Nutritionally variant streptococci bacteremia in cancer patients: a retrospective study, 1999-2014.

BACKGROUND: Nutritionally variant Streptococci (NVS), Abiotrophia and Granulicatella are implicated in causing endocarditis and blood stream infections more frequently than other sites of infection. Neutropenia and mucositis are the most common predisposing factors for infection with other pathogens in cancer patients. In this study, we investigated the clinical characteristics of NVS bacteremia in cancer patients and identified risk factors and outcomes associated with these infections. MATERIALS AND METHODS: We retrospectively reviewed all cases of NVS bacteremia occurring from June 1999 to April 2014 at H. Lee Moffitt Cancer Center and Research Institute. The computerized epidemiology report provided by the microbiology laboratory identified thirteen cancer patients with NVS bacteremia. We collected data regarding baseline demographics and clinical characteristics such as age, sex, underlying malignancy, neutropenic status, duration of neutropenia, treatment, and outcome. RESULTS: Thirteen patients were identified with positive NVS blood stream infection. Ten patients (77%) had hematologic malignancies, including chronic lymphocytic leukemia (CLL)(1), multiple myeloma (MM)(1), acute myelogenous leukemia (AML)(4), and non-Hodgkin's lymphoma (NHL)(4). The non-hematologic malignancies included esophageal cancer(2) and bladder cancer (1). CONCLUSION: NVS should be considered as a possible agent of bacteremia in cancer patients with neutropenia and a breach in oral, gastrointestinal and genitourinary mucosa (gingivitis/mucositis).

Significant changes in gastrointestinal tract parasitic infections in children of St. Kitts over the 9-year period 1982-1991

When 239 (1982) and 361 (1991) five-year and nine-year-old children in St. Kitts were assessed for the presence of parasitic infections, there were significant reductions in the prevalence of trichuriasis from 83 percent to 58 percent, of ascariasis from 24 percent to 8.6 percent and of giardiasis from 15 percent to 9 percent. Anthelminthic use, which appeared to be the most important responsible intervention tool, remained roughly at the same level at 59-51 percent. However, the types of anthelminthics used changed over the period. Pizerazine citrate, which was by 66 percent in 1982, only had 35 percent usuage in 1991. Albendazole which was not used at all in 1982 was taken by 32 percent of the children in 1991 and at the same time the use of laevo-tetramisole increased by 20 percent from 14 percent. Suggestions are made for an island-wide mass intervention programme to manage parasitic infections. (AU)

Significant changes in gastrointestinal tract parasitic infections in children of St. Kitts over the 9-year period 1982-1991

When 239 (1982) and 361 (1991) five-year and nine-year-old children in St. Kitts were assessed for the presence of parasitic infections, there were significant reductions in the prevalence of trichuriasis from 83 per cent to 58 per cent , of ascariasis from 24 per cent to 8.6 per cent and of giardiasis from 15 per cent to 9 per cent . Anthelminthic use, which appeared to be the most important responsible intervention tool, remained roughly at the same level at 59-51 per cent . However, the types of anthelminthics used changed over the period. Piperazine citrate, which was used by 66 per cent in 1982, only had 35 per cent usuage in 1991. Albendazole which was not used at all in 1982 was taken by 32 per cent of the children in 1991 and at the same time the use of laevo-tetramisole increased by 20 per cent from 14 per cent . Suggestions are made for an island-wide mass intervention programme to manage parasitic infections.