Viridans-Group Streptococci: Difference between revisions
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==Background== | ==Background== | ||
*A [[Gram Positive Bacteria]] in the [[Streptococcus Genus]] | |||
*In general, low virulence pathogens and likely [[Blood Culture Contaminant]] unless risk factor (21-50% of positive blood cultures are clinically significant)<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref> | |||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy | ==Types== | ||
*Streptococcus milleri | |||
*Streptococcus sanguis | |||
*Streptococcus mitis | |||
*Streptococcus bovis | |||
==Risk Factors for Viridans Bacteremia<ref>Antibiotic Therapy for Positive Blood Cultures. Perez-Jorge EV, et al. Antimicrobe. http://www.antimicrobe.org/new/e38rev2.asp</ref>== | |||
*neutropenia | |||
*oral mucositis | |||
*irradiation to the oral cavity | |||
*antibiotic prophylaxis with trimethoprim-sulfamethoxazole or fluoroquinolones | |||
*intravenous hyperalimentation | |||
*high dose chemotherapy | |||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | |||
{| class="wikitable" | {| class="wikitable" | ||
| align="center" style="background:#f0f0f0;"|''' | | align="center" style="background:#f0f0f0;"|'''Category''' | ||
| align="center" style="background:#f0f0f0;"|'''''' | | align="center" style="background:#f0f0f0;"|'''Antibiotic''' | ||
| align="center" style="background:#f0f0f0;"|'''Viridans strep''' | | align="center" style="background:#f0f0f0;"|'''[[Viridans strep]]''' | ||
|- | |- | ||
| ||Penicillin | | [[Penicillins]]||[[Penicillin G]]||I | ||
|- | |- | ||
| | | ||[[Penicillin V]]||I | ||
|- | |- | ||
| || | | ||[[Methicillin]]||I | ||
|- | |- | ||
| || | | ||[[Nafcillin]]/[[Oxacillin]]||I | ||
|- | |- | ||
| | | ||[[Cloxacillin]]/[[Diclox.]]||I | ||
|- | |- | ||
| ||Amox | | Amino-[[Penicillins]]||[[AMP]]/[[Amox]]||I | ||
|- | |- | ||
| || | | ||[[Amox-Clav]]||I | ||
|- | |- | ||
| | | ||[[AMP-Sulb]]||I | ||
|- | |- | ||
| || | | Anti-Pseudomonal [[Penicillins]]||[[Ticarcillin]]||I | ||
|- | |- | ||
| || | | ||[[Ticar-Clav]]||I | ||
|- | |- | ||
| [[ | | ||[[Pip-Tazo]]||I | ||
|- | |- | ||
| || | | ||Piperacillin||I | ||
|- | |- | ||
| || | | [[Carbapenems]]||Doripenem||S | ||
|- | |- | ||
| || | | ||[[Ertapenem]]||S | ||
|- | |- | ||
| || | | ||[[Imipenem]]||S | ||
|- | |- | ||
| ||[[ | | ||[[Meropenem]]||S | ||
|- | |- | ||
| | | ||[[Aztreonam]]||R | ||
|- | |- | ||
| || | | [[Fluroquinolones]]||[[Ciprofloxacin]]||R | ||
|- | |- | ||
| || | | ||[[Ofloxacin]]||R | ||
|- | |- | ||
| || | | ||Pefloxacin||X1 | ||
|- | |- | ||
| || | | ||[[Levofloxacin]]||S | ||
|- | |- | ||
| || | | ||[[Moxifloxacin]]||S | ||
|- | |- | ||
