Analysis of Clinical Characteristics and Antimicrobial Resistance in 249 Isolates of Streptococcus mitis: a Single-Centre Study

Basaranoglu ST, Ozsurekci Y, Aykac K, Aycan AE, Bıcakcigil A, Altun B, Sancak B, Cengiz AB, Kara A, Ceyhan M. Streptococcus mitis/oralis causing blood stream infections in pediatric patients. Jpn J Infect Dis. 2019;72(1):1–6. https://doi.org/10.7883/yoken. JJID.2018.074 Basaranoglu ST Ozsurekci Y Aykac K Aycan AE Bıcakcigil A Altun B Sancak B Cengiz AB Kara A Ceyhan M. Streptococcus mitis/oralis causing blood stream infections in pediatric patients . Jpn J Infect Dis . 2019 ; 72 ( 1 ): 1 – 6 . https://doi.org/10.7883/yoken.JJID.2018.074 Search in Google Scholar

CLSI. Performance standards for antimicrobial susceptibility testing. 32^rd ed. CLSI supplement M100. Wayne (USA): Clinical and Laboratory Standards Institute; 2022. CLSI . Performance standards for antimicrobial susceptibility testing. 32^rd ed . CLSI supplement M100 . Wayne (USA) : Clinical and Laboratory Standards Institute ; 2022 . Search in Google Scholar

De Paolis F, Beghetto E, Spadoni A, Montagnani F, Felici F, Oggioni MR, Gargano N. Identification of a human immunodominant B-cell epitope within the immunoglobulin A1 protease of Streptococcus pneumoniae. BMC Microbiol. 2007;7:113. https://doi.org/10.1186/1471-2180-7-113 De Paolis F Beghetto E Spadoni A Montagnani F Felici F Oggioni MR Gargano N. Identification of a human immunodominant B-cell epitope within the immunoglobulin A1 protease of Streptococcus pneumoniae . BMC Microbiol . 2007 ; 7 : 113 . https://doi.org/10.1186/1471-2180-7-113 Search in Google Scholar

Denapaite D, Brückner R, Nuhn M, Reichmann P, Henrich B, Maurer P, Schähle Y, Selbmann P, Zimmermann W, Wambutt R, et al. The genome of Streptococcus mitis B6 – What is a commensal? PLoS One. 2010;5(2):e9426. https://doi.org/10.1371/journal. pone.0009426 Denapaite D Brückner R Nuhn M Reichmann P Henrich B Maurer P Schähle Y Selbmann P Zimmermann W Wambutt R The genome of Streptococcus mitis B6 – What is a commensal? PLoS One . 2010 ; 5 ( 2 ): e9426 . https://doi.org/10.1371/journal.pone.0009426 Search in Google Scholar

Dinani A, Ktaich N, Urban C, Rubin D. Levofloxacin-resistant-Streptococcus mitis endophthalmitis: a unique presentation of bacterial endocarditis. J Med Microbiol. 2009;58(Pt 10):1385– 1387. https://doi.org/10.1099/jmm.0.012658-0 Dinani A Ktaich N Urban C Rubin D. Levofloxacin-resistant-Streptococcus mitis endophthalmitis: a unique presentation of bacterial endocarditis . J Med Microbiol . 2009 ; 58 ( Pt 10 ): 1385 – 1387 . https://doi.org/10.1099/jmm.0.012658-0 Search in Google Scholar

Ergin A, Eser ÖK, Hasçelik G. Erythromycin and penicillin resistance mechanisms among viridans group streptococci isolated from blood cultures of adult patients with underlying diseases. New Microbiol. 2011;34(2):187–193. Ergin A Eser ÖK Hasçelik G. Erythromycin and penicillin resistance mechanisms among viridans group streptococci isolated from blood cultures of adult patients with underlying diseases . New Microbiol . 2011 ; 34 ( 2 ): 187 – 193 . Search in Google Scholar

Fukayama H, Shoji K, Yoshida M, Iijima H, Maekawa T, Ishiguro A, Miyairi I. Bacterial meningitis due to the Streptococcus mitis group in children with cerebrospinal fluid leak. IDCases. 2022;27:e01406. https://doi.org/10.1016/j.idcr.2022.e01406 Fukayama H Shoji K Yoshida M Iijima H Maekawa T Ishiguro A Miyairi I. Bacterial meningitis due to the Streptococcus mitis group in children with cerebrospinal fluid leak . IDCases . 2022 ; 27 : e01406 . https://doi.org/10.1016/j.idcr.2022.e01406 Search in Google Scholar

