The clinical Spectrum of Viridans Group Streptococci infections in paediatric patients at a tertiary hospital

Nkosinathi S Shongwe; Fikile C Mabena; Jeannette Wadula; Karen Petersen

doi:10.4102/sajid.v39i1.563

The clinical Spectrum of Viridans Group Streptococci infections in paediatric patients at a tertiary hospital

S Afr J Infect Dis. 2024 Apr 29;39(1):563. doi: 10.4102/sajid.v39i1.563. eCollection 2024.

Authors

Nkosinathi S Shongwe¹, Fikile C Mabena^{1

2}, Jeannette Wadula^{3

4}, Karen Petersen^{1

2}

Affiliations

¹ Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
² Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
³ Department of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁴ Department of Clinical Microbiology and Infectious Diseases, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.

Abstract

Background: Viridans Group Streptococci (VGS) are often considered organisms of low virulence; however, infection can result in clinically significant sepsis and life-threatening complications in paediatric patients.

Objectives: This study aimed to describe the spectrum of clinical presentation of VGS bacteraemia in paediatric patients, to analyse risk factors, and to describe the antibiotics resistance patterns of VGS.

Method: Cultures of VGS in paediatric patients admitted to Chris Hani Baragwanath Academic Hospital in 2019 were identified through National Health Laboratory Service. Data were extracted from archived clinical records and analysed. Sepsis scores were calculated at the time of bacteraemia.

Results: A total of 133 cultures were identified; 64 (48.1%) polymicrobial cultures and no records 4 (0.03%) were excluded; 65 (48.9%) were analysed. The median age was 1.5 months (range 0.03 to 168, interquartile range [IQR]: 0.3-13.25), 27/65 (42%) were neonates. The median duration of hospitalisation was 7 days (IQR: 3-21). The commonest diagnoses were neonatal sepsis 30.8% (n = 20) and pneumonia 28% (n = 18). The systemic inflammatory response syndrome (SIRS) score was ≥ 2 in 57% (16/28) patients; paediatric sequential organ failure assessment (pSOFA) score was > 2 in 10/24 (42%). Fifty-seven (88%) patients were discharged; three (5%) required ICU admission and 8/65 (12.3%) died. Malnutrition was present in 50% of patients who died. Cephalosporins and penicillin had sensitivity of 89% and 55%, respectively.

Conclusion: Viridans Group Streptococci bacteraemia was common in neonates, and pneumonia was a common presentation in this cohort. The VGS bacteraemia was associated with morbidity and deaths in this cohort.

Contribution: The VGS should be considered a significant organism when cultured from sterile sites and routine antibiotic susceptibility testing should be performed. Prospective studies are recommended.

Keywords: Viridans Group Streptococcus; antibiotics; clinical presentation; organism; susceptibility.

Grants and funding

Funding information This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.