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Streptococcus bovis/Streptococcus equinus complex fecal carriage, colorectal carcinoma, and infective endocarditis: a new appraisal of a complex connection

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Abstract

The proportion of group D streptococcal infective endocarditis (IE) (predominantly due to Streptococcus gallolyticus) and the incidence of colorectal cancer are higher in France than in most European countries. We assumed that this could be explained by a high group D streptococci (GDS) fecal carriage rate. The aims of this study were to re-assess the GDS fecal carriage rate in France and its relationship with colorectal cancer. Consecutive adult subjects who were to undergo a complete colonoscopy were invited to participate. GDS were searched in subjects’ stools before their colonoscopy using biomolecular techniques. Colonoscopic findings were sorted into four subgroups: normal colonoscopy, non-tumoral lesions, benign tumors, and premalignant/malignant tumors. GDS fecal carriages were calculated overall and in each subgroup and compared. The data from 259 subjects were analyzed. GDS were identified in the feces of 12 subjects, with the following distribution: S. lutetiensis (n = 9), S. pasteurianus (n = 2), and S. gallolyticus (n = 1). This accounted for an overall GDS fecal carriage rate of 4.6 %. The GDS fecal carriage rate was 6 % in case of normal colonoscopy, 1.3 % in case of non-tumoral lesions, 3.2 % in case of benign tumors, and 11 % in case of premalignant/malignant tumors. These four percentages were not statistically different. The GDS fecal carriage rate was lower than expected, which did not confirm our working hypothesis. Most strains belonged to S. bovis biotype II, while S. gallolyticus was found only once. These findings suggest that different GDS play different roles in the etiopathogenesis of IE and colorectal cancer.

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Acknowledgments

We acknowledge Mathilde Choux who performed the bacteriological analyses.

Funding

This work was supported by a research grant from the French Ministry of Health Program (Programme Hospitalier de Recherche Clinique, PHRC).

Conflict of interest

All authors do not have any commercial or other association that might pose a conflict of interest.

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Authors and Affiliations

  1. Department of Infectious Diseases, University of Franche-Comté, UMR 6249, University Hospital, 25000, Besançon, France

    C. Chirouze & B. Hoen

  2. Department of Bacteriology, University Hospital, 25000, Besançon, France

    I. Patry & G. Couetdic

  3. Inserm CIC 007; Inserm U738AP-HP, Université Paris Diderot, University Hospital Bichat, 75007, Paris, France

    X. Duval

  4. Clinique Mutualiste, 69003, Lyon, France

    V. Baty

  5. Infectious Diseases and ICU, Pontchaillou University Hospital, 35000, Rennes, France

    P. Tattevin

  6. Department of Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, 93000, Bobigny, France

    T. Aparicio

  7. Department of Gastro-Enterology and Liver Diseases, Pontchaillou University Hospital, 35000, Rennes, France

    M. Pagenault

  8. Department of Gastroenterology, University Hospital, 25000, Besançon, France

    F. Carbonnel

  9. Service des Maladies Infectieuses et Tropicales—CHRU Jean Minjoz, 25030, Besançon cedex, France

    C. Chirouze

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  1. C. Chirouze
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  10. B. Hoen
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Correspondence to C. Chirouze.

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Chirouze, C., Patry, I., Duval, X. et al. Streptococcus bovis/Streptococcus equinus complex fecal carriage, colorectal carcinoma, and infective endocarditis: a new appraisal of a complex connection. Eur J Clin Microbiol Infect Dis 32, 1171–1176 (2013). https://doi.org/10.1007/s10096-013-1863-3

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  • DOI: https://doi.org/10.1007/s10096-013-1863-3

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