Harju I, Lange C, Kostrzewa M, Maier T, Rantakokko-Jalava K, Haanperä M. Improved differentiation of Streptococcus pneumoniae and other S. mitis group streptococci by MALDI Biotyper using an improved MALDI Biotyper database content and a novel result interpretation algorithm. J Clin Microbiol. 2017;55(3):914–922. https://doi.org/10.1128/jcm.01990-16 Harju I Lange C Kostrzewa M Maier T Rantakokko-Jalava K Haanperä M. Improved differentiation of Streptococcus pneumoniae and other Smitis group streptococci by MALDI Biotyper using an improved MALDI Biotyper database content and a novel result interpretation algorithm . J Clin Microbiol . 2017 ; 55 ( 3 ): 914 – 922 . https://doi.org/10.1128/jcm.01990-16 Search in Google Scholar

Imai K, Nemoto R, Kodana M, Tarumoto N, Sakai J, Kawamura T, Ikebuchi K, Mitsutake K, Murakami T, Maesaki S, et al. Rapid and accurate species identification of mitis group streptococci using the MinION Nanopore Sequencer. Front Cell Infect Microbiol. 2020;10:11. https://doi.org/10.3389/fcimb.2020.00011 Imai K Nemoto R Kodana M Tarumoto N Sakai J Kawamura T Ikebuchi K Mitsutake K Murakami T Maesaki S Rapid and accurate species identification of mitis group streptococci using the MinION Nanopore Sequencer . Front Cell Infect Microbiol . 2020 ; 10 : 11 . https://doi.org/10.3389/fcimb.2020.00011 Search in Google Scholar

Kalizang’oma A, Richard D, Kwambana-Adams B, Coelho J, Broughton K, Pichon B, Hopkins KL, Chalker V, Beleza S, Bentley SD, et al. Population genomics of Streptococcus mitis in UK and Ireland bloodstream infection and infective endocarditis cases. Nat Commun. 2024;15(1):7812. https://doi.org/10.1038/s41467- 024-52120-z Kalizang’oma A Richard D Kwambana-Adams B Coelho J Broughton K Pichon B Hopkins KL Chalker V Beleza S Bentley SD Population genomics of Streptococcus mitis in UK and Ireland bloodstream infection and infective endocarditis cases . Nat Commun . 2024 ; 15 ( 1 ): 7812 . https://doi.org/10.1038/s41467-024-52120-z Search in Google Scholar

Kanjanabuch P, Banjongjit A, Purisinsith S, Towannang P, Kanjanabuch T. Streptococcus mitis peritonitis in a peritoneal dialysis patient: A case report highlighting the importance of dental hygiene. Cureus. 2024;16(7):e64693. https://doi.org/10.7759/cureus.64693 Kanjanabuch P Banjongjit A Purisinsith S Towannang P Kanjanabuch T. Streptococcus mitis peritonitis in a peritoneal dialysis patient: A case report highlighting the importance of dental hygiene . Cureus . 2024 ; 16 ( 7 ): e64693 . https://doi.org/10.7759/cu-reus.64693 Search in Google Scholar

Krcmery V Jr, Spanik S, Trupl J. First report of vancomycin-resistant Streptococcus mitis bacteremia in a leukemic patient after prophylaxis with quinolones and during treatment with vancomycin. J Chemother. 1996;8(4):325–326. https://doi.org/10.1179/joc.1996.8.4.325 Krcmery V Jr Spanik S Trupl J. First report of vancomycin-resistant Streptococcus mitis bacteremia in a leukemic patient after prophylaxis with quinolones and during treatment with vancomycin . J Chemother . 1996 ; 8 ( 4 ): 325 – 326 . https://doi.org/10.1179/joc.1996.8.4.325 Search in Google Scholar

Lessa FC, Milucky J, Rouphael NG, Bennett NM, Talbot HK, Harrison LH, Farley MM, Walston J, Pimenta F, Gertz RE, et al. Streptococcus mitis expressing pneumococcal serotype 1 capsule. Sci Rep. 2018;8(1):17959. https://doi.org/10.1038/s41598-018- 35921-3 Lessa FC Milucky J Rouphael NG Bennett NM Talbot HK Harrison LH Farley MM Walston J Pimenta F Gertz RE Streptococcus mitis expressing pneumococcal serotype 1 capsule . Sci Rep . 2018 ; 8 ( 1 ): 17959 . https://doi.org/10.1038/s41598-018-35921-3 Search in Google Scholar

