S. bovis urinary tract infection, management and associations

As part of a move to improve antimicrobial stewardship NHS GGC recently implemented identification to species level and Vitek 2 sensitivity testing on all urinary isolates. As part of this we have noticed an increased number of isolates of the Streptococcus bovis group in urinary samples. It is possible that these were previously labelled as Enterococcus spp. The significance of S. bovis isolates in urinary tract is uncertain.

Methods

We reviewed a year of S. bovis urinary isolates to ascertain whether there is any association with GI malignancy or endocarditis as is recognised with blood culture isolates of this group.

54 isolates were reviewed dating between Feb 2018 and 2019 allowing at least 6 months follow up. 94% of cases were in females. 46% of isolates were mixed usually with a member of the Enterobactereaceales. There were no cases of either known or newly diagnosed endocarditis amongst this patient cohort. 9% of cases had a known GI malignancy.

9% of our urinary isolates of S. bovis were associated with a known GI malignancy. This is compared with 11% of blood culture isolates also from our unit in 2016.