Granulicatella adiacens infections in children: a single-center retrospective study

Abstract

Purpose: Granulicatella spp. although rare, are notable pathogens in various infections, particularly in bacteraemia and infective endocarditis. Because of their unique growth requirements and difficulties in antimicrobial testing, identifying and treating these microorganisms poses significant challenges.

Methods: This retrospective study was conducted at Dr. Sami Ulus Maternity and Children's Health and Diseases Research and Education Hospital, a tertiary care centre in Ankara, Turkey. Blood cultures were screened for Granulicatella spp. between January 2005 and January 2017. Clinical and laboratory features of the patients were documented.

Results: During the 12-year study period, 4125 patients with positive blood culture results were investigated. No cases of G. para-adiacens or G. elegans infection were identified. G. adiacens infection was diagnosed in seven patients (five males and two females) representing 0.1%. The mean age of the patients was 79.5 ± 49.8 months (median: 96 months, range: 10-140 months). Six patients had underlying conditions, including congenital heart diseases (two patients), gastrointestinal diseases (two patients), haematological malignancy (one patient), and neurological disorders (one patient). Three patients had bacteraemia, two had central line-related bloodstream infection (CRBSI), one had bacteraemia and pneumonia, and one had infective endocarditis. Four infections were community-acquired and three were healthcare-associated. All patients survived.

Conclusion: Although rare, G. adiacens can cause severe infections in children. Clinicians should be particularly vigilant for this pathogen, especially in children with cardiac disease, malignancy, or mucosal disruption, particularly when slow-growing gram-positive cocci are isolated from blood cultures or other sterile sites.

Keywords: Granulicatella adiacens; Bacteraemia; Central line-related bloodstream infection; Children; Endocarditis.