Marron A, Carratalà J, Alcaide F, Fernández-Sevilla A, Gudiol F. High rates of resistance to cephalosporins among viridans-group streptococci causing bacteraemia in neutropenic cancer patients. J Antimicrob Chemother. 2001;47(1):87–91. https://doi.org/10.1093/jac/47.1.87 Marron A Carratalà J Alcaide F Fernández-Sevilla A Gudiol F. High rates of resistance to cephalosporins among viridans-group streptococci causing bacteraemia in neutropenic cancer patients . J Antimicrob Chemother . 2001 ; 47 ( 1 ): 87 – 91 . https://doi.org/10.1093/jac/47.1.87 Search in Google Scholar

Marron A, Carratalà J, González-Barca E, Fernández-Sevilla A, Alcaide F, Gudiol F. Serious complications of bacteremia caused by viridans streptococci in neutropenic patients with cancer. Clin Infect Dis. 2000;31(5):1126-30. https://doi.org/10.1086/317460 Marron A Carratalà J González-Barca E Fernández-Sevilla A Alcaide F Gudiol F. Serious complications of bacteremia caused by viridans streptococci in neutropenic patients with cancer . Clin Infect Dis . 2000 ; 31 ( 5 ): 1126 - 30 . https://doi.org/10.1086/317460 Search in Google Scholar

Mitchell J. Streptococcus mitis: Walking the line between commensalism and pathogenesis. Mol Oral Microbiol. 2011;26(2):89–98. https://doi.org/10.1111/j.2041-1014.2010.00601.x Mitchell J. Streptococcus mitis: Walking the line between commensalism and pathogenesis . Mol Oral Microbiol . 2011 ; 26 ( 2 ): 89 – 98 . https://doi.org/10.1111/j.2041-1014.2010.00601.x Search in Google Scholar

Narikiyo M, Tanabe C, Yamada Y, Igaki H, Tachimori Y, Kato H, Muto M, Montesano R, Sakamoto H, Nakajima Y, et al. Frequent and preferential infection of Treponema denticola, Streptococcus mitis, and Streptococcus anginosus in esophageal cancers. Cancer Sci. 2004;95(7):569–574. https://doi.org/10.1111/j.1349-7006.2004.tb02488.x Narikiyo M Tanabe C Yamada Y Igaki H Tachimori Y Kato H Muto M Montesano R Sakamoto H Nakajima Y Frequent and preferential infection of Treponema denticola, Streptococcus mitis, and Streptococcus anginosus in esophageal cancers . Cancer Sci . 2004 ; 95 ( 7 ): 569 – 574 . https://doi.org/10.1111/j.1349-7006.2004.tb02488.x Search in Google Scholar

Nix ID, Idelevich EA, Schlattmann A, Sparbier K, Kostrzewa M, Becker K. MALDI-TOF mass spectrometry-based optochin susceptibility testing for differentiation of Streptococcus pneumoniae from other Streptococcus mitis group streptococci. Microorganisms. 2021;9(10):2010. https://doi.org/10.3390/microorgan-isms9102010 Nix ID Idelevich EA Schlattmann A Sparbier K Kostrzewa M Becker K. MALDI-TOF mass spectrometry-based optochin susceptibility testing for differentiation of Streptococcus pneumoniae from other Streptococcus mitis group streptococci . Microorganisms . 2021 ; 9 ( 10 ): 2010 . https://doi.org/10.3390/microorgan-isms9102010 Search in Google Scholar

Pan F, Zhao N, Zhao W, Wang C, Sun Y, Zhang H, Qin J, Liu Q, Zhang H. Performance of two matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) systems for identification of the viridans group streptococci. Infect Drug Resist. 2023;16:2901–2909. https://doi.org/10.2147/IDR. S407667 Pan F Zhao N Zhao W Wang C Sun Y Zhang H Qin J Liu Q Zhang H. Performance of two matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS) systems for identification of the viridans group streptococci . Infect Drug Resist . 2023 ; 16 : 2901 – 2909 . https://doi.org/10.2147/IDR.S407667 Search in Google Scholar

