Viridans-Group Streptococci: Difference between revisions
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==Background== | ==Background== | ||
*A [[Gram Positive Bacteria]] in the [[Streptococcus Genus]] | *A [[Gram Positive Bacteria]] in the [[Streptococcus Genus]] | ||
*In general, low virulence pathogens and likely [[Blood Culture Contaminant]] (21-50% of positive blood cultures are clinically significant) unless risk factor (see below) | *In general, low virulence pathogens and likely [[Blood Culture Contaminant]] (21-50% of positive blood cultures are clinically significant) unless risk factor (see below)<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref> | ||
==Types== | ==Types<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>== | ||
**Streptococcus milleri | **Streptococcus milleri | ||
**Streptococcus sanguis | **Streptococcus sanguis | ||
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**Streptococcus bovis | **Streptococcus bovis | ||
==Risk Factors Viridans Bacteremia== | ==Risk Factors Viridans Bacteremia<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>== | ||
*neutropenia | *neutropenia | ||
*oral mucositis | *oral mucositis | ||
Revision as of 07:14, 22 April 2014
Background
- A Gram Positive Bacteria in the Streptococcus Genus
- In general, low virulence pathogens and likely Blood Culture Contaminant (21-50% of positive blood cultures are clinically significant) unless risk factor (see below)[1]
Types[2]
- Streptococcus milleri
- Streptococcus sanguis
- Streptococcus mitis
- Streptococcus bovis
Risk Factors Viridans Bacteremia[3]
- neutropenia
- oral mucositis
- irradiation to the oral cavity
- antibiotic prophylaxis with trimethoprim-sulfamethoxazole and fluoroquinolones
- intravenous hyperalimentation
- high dose chemotherapy
Antibiotic Sensitivities[4]
| Organisms | ' | Viridans strep |
| Penicillins | Penicillin G | +/- |
| Penicillin V | +/- | |
| Anti-Staphylocccal Penicillins | Methicillin | +/- |
| Nafcillin/Oxacillin | +/- | |
| Cloxacillin/Diclox. | +/- | |
| Amino-Penicillins | AMP/Amox | +/- |
| Amox/Clav | +/- | |
| AMP-Sulb | +/- | |
| Anti-Pseudomonal Penicillins | Ticarcillin | +/- |
| Ticar-Clav | +/- | |
| Pip-Taxo | +/- | |
| Carbapenems | Piperacillin | +/- |
| Doripenem | + | |
| Ertapenem | + | |
| Imipenem | + | |
| Meropenem | + | |
| Aztreonam | 0 | |
| Fluroquinolones | Ciprofloxacin | 0 |
| Ofloxacin | 0 | |
| Pefloxacin | ||
| Levofloxacin | + | |
| Moxifloxacin | + | |
| Gemifloxacin | + | |
| Gatifloxacin | + | |
| 1st G Cephalosporin | Cefazolin | + |
| 2nd G. Cephalosporin | Cefotetan | + |
| Cefoxitin | + | |
| Cefuroxime | + | |
| 3rd/4th G. Cephalosporin | CefoTAXime | + |
| Cefizoxime | + | |
| CefTRIAXone | + | |
| Ceftobiprole | + | |
| Ceftaroline | + | |
| CefTAZidime | +/- | |
| Cefepime | + | |
| Oral 1st G. Cephalosporin | Cefadroxil | + |
| Cephalexin | + | |
| Oral 2nd G. Cephalosporin | Cefaclor/Loracarbef | + |
| Cefproxil | 0 | |
| Cefuroxime axetil | + | |
| Oral 3rd G. Cephalosporin | Cefixime | + |
| Ceftibuten | 0 | |
| Cefpodox/Cefdinir/Cefditoren | + | |
| Aminoglycosides | Gentamicin | |
| Tobramycin | ||
| Amikacin | ||
| Chloramphenicol | ||
| Clindamycin | ||
| Macrolides | Erythromycin | |
| Azithromycin | ||
| Clarithromycin | ||
| Ketolide | Telithromycin | |
| Tetracyclines | Doxycycline | |
| Minocycline | ||
| Glycylcycline | Tigecycline | |
| Glyco/Lipoclycopeptides | Vancomycin | |
| Teicoplanin | ||
| Telavancin | ||
| Fusidic Acid | ||
| Trimethoprim | ||
| TMP-SMX | ||
| Urinary Agents | Nitrofurantoin | |
| Fosfomycin | ||
| Other | Rifampin | |
| Metronidazole | ||
| Quinupristin dalfoppristin | ||
| Linezolid | ||
| Daptomycin | ||
| Colistimethate |
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
Table Overview
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See Also
References
- ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
- ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
- ↑ Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp
- ↑ Sanford Guide to Antimicrobial Therapy 2010