) revealed streptococcus intermedius. He made a good recovery with no recollection or neurological deficit on follow up.ConclusionThis case highlights the possibility of occurrence of this rare infection in otherwise healthy individuals without obvious precipitating factor. It also indicates the superiority of MRI brain over CT head in detection of subdural collection. The rapid diagnosis and intervention improve the outcome of the patient.

Bacteria of healthy periodontal tissues as candidates of probiotics: a systematic review

ObjectivesThe use of probiotics could promote the balance of the subgingival microbiota to contribute to periodontal health. This study aimed to identify the potential of bacteria commonly associated with healthy periodontal tissues as probiotic candidates.Material and methodsA systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed, Scopus, Science Direct, ProQuest, and Ovid databases as well as the combination of Medical Subject Headings (MeSH) and non-MeSH terms. Based on the selection criteria, original studies published in English and identifying the microorganisms present in the periodontium of healthy individuals and patients with periodontitis using the high-throughput 16S ribosomal gene sequencing technique were included.ResultsOut of 659 articles, 12 met the criteria for this review. These articles were published from 2012 to 2020 and mainly originated from the United States, China, and Spain. Most of these studies reported adequate criteria for selecting participants, using standardized clinical criteria, and compliance with quality based on the tools used. In periodontal healthy tissue were identified species like Actinomyces viscosus, Actinomyces naeslundii, Haemophilus parainfluenzae, Rothia dentocariosa, Streptococcus sanguinis, Streptococcus mitis, Streptococcus oralis, Streptococcus gordonii, Streptococcus intermedius, and Prevotella nigrescens which have recognized strains with a capacity to inhibit periodontopathogens.ConclusionsS. sanguinis, S. oralis, S. mitis, and S. gordonii are among the bacterial species proposed as potential probiotics because some strains can inhibit periodontopathogens and have been reported as safe for humans.

Metagenomic Analysis of Biliary Microbial Flora in Patients with Gallbladder Cancer or Gallstones-Associated Chronic Cholecystitis

Biliary dysbiosis is associated with gallbladder cancer (GBC). We aimed to look for biliary bacteria specifically detected in GBC patients. We used 16S rRNA-based metagenomic analysis to elucidate biliary microbiota in 30 GBC and 30 gallstones-associated chronic cholecystitis patients. Relative abundance of five genera, Streptococcus, Enterococcus, Halomonas, Escherichia and Caulobacter was significantly associated with GBC. Of 15-species, 7 were detected significantly higher in GBC, Streptococcus anginosus, Streptococcus constellatus, Streptococcus intermedius, Actinomyces bowdenii, Actinomyces israelii, Actinomyces gerencseriae, and Escherichia fergusonii were biosafety level-2 infectious bacteria; other 8 species were biosafety level-1 bacteria. These bacterial species may be involved in pathogenesis of GBC.

Exploring odontogenic brain abscesses: a comprehensive review.

Whether in neurology or dentistry, odontogenic brain abscess stands as an ailment demanding undivided attention. The onset of this disease is insidious, with a relatively low incidence rate but a markedly high fatality rate. Moreover, its symptoms lack specificity, easily leading to misdiagnosis, oversight, and treatment delays. Hence, clinicians should maintain heightened vigilance when faced with pathogenic bacteria of dental origin in patients. This paper encapsulates the latest research findings on the clinical manifestations and essential treatment points of odontogenic brain abscess. It may offer a crucial reference for prompt diagnosis and improved therapeutic approaches. Odontogenic brain abscess, an infection of the cerebral parenchyma, usually appears in immunocompromised patients with dental ailments or postdental surgeries. The main pathogenic microorganisms include Streptococcus intermedius, Fusobacterium nucleatum, Streptococcus anginosus, and Millerella. Given the undetectable and nonspecific symptoms in patients, the diagnostic process relies on microbiological methods. Therefore, clinicians should actively investigate and identify the pathogenic microorganisms of odontogenic brain abscess for early detection and selection of appropriate treatment regimens to avoid disease management delays.

Comparative Lipidomics of Oral Commensal and Opportunistic Bacteria.