Prod’homme M, Grasset D, Chalaron M, Boscherini D. Epidural abscess related to Streptococcus mitis in a 57-year-old immunocompetent patient. BMJ Case Rep. 2021;14(4):e239295. https://doi. org/10.1136/bcr-2020-239295 Prod’homme M Grasset D Chalaron M Boscherini D. Epidural abscess related to Streptococcus mitis in a 57-year-old immunocompetent patient . BMJ Case Rep . 2021 ; 14 ( 4 ): e239295 . https://doi.org/10.1136/bcr-2020-239295 Search in Google Scholar

Rasmussen LH, Højholt K, Dargis R, Christensen JJ, Skovgaard O, Justesen US, Rosenvinge FS, Moser C, Lukjancenko O, Rasmussen S, et al. In silico assessment of virulence factors in strains of Streptococcus oralis and Streptococcus mitis isolated from patients with infective endocarditis. J Med Microbiol. 2017;66(9):1316– 1323. https://doi.org/10.1099/jmm.0.000573 Rasmussen LH Højholt K Dargis R Christensen JJ Skovgaard O Justesen US Rosenvinge FS Moser C Lukjancenko O Rasmussen S In silico assessment of virulence factors in strains of Streptococcus oralis and Streptococcus mitis isolated from patients with infective endocarditis . J Med Microbiol . 2017 ; 66 ( 9 ): 1316 – 1323 . https://doi.org/10.1099/jmm.0.000573 Search in Google Scholar

Reilly AF, Lange BJ. Infections with viridans group streptococci in children with cancer. Pediatr Blood Cancer. 2007;49(6):774–780. https://doi.org/10.1002/pbc.21250 Reilly AF Lange BJ. Infections with viridans group streptococci in children with cancer . Pediatr Blood Cancer . 2007 ; 49 ( 6 ): 774 – 780 . https://doi.org/10.1002/pbc.21250 Search in Google Scholar

Sadowy E, Bojarska A, Kuch A, Skoczyńska A, Jolley KA, Maiden MCJ, van Tonder AJ, Hammerschmidt S, Hryniewicz W. Relationships among streptococci from the mitis group, misidentified as Streptococcus pneumoniae. Eur J Clin Microbiol Infect Dis. 2020;39(10):1865–1878. https://doi.org/10.1007/s10096-020- 03916-6 Sadowy E Bojarska A Kuch A Skoczyńska A Jolley KA Maiden MCJ van Tonder AJ Hammerschmidt S Hryniewicz W. Relationships among streptococci from the mitis group, misidentified as Streptococcus pneumoniae . Eur J Clin Microbiol Infect Dis . 2020 ; 39 ( 10 ): 1865 – 1878 . https://doi.org/10.1007/s10096-020-03916-6 Search in Google Scholar

Shelburne SA, Sahasrabhojane P, Saldana M, Yao H, Su X, Horstmann N, Thompson E, Flores AR. Streptococcus mitis strains causing severe clinical disease in cancer patients. Emerg Infect Dis. 2014;20(5):762–771. https://doi.org/10.3201/eid2005.130953 Shelburne SA Sahasrabhojane P Saldana M Yao H Su X Horstmann N Thompson E Flores AR. Streptococcus mitis strains causing severe clinical disease in cancer patients . Emerg Infect Dis . 2014 ; 20 ( 5 ): 762 – 771 . https://doi.org/10.3201/eid2005.130953 Search in Google Scholar

Talari Sree CS, Calerappa RS, Anke G. Aerobic bacteria study, clinical spectrum, and outcome of patients with community-acquired multidrug-resistant pathogens. J Family Med Prim Care. 2024;13(11):5052–5059. https://doi.org/10.4103/jfmpc. jfmpc_680_24 Talari Sree CS Calerappa RS Anke G. Aerobic bacteria study clinical spectrum, and outcome of patients with community-acquired multidrug-resistant pathogens . J Family Med Prim Care . 2024 ; 13 ( 11 ): 5052 – 5059 . https://doi.org/10.4103/jfmpc.jfmpc_680_24 Search in Google Scholar