| || | | ||Gemifloxacin||S | ||
|- | |- | ||
| | | ||Gatifloxacin||S | ||
|- | |- | ||
| | | 1st G [[Cephalo]]||Cefazolin||S | ||
|- | |- | ||
| || | | 2nd G. [[Cephalo]]||[[Cefotetan]]||S | ||
|- | |- | ||
| || | | ||[[Cefoxitin]]||S | ||
|- | |- | ||
| | | ||[[Cefuroxime]]||S | ||
|- | |- | ||
| || | | 3rd/4th G. [[Cephalo]]||[[Cefotaxime]]||S | ||
|- | |- | ||
| || | | ||Cefizoxime||S | ||
|- | |- | ||
| || | | ||[[CefTRIAXone]]||S | ||
|- | |- | ||
| ||Ceftaroline|| | | ||Ceftaroline||S | ||
|- | |- | ||
| ||[[CefTAZidime]]|| | | ||[[CefTAZidime]]||I | ||
|- | |- | ||
| ||[[Cefepime]]|| | | ||[[Cefepime]]||S | ||
|- | |- | ||
| Oral 1st G. | | Oral 1st G. [[Cephalo]]||Cefadroxil||S | ||
|- | |- | ||
| ||[[Cephalexin]]|| | | ||[[Cephalexin]]||S | ||
|- | |- | ||
| Oral 2nd G. | | Oral 2nd G. [[Cephalo]]||Cefaclor/Loracarbef||S | ||
|- | |- | ||
| ||Cefproxil|| | | ||Cefproxil||R | ||
|- | |- | ||
| ||Cefuroxime axetil|| | | ||Cefuroxime axetil||S | ||
|- | |- | ||
| Oral 3rd G. | | Oral 3rd G. [[Cephalo]]||Cefixime||S | ||
|- | |- | ||
| ||Ceftibuten|| | | ||Ceftibuten||R | ||
|- | |- | ||
| ||Cefpodox/Cefdinir/Cefditoren|| | | ||Cefpodox/Cefdinir/Cefditoren||S | ||
|- | |- | ||
| [[Aminoglycosides]]||[[Gentamicin]]|| | | [[Aminoglycosides]]||[[Gentamicin]]||X1 | ||
|- | |- | ||
| ||Tobramycin|| | | ||Tobramycin||X1 | ||
|- | |- | ||
| ||[[Amikacin]]|| | | ||[[Amikacin]]||X1 | ||
|- | |- | ||
| ||Chloramphenicol|| | | ||[[Chloramphenicol]]||X1 | ||
|- | |- | ||
| ||[[Clindamycin]]|| | | ||[[Clindamycin]]||X1 | ||
|- | |- | ||
| [[Macrolides]]||Erythromycin|| | | [[Macrolides]]||Erythromycin||X1 | ||
|- | |- | ||
| ||[[Azithromycin]]|| | | ||[[Azithromycin]]||X1 | ||
|- | |- | ||
| ||Clarithromycin|| | | ||Clarithromycin||X1 | ||
|- | |- | ||
| Ketolide||Telithromycin|| | | Ketolide||Telithromycin||X1 | ||
|- | |- | ||
| Tetracyclines||[[Doxycycline]]|| | | Tetracyclines||[[Doxycycline]]||X1 | ||
|- | |- | ||
| ||Minocycline|| | | ||Minocycline||X1 | ||
|- | |- | ||
| Glycylcycline||Tigecycline|| | | Glycylcycline||Tigecycline||X1 | ||
|- | |- | ||
| | | ||Daptomycin||X1 | ||
|- | |- | ||
| || | | Glyco/Lipoclycopeptides||[[Vancomycin]]||X1 | ||
|- | |- | ||
| || | | ||Teicoplanin||X1 | ||
|- | |- | ||
| || | | ||Telavancin||X1 | ||
|- | |- | ||
| || | | ||Fusidic Acid||X1 | ||
|- | |- | ||
| || | | ||Trimethoprim||X1 | ||
|- | |- | ||
| | | ||[[TMP-SMX]]||X1 | ||
|- | |- | ||
| || | | Urinary Agents||[[Nitrofurantoin]]||X1 | ||
|- | |- | ||
| | | ||Fosfomycin||X1 | ||
|- | |- | ||
| ||[[ | | Other||[[Rifampin]]||X1 | ||
|- | |- | ||
| || | | ||[[Metronidazole]]||X1 | ||
|- | |- | ||
| || | | ||Quinupristin dalfoppristin||X1 | ||
|- | |- | ||