The oral cavity contains a vast array of microbes that contribute to the balance between oral health and disease. In addition, oral bacteria can gain access to the circulation and contribute to other diseases and chronic conditions. There are a limited number of publications available regarding the comparative lipidomics of oral bacteria and fungi involved in the construction of oral biofilms, hence our decision to study the lipidomics of representative oral bacteria and a fungus. We performed high-resolution mass spectrometric analyses (<2.0 ppm mass error) of the lipidomes from five Gram-positive commensal bacteria: Streptococcus oralis, Streptococcus intermedius, Streptococcus mitis, Streptococcus sanguinis, and Streptococcus gordonii; five Gram-positive opportunistic bacteria: Streptococcus mutans, Staphylococcus epidermis, Streptococcus acidominimus, Actinomyces viscosus, and Nanosynbacter lyticus; seven Gram-negative opportunistic bacteria: Porphyromonas gingivalis. Prevotella brevis, Proteus vulgaris, Fusobacterium nucleatum, Veillonella parvula, Treponema denticola, and Alkermansia muciniphila; and one fungus: Candida albicans. Our mass spectrometric analytical platform allowed for a detailed evaluation of the many structural modifications made by microbes for the three major lipid scaffolds: glycerol, sphingosine and fatty acyls of hydroxy fatty acids (FAHFAs).

Human genetic associations of the airway microbiome in chronic obstructive pulmonary disease

Little is known about the relationships between human genetics and the airway microbiome. Deeply sequenced airway metagenomics, by simultaneously characterizing the microbiome and host genetics, provide a unique opportunity to assess the microbiome-host genetic associations. Here we performed a co-profiling of microbiome and host genetics with the identification of over 5 million single nucleotide polymorphisms (SNPs) through deep metagenomic sequencing in sputum of 99 chronic obstructive pulmonary disease (COPD) and 36 healthy individuals. Host genetic variation was the most significant factor associated with the microbiome except for geography and disease status, with its top 5 principal components accounting for 12.11% of the microbiome variability. Within COPD individuals, 113 SNPs mapped to candidate genes reported as genetically associated with COPD exhibited associations with 29 microbial species and 48 functional modules (P < 1 × 10−5), where Streptococcus salivarius exhibits the strongest association to SNP rs6917641 in TBC1D32 (P = 9.54 × 10−8). Integration of concurrent host transcriptomic data identified correlations between the expression of host genes and their genetically-linked microbiome features, including NUDT1, MAD1L1 and Veillonella parvula, TTLL9 and Stenotrophomonas maltophilia, and LTA4H and Haemophilus influenzae. Mendelian randomization analyses revealed a potential causal link between PARK7 expression and microbial type III secretion system, and a genetically-mediated association between COPD and increased relative abundance of airway Streptococcus intermedius. These results suggest a previously underappreciated role of host genetics in shaping the airway microbiome and provide fresh hypotheses for genetic-based host-microbiome interactions in COPD.

Streptococcus intermedius causing primary bacterial ventriculitis in a patient with severe periodontitis - a case report

BackgroundStreptococcus intermedius is a member of the S. anginosus group and is part of the normal oral microbiota. It can cause pyogenic infections in various organs, primarily in the head and neck area, including brain abscesses and meningitis. However, ventriculitis due to periodontitis has not been reported previously.Case presentationA 64-year-old male was admitted to the hospital with a headache, fever and later imbalance, blurred vision, and general slowness. Neurological examination revealed nuchal rigidity and general clumsiness. Meningitis was suspected, and the patient was treated with dexamethasone, ceftriaxone and acyclovir. A brain computer tomography (CT) scan was normal, and cerebrospinal fluid (CSF) Gram staining and bacterial cultures remained negative, so the antibacterial treatment was discontinued. Nine days after admission, the patient’s condition deteriorated. The antibacterial treatment was restarted, and a brain magnetic resonance imaging revealed ventriculitis. A subsequent CT scan showed hydrocephalus, so a ventriculostomy was performed. In CSF Gram staining, chains of gram-positive cocci were observed. Bacterial cultures remained negative, but a bacterial PCR detected Streptococcus intermedius. An orthopantomography revealed advanced periodontal destruction in several teeth and periapical abscesses, which were subsequently operated on. The patient was discharged in good condition after one month.ConclusionsPoor dental health can lead to life-threatening infections in the central nervous system, even in a completely healthy individual. Primary bacterial ventriculitis is a diagnostic challenge, which may result in delayed treatment and increased mortality.

Retrospective analysis of antimicrobial resistance in bacterial pathogens from pet rabbits in Hong Kong, 2019-2022.