Thielemans E, Oliver J, McMinn A, Baker C, Britton PN, Clark J, Marshall H, Blyth CC, Francis J, Buttery J, et al. Clinical description and outcomes of Australian children with invasive group A streptococcal disease. Pediatr Infect Dis J. 2020;39(5):379–384. https://doi.org/10.1097/INF.0000000000002596 Thielemans E Oliver J McMinn A Baker C Britton PN Clark J Marshall H Blyth CC Francis J Buttery J Clinical description and outcomes of Australian children with invasive group A streptococcal disease . Pediatr Infect Dis J . 2020 ; 39 ( 5 ): 379 – 384 . https://doi.org/10.1097/INF.0000000000002596 Search in Google Scholar

Tian XY, Zheng N, Han RW, Ho H, Wang J, Wang YT, Wang SQ, Li HG, Liu HW, Yu ZN. Antimicrobial resistance and virulence genes of Streptococcus isolated from dairy cows with mastitis in China. Microb Pathog. 2019;131:33–39. https://doi.org/10.1016/j. micpath.2019.03.035 Tian XY Zheng N Han RW Ho H Wang J Wang YT Wang SQ Li HG Liu HW Yu ZN. Antimicrobial resistance and virulence genes of Streptococcus isolated from dairy cows with mastitis in China . Microb Pathog . 2019 ; 131 : 33 – 39 . https://doi.org/10.1016/j.micpath.2019.03.035 Search in Google Scholar

Tunkel AR, Sepkowitz KA. Infections caused by viridans streptococci in patients with neutropenia. Clin Infect Dis. 2002;34(11):1524–1529. https://doi.org/10.1086/340402 Tunkel AR Sepkowitz KA. Infections caused by viridans streptococci in patients with neutropenia . Clin Infect Dis . 2002 ; 34 ( 11 ): 1524 – 1529 . https://doi.org/10.1086/340402 Search in Google Scholar

Wan TW, Lee TF, Chen XJ, Hunag YT, Teng LJ, Hsueh PR, Chiu HC. Performance assessment of the Bruker Biotyper MALDI-TOF MS for the identification of difficult-to-identify viridans group streptococci. J Clin Microbiol. 2023;61(12):e0114323. https://doi. org/10.1128/jcm.01143-23 Wan TW Lee TF Chen XJ Hunag YT Teng LJ Hsueh PR Chiu HC. Performance assessment of the Bruker Biotyper MALDI-TOF MS for the identification of difficult-to-identify viridans group streptococci . J Clin Microbiol . 2023 ; 61 ( 12 ): e0114323 . https://doi.org/10.1128/jcm.01143-23 Search in Google Scholar

Zhang B, Zhou J, Xie G, Zhang L, Zhang Y, Xu K, Feng T, Yang S. A Case of urinary tract infection caused by multidrug resistant Streptococcus mitis/oralis. Infect Drug Resist. 2023;16:4285–4288. https://doi.org/10.2147/idr.s416387 Zhang B Zhou J Xie G Zhang L Zhang Y Xu K Feng T Yang S. A Case of urinary tract infection caused by multidrug resistant Streptococcus mitis/oralis . Infect Drug Resist . 2023 ; 16 : 4285 – 4288 . https://doi.org/10.2147/idr.s416387 Search in Google Scholar

Zhang Y, Shang L, Roffel S, Spiekstra SW, Deng D, Gibbs S. Streptococcus mitis enhances metal-induced apoptosis in reconstructed human gingiva but not skin. Toxicol In Vitro. 2024;100:105913. https://doi.org/10.1016/j.tiv.2024.105913 Zhang Y Shang L Roffel S Spiekstra SW Deng D Gibbs S. Streptococcus mitis enhances metal-induced apoptosis in reconstructed human gingiva but not skin . Toxicol In Vitro . 2024 ; 100 : 105913 . https://doi.org/10.1016/j.tiv.2024.105913 Search in Google Scholar

Zhou JM, Wu CY, Li JP, Ye YH, Fang C, Zhou MM. Low penicillin susceptibility in Streptococcus mitis/oralis from bloodstream infections in pediatric populations. Microbiol Spectr. 2024;12(11):e0135024. https://doi.org/10.1128/spectrum.01350-24 Zhou JM Wu CY Li JP Ye YH Fang C Zhou MM. Low penicillin susceptibility in Streptococcus mitis/oralis from bloodstream infections in pediatric populations . Microbiol Spectr . 2024 ; 12 ( 11 ): e0135024 . https://doi.org/10.1128/spec-trum.01350-24 Search in Google Scholar