Peptostreptococcus

ペプトストレプトコッカス属

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/07/24 21:49:50」(JST)

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Peptostreptococcus
Peptostreptococcus spp. growing in characteristic chain formations.
Scientific classification
Kingdom:	Bacteria
Phylum:	Firmicutes
Class:	Clostridia
Order:	Clostridiales
Family:	Clostridiaceae
Genus:	Peptostreptococcus
Species
P. anaerobius P. asaccharolyticus P. harei P. hydrogenalis P. indoliticus P. ivorii P. lacrimalis P. lactolyticus P. magnus P. micros P. octavius P. prevotii P. tetradius P. vaginalis etc.

Peptostreptococcus is a genus of anaerobic, Gram-positive, non-spore forming bacteria. The cells are small, spherical, and can occur in short chains, in pairs or individually. Peptostreptococcus are slow-growing bacteria with increasing resistance to antimicrobial drugs.

The most frequently identified species of Peptostreptococcus is P. magnus.

Pathogenesis

Peptostreptococcus species are commensal organisms in humans, living predominantly in the mouth, skin, gastrointestinal, vagina and urinary tracts, and compose a portion of the bacterial gut flora. Under immunosuppressed or traumatic conditions these organisms can become pathogenic, as well as septicemic, harming their host. Peptostreptococcus can cause brain, liver, breast, and lung abscesses, as well as generalized necrotizing soft tissue infections. They participate in mixed anaerobic infections, a term which is used to describe infections that are caused by multiple bacteria that do not require or may even be harmed by oxygen.

Peptostreptococcus species are susceptible to beta-lactam antibiotics.

They are isolated with high frequency from all specimen sources. Anaerobic gram-positive cocci such as Peptostreptococcus are the second most frequently recovered anaerobes and account for approximately one quarter of anaerobic isolates found. Most often Anaerobic gram-positive cocci are usually recovered mixed in with other anaerobic or aerobic bacteria from various infections at different sites of the human body. This contributes to the difficulty of isolating Peptostreptococcus organisms.

Infections

Peptostreptococcus species that are found in clinical infections were once part of the genus formerly known as Peptococcus. Peptostreptococcus is the only genus among anaerobic gram-positive cocci that is encountered in clinical infections. As such, Peptostreptococcus species are viewed as being clinically significant anaerobic cocci. Other similar clinically significant anaerobic cocci include Veillonella species (gram-negative cocci), and microaerophilic streptococci (aerotolerant). Anaerobic gram-positive cocci include various clinically significant species of the genus Peptostreptococcus.

Some clinically significant Peptostreptococcus species are, Gaffkya anaerobia, which was renamed Peptostreptococcus tetradius. The species of anaerobic gram-positive cocci isolated most commonly include Peptostreptococcus magnus, Peptostreptococcus asaccharolyticus, Peptostreptococcus anaerobius, Peptostreptococcus prevotii, and Peptostreptococcus micros.

Anaerobic gram-positive cocci that produce large amounts of lactic acid during the process of carbohydrate fermentation were reclassified as Streptococcus parvulus and Streptococcus morbillorum from Peptococcus or Peptostreptococcus. Most of these organisms are anaerobic, but some are microaerophilic.

Due to a large amount of new research done on the human microbe and more information on bacteria, many species of bacteria have been renamed and re-classified. Based on DNA homology and whole-cell polypeptide-pattern study findings supported by phenotypic characteristics, the DNA homology group of microaerobic streptococci that was formerly known as Streptococcus anginosus or Streptococcus milleri is now composed of three distinct species: S anginosus, Streptococcus constellatus, and Streptococcus intermedius. The microaerobic species S morbillorum was transferred into the genus Gemella. A new species within the genus Peptostreptococcus is Peptostreptococcus hydrogenalis; it contains the indole-positive, saccharolytic strains of the genus.

Peptostreptococcus infections occur in/on all body sites, including the CNS, head, neck, chest, abdomen, pelvis, skin, bone, joint, and soft tissues. Adequate therapy must be taken against infections, or it could result in clinical failures. Peptostreptoccocci are often overlooked and they are very difficult to isolate, appropriate specimen collection is required. Peptostreptococci grow slowly which makes them increasingly resistant to antimicrobrials.

