Streptococcus bovis Group Bacteremia at a Large Community Teaching Hospital

Introduction Streptococcus bovis group (SBG) has undergone recent nomenclature changes. This quality improvement project was developed to determine if providers recognized these taxonomic changes and subsequently recognized SBG as a harbinger of colon cancer, endocarditis, and gastrointestinal tract anatomic abnormalities. Methods This study was deemed a quality improvement project by the Summa Health Institutional Review Board. We reviewed all records of patients (≥18 years of age) with SBG bacteremia from 01-01-2018 to 12-31-2022 and report epidemiological, clinical and chart information on SBG bacteremia to assess physician recognition of these SBG nomenclature changes. Data were compared to our similar study from 2006–2017. Results Fifty-five patients had SBG bacteremia. The mean age was 72 years (range: 28–98). Identifiable sources of bacteremia were upper gastrointestinal (GI) tract (14 pts), lower GI tract (15 pts), osteomyelitis (3 pts), pyelonephritis (2 pts), and meningitis (1 pt). Eighteen patients had primary bacteremia. Taxonomic changes were recognized almost exclusively by infectious disease physicians. Gastroenterology physicians were consulted in 24/55 episodes and performed primarily diagnostic procedures. Mortality rate was 21.4% (12/56). Fewer patients underwent endoscopy (21.8%, 12/55 vs 52.4%, 22/42, P value = 0.025), fewer malignancies were detected (0%, 0/55 vs 11%, 5/42, P value = 0.0132), and fewer cases of endocarditis were diagnosed (9%, 5/55 vs 28.6%, 12/42, P value = 0.0160) compared to our prior study. Conclusions In 2017, the medical record reporting system for SBG bacteremia changed and no longer included a “ bovis group” identifier in our blood culture reports resulting in new SBG names being recognized only by infectious disease physician. Significantly fewer endoscopic procedures, fewer cases of endocarditis and fewer cases of GI tract malignancies were detected.