| ||[[ | | ||[[Linezolid]]||X1 | ||
|- | |- | ||
| ||Colistimethate|| | | ||Colistimethate||X1 | ||
|} | |} | ||
===Key=== | ===Key=== | ||
{{Template:Antibacterial Spectra Key}} | {{Template:Antibacterial Spectra Key}} |
Latest revision as of 06:30, 3 June 2014
Background
- A Gram Positive Bacteria in the Streptococcus Genus
- In general, low virulence pathogens and likely Blood Culture Contaminant unless risk factor (21-50% of positive blood cultures are clinically significant)[1]
Types
- Streptococcus milleri
- Streptococcus sanguis
- Streptococcus mitis
- Streptococcus bovis
Risk Factors for Viridans Bacteremia[2]
- neutropenia
- oral mucositis
- irradiation to the oral cavity
- antibiotic prophylaxis with trimethoprim-sulfamethoxazole or fluoroquinolones
- intravenous hyperalimentation
- high dose chemotherapy
Antibiotic Sensitivities[3]
Category | Antibiotic | Viridans strep |
Penicillins | Penicillin G | I |
Penicillin V | I | |
Methicillin | I | |
Nafcillin/Oxacillin | I | |
Cloxacillin/Diclox. | I | |
Amino-Penicillins | AMP/Amox | I |
Amox-Clav | I | |
AMP-Sulb | I | |
Anti-Pseudomonal Penicillins | Ticarcillin | I |
Ticar-Clav | I | |
Pip-Tazo | I | |
Piperacillin | I | |
Carbapenems | Doripenem | S |
Ertapenem | S | |
Imipenem | S | |
Meropenem | S | |
Aztreonam | R | |
Fluroquinolones | Ciprofloxacin | R |
Ofloxacin | R | |
Pefloxacin | X1 | |
Levofloxacin | S | |
Moxifloxacin | S | |
Gemifloxacin | S | |
Gatifloxacin | S | |
1st G Cephalo | Cefazolin | S |
2nd G. Cephalo | Cefotetan | S |
Cefoxitin | S | |
Cefuroxime | S | |
3rd/4th G. Cephalo | Cefotaxime | S |
Cefizoxime | S | |
CefTRIAXone | S | |
Ceftaroline | S | |
CefTAZidime | I | |
Cefepime | S | |
Oral 1st G. Cephalo | Cefadroxil | S |
Cephalexin | S | |
Oral 2nd G. Cephalo | Cefaclor/Loracarbef | S |
Cefproxil | R | |
Cefuroxime axetil | S | |
Oral 3rd G. Cephalo | Cefixime | S |
Ceftibuten | R | |
Cefpodox/Cefdinir/Cefditoren | S | |
Aminoglycosides | Gentamicin | X1 |
Tobramycin | X1 | |
Amikacin | X1 | |
Chloramphenicol | X1 | |
Clindamycin | X1 | |
Macrolides | Erythromycin | X1 |
Azithromycin | X1 | |
Clarithromycin | X1 | |
Ketolide | Telithromycin | X1 |
Tetracyclines | Doxycycline | X1 |
Minocycline | X1 | |
Glycylcycline | Tigecycline | X1 |
Daptomycin | X1 | |
Glyco/Lipoclycopeptides | Vancomycin | X1 |
Teicoplanin | X1 | |
Telavancin | X1 | |
Fusidic Acid | X1 | |
Trimethoprim | X1 | |
TMP-SMX | X1 | |
Urinary Agents | Nitrofurantoin | X1 |
Fosfomycin | X1 | |
Other | Rifampin | X1 |
Metronidazole | X1 | |
Quinupristin dalfoppristin | X1 | |
Linezolid | X1 | |
Colistimethate | X1 |
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
- ↑ Sanford Guide to Antimicrobial Therapy 2014