The most common Peptostreptococcus species found in infections are P. magnus (18% of all anaerobic gram-positive cocci and microaerophilic streptococci), P asaccharolyticus (17%), P anaerobius (16%), P prevotii (13%), P micros (4%), Peptostreptococcus saccharolyticus (3%), and Peptostreptococcus intermedius (2%).

P magnus were highly recovered in bone and chest infections. P asaccharolyticus and P anaerobius and the highest recovery rate in obstetrical/gynecological and respiratory tract infections and wounds. When anaerobic and facultative cocci were recovered most of the infection were polymicrobial. Most patients from whom microaerophilic streptococci were recovered in pure culture had abscesses (e.g., dental, intracranial, pulmonary), bacteremia, meningitis, or conjunctivitis. P. Magnus is the most commonly isolated anaerobic cocci and is often recovered in pure culture. Other common peptostreptococci in the different infectious sites are P anaerobius which occurs in oral infections; P micros in respiratory tract infection.s, P magnus, P micros, P asaccharolyticus, Peptostreptococcus vaginalis, and P anaerobius in skin and soft tissue infections; P magnus and P micros in deep organ abscesses; P magnus, P micros, and P anaerobius in gastrointestinal tract–associated infections; P magnus, P micros, P asaccharolyticus, P vaginalis, P tetradius, and P anaerobius in female genitourinary infections; and P magnus, P asaccharolyticus, P vaginalis, and P anaerobius in bone and joint infections and leg and foot ulcers.

Many infections caused by peptostreptococcus bacteria are synergistic. Bacterial synergy, the presence of which is determined by mutual induction of sepsis enhancement, increased mortality, increased abscess inducement, and enhancement of the growth of the bacterial components in mixed infections, is found between anaerobic gram-positive cocci and their aerobic and anaerobic counterparts. The ability of anaerobic gram-positive cocci and microaerophilic streptococci to produce capsular material is an important virulence mechanism, but other factors may also influence the interaction of these organisms in mixed infections.

Although anaerobic cocci can be isolated from infections at all body sites, a predisposition for certain sites has been observed. In general, Peptostreptococcus species, particularly P magnus, have been recovered more often from subcutaneous and soft tissue abscesses and diabetes-related foot ulcers than from intra-abdominal infections. Peptostreptococcus infections occur more often in chronic infections.

Frequency of infections

In the United States it is difficult to determine the exact frequency of peptostreptococcus infections because of inappropriate collection methods, transportation, and specimen cultivation. Peptostreptococcus infections are most commonly found in patients who have had or have chronic infections. Patients who have predisposing conditions are shown to have 5% higher recovery rate of the bacteria in blood cultures.

Of all anaerobic bacteria recovered at hospitals from 1973–1985, anaerobic gram-positive cocci accounted for 26% of it. The infected sited where these organisms were found in the greatest abundance were obstetrical and gynecological sites (35%), bones (39%) cysts (40%), and ears (53%). Occasionally found in other places such as abdomen, lymph nodes, bile, and eyes.

Frequency of infections is greater in developing countries because treatment is often slow, or it is impossible to get the adequate treatment, but mortality due to peptostreptococcus infections have decreased in the last 30 years and will continue to do so due to better treatment.

All ages are susceptible to peptostreptococcus infections, however children are more likely to get head and neck infections.^{[citation needed]}

Infection types

Skin and soft tissue infections

Anaerobic gram-positive cocci and microaerophilic streptococci are often recovered in polymicrobial skin and soft tissue infections, such as gangrene, fasciitis, ulcers, diabetes-related foot infections, burns, human or animal bites, infected cysts, abcesse of the breast, rectum, and anus. Anaerobic gram-positive cocci and microaerophilic streptococci are generally found mixed with other aerobic and anaerobic florae that originate from the mucosal surface adjacent to the infected site or that have been inoculated into the infected site.

Gastrointestinal florae can cause infections such as gluteal decubitus ulcers, diabetes-related foot infections, and rectal abscesses. Anaerobic gram-positive cocci and microaerophilic streptococci are part of the normal skin florae, so it is hard to avoid contamination by these florae when obtaining specimens.

