Viridans group streptococci (VGS) – antimicrobial resistance in children with sepsis. A scoping review.

Abstract

Background: The Viridans group streptococci (VGS) is a common commensal bacterium and is historically counted as a contaminant when cultured in blood. Over the past years there seem to be an increase in the incidence of invasive VGS infections, especially in children and neutropenic patients. The knowledge about VGS as source of severe infections in children is limited. The purpose of this scoping review is to summarize data from current available literature on the antimicrobial resistance (AMR) profiles of VGS as cause of sepsis in neonates and children after the neonatal period. <p>

<p>Method: A systematic literature search was performed in MEDLINE and Embase, and matching studies published between 1st of January 2015 – 31st of December 2023 were considered. We aimed to identify articles reporting VGS as cause of sepsis in children and neonates. After full text-screening all included studies also reporting AMR patterns for VGS were included in this sub-study. Two reviewers independently screened abstracts and full text articles. The study is registered in an international prospective register for systematic reviews (PROSPERO ID: CRD42022282804) but was later changed to a scoping review. <p>

<p>Results: In total, 18 articles were included after screening 9219 abstracts and 1287 potentially relevant full text articles. In total, 194/776 (25%) isolates were resistant to penicillin, 92/276 (33.3%) isolates were resistant to ampicillin/amoxicillin, 14/29 (48.3%) isolates were resistant to gentamicin, 164/748 (21.9%) isolates were resistant to 3rd generation cephalosporines, 275/393 (70.0%) to erythromycin, 10/442 (2.3%) isolates were resistant to vancomycin and 57/565 (10.1%) were resistant to fluoroquinolones. <p>

<p>Conclusion: In conclusion, the data showing antibiotic susceptibility patterns for VGS-bacteremia in children are still limited, and findings from existing literature are diverse. To examine this matter closer, we suggest more research on AMR in VGS.