First Isolation of Streptococcus gallolyticus subsp. pasteurianus from a Korean Patient with Severe Septic Shock

Seri Jeong; Ji Yeon Park; Sang Hoon Han; Yangsoon Lee; Dongeun Yong; Kyungwon Lee; Yunsop Chong

doi:10.5145/KJCM.2011.14.4.144

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Jeong, Park, Han, Lee, Yong, Lee, and Chong: First Isolation of Streptococcus gallolyticus subsp. pasteurianus from a Korean Patient with Severe Septic Shock

Original Article

Korean J Clin Microbiol 2011;14(4):144-147.

Published online: 21 December 2011

DOI: https://doi.org/10.5145/KJCM.2011.14.4.144

First Isolation of Streptococcus gallolyticus subsp. pasteurianus from a Korean Patient with Severe Septic Shock

Seri Jeong¹, Ji Yeon Park¹, Sang Hoon Han², Yangsoon Lee^1,³, Dongeun Yong¹, Kyungwon Lee¹, Yunsop Chong¹

¹Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Seoul, Korea

²Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

³Department of Laboratory Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea

Correspondence: Dongeun Yong, Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. (Tel) 82-2-2228-2442, (Fax) 82-2-313-0956, (E-mail) deyong@yuhs.ac

Received 25 July 2011 Revised 7 October 2011 Accepted 14 October 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 60-year-old man presented with a 1-day history of fever, vomiting, and diarrhea. He was diagnosed with severe septic shock on the basis of a body temperature of 38.9°C, heart rate of 92/min, respiratory rate of 25/min, WBC count of 22,970/μL, C-reactive protein (CRP) level of 136 mg/L, blood urea nitrogen (BUN) of 34.0 mg/dL, and creatinine of 2.98 mg/dL. On blood culture, Gram-positive cocci were detected in all 6 bottles. Small grayish non-hemolytic colonies were found on blood agar plates after incubation at 37°C for 2 days. The isolates were negative for catalase and L-pyrrolidonyl-β-naphthylamide hydrolysis, and positive for bile-esculin and leucine aminopeptidase activity. The strain was identified as Streptococcus gallolyticus subsp. pasteurianus using Vitek 2 GP II systems. We performed 16S rRNA gene sequencing and detected 100% identity with S. gallolyticus subsp. pasteurianus strain CIP 107122^T (1,345/ 1,345-bp). The patient recovered after receiving ampicillin-sulbactam. This is the first report of phenotypic and genetic identification of S. gallolyticus subsp. pasteurianus causing severe septic shock in a Korean patient.

Keywords: Streptococcus gallolyticus subsp. pasteurianus, Septic shock, 16S rRNA gene sequencing

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Table 1.

Biochemical characteristics of Streptococcus gallolyticus subsp. pasteurianus clinical isolate

Characteristics	Isolates of this case	S. gallolyticus subsp. pasteurianus^∗	S. gallolyticus subsp. pasteurianus^∗
Catalase	−	−	−
PYR hydrolysis	−	−	−
Leucine aminopeptidase	+	+	+
Bile-esculin test	+	+	+
β-Glucuronidase	−	+	−
α-Galactosidase	+	v	+
β-Galactosidase	+	+	−
Acid production from 　 Starch	−^†	−	+
Inulin	−	−	+
Lactose	+	+	+
Mannitol	−	−	+
Raffinose	+	v	+
Trehalose	+	+	+

^∗ The biochemical characteristics of the subspecies of S. gallolyticus were obtained from a report by Schlegel et al. [9].

^† The test of starch acidification performed manually. For the rest, Vitek2 GP I and GP II system were used. Abbreviations: +, ≥80% of strains positive; −, ≤20% of strains positive; v, 21-79% activity compared to the positive control reaction.

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