CNS infections

CNS infections can be isolated from subdural empyema and brain abscesses which are a result of chronic infections. Also isolated from sinuses, teeth and mastoid. 46% of 39 brain abscesses in one study showed anaerobic gram-positive cocci and microaerophilic streptococci.

Upper respiratory tract and dental infections

There is a high rate of anaerobic cocci colonization which accounts for the organisms significance in these infections. Anaerboci gram-positive cocci and micraerophilic streptococci are often recovered in these infections. They have been recovered in 15% of patients with chronic mastoiditis. When peptostreptococci and other anaerobes predominate, aggressive treatment of acute infection can prevent chronic infection. When the risk of anaerobic infection is high, as with intra-abdominal and post-surgical infections, proper antimicrobial prophylaxis may reduce the risk 90% of the time, other organisms were mixed in with the anaerobic gram-positive cocci and microaerophilic streptococci. This includes streptococcus species, and staphylococcus aureus.

Bacteremia and endocarditis

Peptostreptococci can cause fatal endocarditis, paravalvular abscess, and pericarditis. The most frequent source of bacteremia due to Peptostreptococcus are infections of the oropharynx, lower respiratory tract, female genital tract, abdomen, skin, and soft tissues. Recent gynecological surgery, immunosuppression, dental procedures, infections of the female genital tract, abdominal and soft tissue along with gastrointestinal surgery are predisposing factors for bacteremia due to peptostreptococcus.

Microaerophilic streptococci typically account for 5-10% of cases of endocarditis; however, peptostreptococci have only rarely been isolated.

Anaerobic pleuropulmonary infections

Anaerobic gram-positive cocci and microaerophilic streptococci are most frequently found in aspiration pneumonia, empyema, lung abscesses, and mediastinitis. These bacteria account for 10-20% of anaerobic isolated recovered from pulmonary infections. It is difficult to obtain appropriate culture specimens. It requires a direct lung puncture, or the use of trans-tracheal aspiration.

Abdominal infections

Anaerobic gram-positive cocci are part of the normal gastrointestinal florae. They are isolated in approximately 20% of specimens from intra-abdominal infections, such as peritonitis. Found in abscesses of the liver, spleen, and abdomen. Like in upper respiratory tract and dental infections, anaerobic gram-positive cocci are recovered mixed with other bacteria. In this case they are mixed with organisms of intestinal origin such as E coli, bacteroides fragilis group, and clostridium species.

Female pelvic infections

The anaerobic gram-positive cocci most often found are P asaccacharolyticus, P anaerobis, and P prevotii. Anaerobic gram-positive cocci and microaerophilic streptococci can be isolated in 25-50% of patients with endometritis, pyoderma, pelvic abscess, Bartholin gland abscess, postsurgical pelvic infections, or pelvic inflammatory disease. The origin of these organisms is probably the vaginal and cervical florae. Anaerobic gram-positive cocci are generally found mixed with Prevotella bivia and Prevotella disiens. Osteomyelitis and arthritis:

Anaerobic gram-positive cocci are frequently isolated from anaerobically infected bones and joints., they accounted for 40% of anaerobic isolates of osteomyelitis caused by anaerobic bacteria and 20% of anaerobic isolates of arthritis caused by anaerobic bacteria. P magnus and P prevotii are the predominant bone and joint isolates. Management of these infections requires prolonged courses of antimicrobials and is enhanced by removal of the foreign material.

Causes of infection

Infections with anaerobic gram-positive cocci and microaerophilic streptococci are often caused by:

• Trauma
• Immunodeficiency
• Steroid therapy
• Vascular disease
• Malignancy
• Reduced blood supply
• Previous surgery
• Presence of a foreign body
• Sickle cell anemia
• Diabetes

Treatment

When peptostreptococci and other anaerobes predominate, aggressive treatment of acute infection can prevent chronic infection. When the risk of anaerobic infection is high, as with intra-abdominal and post-surgical infections, proper antimicrobial prophylaxis may reduce the risk. Therapy with antimicrobials (e.g., aminoglycosides, trimethoprim-sulfamethazine, older quinolones) often does not eradicate anaerobes.^{[citation needed]}

References

External links

• Peptostreptococcus infections from eMedicine.

