Bloodstream and endovascular infections due to Abiotrophia defectiva and Granulicatella species
Laurence Senn1 , José M Entenza1 , Gilbert Greub2 , Katia Jaton2 , Aline Wenger2 , Jacques Bille2
, Thierry Calandra1  and Guy Prod'hom2
1  Infectious Diseases Service, University Hospital, Lausanne, Switzerland
2  Institute of Microbiology, University Hospital, Bugnon 46, 1011 Lausanne CHUV, Switzerland
author email corresponding author email

BMC Infectious Diseases 2006, 6:9doi:10.1186/1471-2334-6-9

Abiotrophia and Granulicatella species, previously referred to as nutritionally variant streptococci
(NVS), are significant causative agents of endocarditis and bacteraemia. In this study, we reviewed
the clinical manifestations of infections due to A. defectiva and Granulicatella species that occurred
at our institution between 1998 and 2004.

The analysis included all strains of NVS that were isolated from blood cultures or vascular graft
specimens. All strains were identified by 16S rRNA sequence analysis. Patients' medical charts were
reviewed for each case of infection.

Eleven strains of NVS were isolated during the 6-year period. Identification of the strains by 16S
rRNA showed 2 genogroups: Abiotrophia defectiva (3) and Granulicatella adiacens (6) or
"para-adiacens" (2). The three A. defectiva strains were isolated from immunocompetent patients
with endovascular infections, whereas 7 of 8 Granulicatella spp. strains were isolated from
immunosuppressed patients, mainly febrile neutropenic patients. We report the first case of "G.
para-adiacens" bacteraemia in the setting of febrile neutropenia.

We propose that Granulicatella spp. be considered as a possible agent of bacteraemia in
neutropenic patients.