Prevalence of Colonic and Liver disease in Patients with group D Streptococcus Infection in Tertiary Hospital in Thailand

Abstract

Background: Group D Streptococcus (GDS) infection was most often associated with infective endocarditis and bacteremia. GDS formerly named as Streptococcus bovis. In addition to an association of GDS with colonic disease, evidence of a correlation with liver disease has been presented. This study aimed to evaluate the prevalence of colonic and liver disease in patients with GDS and to identify factors that increase risk of colonic and liver diseases in patients with GDS infection.

Methods: A prospective study of all adult patients with GDS infection at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center between March 2016 and December 2017 and retrospective chart review between January 2012 and February 2016 were performed.

Results: Sixty-two episodes of GDS infection in 45 patients were included in the study. Thirty-two patients (51.6%) were male and mean age was 64 ± 10.7 years. Two patients (3.2%) was diagnosed colorectal cancer and 49 patients (79%) had liver cirrhosis before GDS infection. Most of patients had bacteremia (93.5%). Subspecies were identified in 48.4% of patients, 25 patients (40.3%) were S. gallolyticus and 5 patients (8.1%) were S. pasteurianus. Forty-seven percent of patients had colonic evaluation and 19 patients (30.7%) had colonic disease. Prevalence of colonic disease and liver disease in GDS infection was 33.8% and 79%, respectively. Six patients with GDS infection had both colonic and liver disease. Overall median to mortality was 1.28 years (95%CI 0.68-1.86). Mortality rate was 48 person/100 person-year.

Conclusion: Prevalence of colonic disease and liver disease was 33.8% and 79%, respectively. Patients with GDS infection should be evaluated for colonic and liver disease. Colonic and liver disease may simultaneous occurs in the patients with GDS infection.