UpToDate Contents

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• 1. 嫌気性細菌感染 anaerobic bacterial infections
• 2. 細菌検査室におけるグラム染色および培養結果に対するアプローチ approach to gram stain and culture results in the microbiology laboratory
• 3. 嫌気菌：ヒトの正常細菌叢における歴史および役割 anaerobic bacteria history and role in normal human flora
• 4. 危険を伴う中絶 unsafe abortion
• 5. 急性汎発性発疹性膿疱症（AGEP） acute generalized exanthematous pustulosis agep

English Journal

• Antimicrobial activity of Brazilian propolis extracts against rumen bacteria in vitro.

• de Aguiar SC, Zeoula LM, Franco SL, Peres LP, Arcuri PB, Forano E.SourceDepartamento de Zootecnia, Universidade Estadual de Maringá, Avenida Colombo 5790, Maringá, PR, 87020-900, Brazil.
• World journal of microbiology & biotechnology.World J Microbiol Biotechnol.2013 May 8. [Epub ahead of print]
• The antimicrobial activity of three Brazilian propolis extracts was evaluated on bacterial strains representing major rumen functional groups. The extracts were prepared using different concentrations of propolis and alcohol, resulting in different phenolic compositions. The propolis extracts inhibi
• PMID 23653262

• [Illumina sequencing 16S rRNA tagging reveals diverse vaginal microbiomes associated with bacterial vaginosis].

• Xu SR, Zong LL, Liu MB, He Y, Huang XM, Zhou HW.SourceDepartment of Obstetrics and Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China.E-mail: 398033535@qq.com.
• Nan fang yi ke da xue xue bao = Journal of Southern Medical University.Nan Fang Yi Ke Da Xue Xue Bao.2013 May;33(5):672-7.
• OBJECTIVE: To analyze and compare vaginal microbiomes in healthy women at child-bearing ages and patients with bacterial vaginosis (BV).METHODS: A total of 74 vaginal swabs of the vaginal fornix were collected from 37 BV patients and 37 healthy women. BV status was assessed according to Amsels clini
• PMID 23688985

• Microbial diversity in uterus of healthy and metritic postpartum Holstein dairy cows.

• Peng Y, Wang Y, Hang S, Zhu W.SourceLaboratory of Gastrointestinal Microbiology, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, Jiangsu, 210095, China.
• Folia microbiologica.Folia Microbiol (Praha).2013 Apr 14. [Epub ahead of print]
• Clone library of bacterial 16S rRNA gene was constructed to evaluate the bacterial diversity and community structure of uterus samples obtained from three postpartum healthy cows and three metritic cows on days 10 and 40. Sequences were assigned to five major groups (Bacteroidetes, Firmicutes, Fusob
• PMID 23585284

Japanese Journal

• 外側翼突筋内に膿瘍を形成した化膿性顎関節炎の1例

• 高田 佳之,小林 正治,西山 秀昌,小野 由起子,泉 直也,齊藤 力
• TMJ : journal of Japanese Society for Temporomandibular Joint = 日本顎関節学会雑誌 23(3), 155-160, 2011-12-20
• … 77;CTおよびMRI所見で右下顎頭内側極の骨吸収と右側顎関節包内および外側翼突筋内に膿瘍形成を認めた｡試験的穿刺により，黄白色の粘稠な膿汁を吸引した｡細菌検査により，口腔内常在菌であるPeptostreptococcus microsが同定された｡抗菌薬の内服投与および静脈内点滴投与で徐々に症状は消退した｡初診から3年経過した現在，右側顎関節部の腫脹は消失し, 開口時に下顎骨の右側偏位と関節雑音を認めるも …
• NAID 10030234959

• Fournier's gangrene in elderly patient : report of a case

• Nakatani Hajime,Hamada Shinichi,Okanoue Toyotake,Kawamura Akihiro,Chikai Takashi,Yamamoto Shinya,Inoue Yuichiro,Hanazaki Kazuhiro
• The journal of medical investigation : JMI 58(3-4), 255-258, 2011-08-00
• … Both Peptostreptococcus Sp. …
• NAID 120003596491

Related Links

• ペプトストレプトコッカス属 (Peptostreptococcus)：抗菌薬インターネット ...