Antimicrobial resistance (AMR) is a growing threat to human and animal health. Data are limited on the prevalence of resistant bacteria in pet rabbits. Therefore, we aimed to identify prevalent bacterial infections and AMR profiles among pet rabbits in Hong Kong (HK). Our search of the CityU Veterinary Diagnostic Laboratory (VDL) database found 301 cases of pet rabbits submitted for bacteriologic and antimicrobial susceptibility testing by veterinarians at 20 exotic veterinary clinics across HK between 2019 and 2022. The rabbits were of 8 different breeds and had a median age of 6.5 y, with 54.8% males, 40.2% females, and 5% unspecified. Of the 301 samples received, 168 (55.8%) had positive bacterial growth; 125 (74.4%) had single bacterial isolates, and 43 (25.6%) had mixed cultures. Cultures included Enterococcus faecalis (21.3%) as the most frequently isolated gram-positive bacterium, followed by Streptococcus intermedius (12.5%), and Staphylococcus aureus (11.3%). The most frequently isolated gram-negative bacteria were Pseudomonas aeruginosa (18.1%), followed by Escherichia coli (8.3%), Pasteurella multocida (6.9%), and Klebsiella pneumoniae (4.2%). Approximately 83% of the isolates had acquired resistance to at least one antimicrobial agent, and 49.4% were multidrug-resistant. The isolated bacteria had high levels of resistance to penicillin (69.8%), clindamycin (47.4%), and doxycycline (46.9%). Our findings highlight the high levels of AMR in bacteria isolated from pet rabbit clinical samples in HK; many of these bacteria are zoonotic and pose a public health threat.

Rectal perforation secondary to invasive cervical cancer presenting as perineal necrotizing fasciitis with subsequent hindquarter amputation: a case report

Necrotizing fasciitis (NF) is a life-threatening soft tissue infection rarely associated with gynecological malignancies. We present a unique case of NF arising from a locally advanced cervical cancer eroding into the rectum, causing occult fecal spillage leading to severe infection and necessitating a hindquarter amputation. A 39-year-old woman presented with sepsis and a necrotic gluteal wound. Extensive debridement revealed "dishwater"-like discharge throughout the left leg fascial compartments, necessitating hindquarter amputation. Despite initial suspicion of a primary skin infection, further investigation revealed a posterolateral rectal perforation secondary to advanced cervical cancer, confirmed by biopsy and imaging. Microbiology identified Streptococcus constellatus, intermedius, and anginosus. This case highlights the atypical presentation of NF associated with advanced cervical cancer. High clinical suspicion and early surgical intervention are crucial for survival. This case expands the understanding of NF etiology and emphasizes the importance of considering rare causes, even in the absence of traditional risk factors.

Identification of keystone taxa in root canals and periapical lesions of post-treatment endodontic infections: Next generation microbiome research.

The aim of this study was to analyse and compare the microbiome present in root canals and periapical lesions of teeth with post-treatment infections, and to identify the presence of keystone taxa in both habitats using next-generation sequencing analysis. Apices and periapical lesions of patients with post-treatment apical periodontitis were surgically extracted. Specimens were cryo-pulverized, bacterial DNA was extracted, and the V3-V4 hypervariable regions of the 16S rRNA gene were sequenced using the Illumina Miseq platform. Bioinformatic analysis was carried out with Mothur software, whilst diversity indices were obtained using operational taxonomic units (OTUs). The diversity indices were compared with the Kruskal-Wallis test, and community composition differences were explored with Permutational Multivariate Analysis of Variance (PERMANOVA). A bacterial functional study was performed with the Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analysis. Co-occurrence network analyses were performed using the Sparse Correlations for Compositional data (SparCC). Eigencentrality, clr-based abundance and ubiquitousness were applied to infer keystone taxa. P values <.05 were considered statistically significant. Thirty-two apices and thirty-nine periapical lesions were sequenced and analysed. A similar alpha-diversity (p < .05) and community composition (p = .91) was observed for apices and lesion samples. The most abundant OTUs identified amongst all samples included Fusobacterium nucleatum, Prevotella loescheii, Streptococcus intermedius, Porphyromonas gingivalis, Parvimonas micra, Synergistetes bacterium, Tannerella forsythia and Peptostreptococcus stomatis. The metabolic pathways with >0.81% abundances included membrane transport, genetic information processing and metabolic pathways. F. nucleatum was identified as a keystone taxon as it showed ubiquitousness, an eigenvector centrality value of 0.83 and a clr-based abundance >4. The microbiome in apices and periapical lesions of post-treatment endodontic infections showed a similar diversity and taxonomic composition. Co-occurrence network analyses at OTU level identified F. nucleatum as a keystone taxon candidate in these infections.

Identification of mutations resulting in derepression of the intermedilysin gene by sequential mutagenesis of its promoter region in Streptococcus intermedius.

