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Abstract - Abiotrophia and Granulicatella Infections in Cancer Patients: A Single-Center Chart Review Study
Joo Eun Kwon, Dae Hyun Lee, George Coba, Annie Topham, Misbahuddin Syed, Asha Ramsakal, John Greene

Abiotrophia and Granulicatella Infections in Cancer Patients: A Single-Center Chart Review Study

Jooeun Kwon1, Dae Hyun Lee2, George Coba1, Annie Topham3, Misbahuddin Syed4, Asha Ramsakal5,

John Greene6

1Morsani College of Medicine, University of South Florida, Tampa, FL, USA

2Division of Cardiovascular Science, Department of General Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

3Department of General Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, USA

4Internal and Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

5Department of Internal Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

6Infectious Diseases and Hospital Epidemiologist, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA

 

ABSTRACT

Objectives: Nutritionally Variant Streptococci (NVS) comprise two primary genera that have been identified from human specimens, particularly the Abiotrophia and Granulicatella species. These infections are often complicated to manage due to the difficulty identifying these organisms, indolent course of disease, and variable resistance to common antimicrobial agents. The wide breadth of disease presentations involving these organisms has not been fully elucidated, particularly in the immunosuppressed cancer patient population.

Method: We performed a retrospective chart review on 28 patients from an academic cancer center with positive NVS cultures, from January 2012 to July 2018. We reviewed patient characteristics, culture data, immunodeficiency status, response to antibiotic therapy, and outcomes of infection.

Results: Of twenty-eight patients, fifteen patients developed bacteremia from either Abiotrophia or Granulicatella species, while thirteen patients had positive wound or body fluid cultures. Most patients with bacteremia had underlying hematologic malignancies and neutropenia. Patients with positive wound or body fluid cultures had an invasive procedure at the related site. Intravenous (IV) vancomycin was the most common agent used, and all but two patients were treated with multiple antibiotic regimens.

Conclusions: Infections with NVS have been reported with a variety of clinically infectious presentations and should be considered in cancer patients with neutropenia or in patients who have undergone invasive procedures. Bacteremia was the most common complication, especially in the setting of hematologic malignancy and neutropenia. Focal body site infection was also a common complication related to invasive procedures in immunocompetent patients. Overall mortality was low and related to complications of septic shock. J Microbiol Infect Dis 2020; 10(2):89-97.

Keywords: Abiotrophia, Granulicatella, bacteremia, cancer, neutropenic infection

 

Volume 10, Number 02 (2020)