Peptostreptococcus. ペプトストレプトコッカス属. Peptostreptococcus spp.ペプト ストレプトコッカス. 嫌気性グラム陽性球菌． しばしば女性性器，呼吸器，腸管および 口腔より検出される． 副鼻腔炎，中耳炎，創傷部，敗血症などで検出される． 混合感染 して ...

• Peptostreptococcus - Wikipedia, the free encyclopedia

Peptostreptococcus is a genus of anaerobic, Gram-positive, non-spore forming bacteria. The cells are small, spherical, and can occur in short chains, in pairs or individually. Peptostreptococcus are slow-growing bacteria with increasing ...

Related Pictures

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★リンクテーブル★

リンク元	「無芽胞嫌気性菌感染症」「誤嚥性肺炎」「ペプトストレプトコッカス」「ペプトストレプトコッカス属」
拡張検索	「Peptostreptococcus属」「Peptostreptococcus anaerobius」「Peptostreptococcus spp.」

「無芽胞嫌気性菌感染症」

　　[★]

英

nonsporulating anaerobic infection, nonspore-forming anaerobic bacterial infection

関

バクテロイデス属

• 無芽胞嫌気性菌が関与する嫌気性菌感染症。
• 多くの細菌が関与するが、嫌気性のグラム陰性桿菌が多い。

• 嫌気性グラム陰性桿菌：Bacteroides、Prevotella、Fusobacterium、Porphyromonas、Bilophila
• 嫌気性グラム陽性球菌：Finegoldia、Micromonas、Peptostreptococcus
• 免疫不全状態時(嫌気性グラム陽性桿菌)：Eggerthella、Eubacterium、Propionibacterium

• ヒトの常在菌でである(内因性感染となる)が、免疫力の低下や組織・器官の奇形が存在する場合、病変を形成しやすい。
• 好気性菌との複合感染をとる。
• 嫌気性グラム陰性桿菌は、カルバペネム、セファマイシンなど一部を除くほとんど全てのβ-ラクタム薬を分解するβ-ラクタマーゼを産生する。(嫌気性なので当然)Bacteroides fragilisにアミノグリコシド系抗菌薬は無効である。
• 治療：クリンダマイシン、リンコマイシン

「誤嚥性肺炎」

　　[★]

日

ごえんせいはいえん

英

aspiration pneumonia

同

誤飲性肺炎、嚥下性肺炎 deglutition pneumonia、吸引性肺炎

原因

• 口腔内容物の気道侵入
• 逆流胃内容の気道侵入

病原体

IRE.521

• 口腔内嫌気性菌

• 嫌気性グラム陽性球菌：Peptostreptococcus
• 色素(産生)性グラム陰性桿菌：Prevotella, Porphyromonas, Bacteroides
• Fusobacterium

QB.H-157

• 黄色ブドウ球菌
• 緑膿菌
• 腸内細菌

リスクファクター

IRE.520 QB.H-157 YN.I-48

• 意識障害：脳血管障害
• 食道疾患：食道通過障害、噴門部逆流
• 嚥下障害：(高齢者)、中枢神経変性疾患(パーキンソン病？)
• 鎮静薬の使用　　←　例えば、101E013
• 口腔内環境の不衛生

「ペプトストレプトコッカス」

　　[★]

ラ

Peptostreptococcus

関

ペプトストレプトコッカス属、Peptostreptococcus属

「ペプトストレプトコッカス属」

　　[★]

英

Peptostreptococcus

同

Peptostreptococcus属

「Peptostreptococcus属」

　　[★]

ラ

Peptostreptococcus

関

ペプトストレプトコッカス属、ペプトストレプトコッカス

「Peptostreptococcus anaerobius」

　　[★]

関

ペプトストレプトコッカス属、グラム陽性球菌

「Peptostreptococcus spp.」

　　[★]

関

anaerobic infections, mixed