Streptococcus intermedius secretes the human-specific cytolysin intermedilysin (ILY), a crucial factor in the pathogenicity of this bacterium. Previously, we reported that a lactose phosphotransferase repressor (LacR) represses ily expression, and that its mutation increases ILY production. Interestingly, UNS40, a strain isolated from a liver abscess, produces high levels of ILY despite the absence of mutations in the lacR promoter and coding regions. Our results showed that a G>A mutation at the-90th position from the transcription start point in the UNS40 ily promoter region increased hemolytic activity and decreased the binding ability to LacR. To elucidate the regions involved in the repression of ily expression, we generated mutant strains, in which point or deletion mutations were introduced into the ily promoter region, and then compared their hemolytic activity. Among the point mutations, -120 C>A and-90 G>A and their flanking mutations increased hemolytic activity. These results indicated that these mutations may increase the virulence of S. intermedius.

Structure of a tripartite protein complex that targets toxins to the type VII secretion system.

Type VII secretion systems are membrane-embedded nanomachines used by Gram-positive bacteria to export effector proteins from the cytoplasm to the extracellular environment. Many of these effectors are polymorphic toxins comprised of an N-terminal Leu-x-Gly (LXG) domain of unknown function and a C-terminal toxin domain that inhibits the growth of bacterial competitors. In recent work, it was shown that LXG effectors require two cognate Lap proteins for T7SS-dependent export. Here, we present the 2.6 Å structure of the LXG domain of the TelA toxin from the opportunistic pathogen Streptococcus intermedius in complex with both of its cognate Lap targeting factors. The structure reveals an elongated α-helical bundle within which each Lap protein makes extensive hydrophobic contacts with either end of the LXG domain. Remarkably, despite low overall sequence identity, we identify striking structural similarity between our LXG complex and PE-PPE heterodimers exported by the distantly related ESX type VII secretion systems of Mycobacteria implying a conserved mechanism of effector export among diverse Gram-positive bacteria. Overall, our findings demonstrate that LXG domains, in conjunction with their cognate Lap targeting factors, represent a tripartite secretion signal for a widespread family of T7SS toxins.

Isolated Facial Vein Thrombosis in a Case of Lemierre's Syndrome

Lemierres disease is an anaerobic post-anginal sepsis presenting in the form of septic thrombosis of internal jugular vein. A 13-year old boy presented with high fever delirium trismus parotid edema and thrombophlebitis of facial vein. Causative agent was Streptococcus intermedius. The condition responded to metronidazole and linezolid. This case is reported due to its rarity.nbsp

S treptococcus intermedius and Other Streptococcus anginosus Group Species in Pediatric Cranial and Intracranial Pyogenic Infections.

S treptococcus intermedius and Other Streptococcus anginosus Group Species in Pediatric Cranial and Intracranial Pyogenic Infections.

A Comparison between Scaling and Root Planning (SRP), Antibiotic and Diode Laser Application in Treatment of Localized Juvenile Periodontitis (Microscopical Study)

The present study aimed to study different ways for treatment of Localized Juvenile periodontitis, cultural and microscopic results of specimens from base line, appeared the following bacterial strains: Bacteroides gracilis ,Fusobacterium nuclautum, Porphyromonas intermedia, Actinomyces, peptostreptococcus species, eikenella corrodens, streptococcus intermedius, Streptococcus salivaris. Which distribution in 50% gram positive and 50% gram negative. Cultural and microscopical result after ten days of the experimental design appeared significant difference P≥ 0.05, at the SRP group results of microscopic and culturing show Peptostreptoccal species, Prevotella intermedia, Fusobacterium nuclautum, Streptococcus Saliveris. While at the SRP and antibiotic treated group (Doxycyclin 100 mg) the pattern of microbial study appeared the following bacteria: Fusobacterium nucleotum, Peptostreptococcus, Streptococcus salivaris. At the other hand the results of third group SRP and diode Laser appeared no growth of microorganism at all site subjected to Laser 0.8 w, 940 nm for 20 sec after ten days of study.

Mitigating Infectious Complications of Injection Pharyngoplasty with Calcium Hydroxyapatite for Velopharyngeal Insufficiency: Retropharyngeal Abscess and Osteomyelitis.

Velopharyngeal insufficiency is a complex condition with various treatment options. In this case, a patient with a cleft palate who was treated for velopharyngeal insufficiency with calcium hydroxyapatite injection pharyngoplasty developed persistent cervical pain on postoperative day 6. CT imaging showed a hypodense structure in the right retropharyngeal tissue, and cultures tested positive for Streptococcus intermedius and Staphylococcus aureus. An MRI later revealed skull base osteomyelitis. The infection was controlled via surgical intervention and antibiotics. This case highlights potential severe complications from injection pharyngoplasty and it underscores the importance of early recognition and management of infectious complications.