Streptococcus

E. coli is usually found in the GI tract, and it makes its way into the urethra, which is basically where you pee out of.

Other pathogens, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis, Streptococcus saprophyticus, those are the major causes of UTIs.

now you can diagnose a UTI by a urinalysis and then they can do a urine culture to determine what specific bacteria is causing the problem so for people who have chronic UTIs you definitely want to do a urinary culture to figure out what is going on there okay increased risk factors for UTIs number one is the female anatomy A lot of UTIs happen with females because they have a shorter urethra.

So they have a shorter path to get in and make an infection.

Interestingly, the bacteria involved aren't exotic.

We are talking about fusospirochetal microbes, Staphylococcus aureus, Streptococcus, and Pseudomonas.

These are organisms that often exist in the normal oral microbiome or the everyday environment.

So how do they suddenly turn into flesh-eating monsters?

So a bunch of guys hanging out, and often it is guys, I hate to say, the Delphi consensus, like a bunch of guys hanging out in a room, breathing in the vapors, saying, what do we all agree on? Whether a clinical response-tailored antibiotic management strategy can shorten treatment duration without compromising safety is unclear, right? So we're going to look at that.

So these are the results of an international, open-label, randomized trial where they assigned adults in stable condition with infective endocarditis caused by Staph aureus, Enterococcus faecalis, or Streptococcus species to receive either response-tailored or standard-duration antibiotic therapy.

Before randomization, all the patients received at least the pre-specified two to four weeks of therapy met criteria for clinical stabilization.

After randomization, patients in the tailored therapy group discontinued antibiotics or And those in the standard therapy group, continued standard therapy, total duration four to six weeks.

This kicked off the hunt for evidence of bacterial infection, and they found it.

A rare form of Streptococcus bacteria was present in all of their patients.

That's right, a variant of the very common bacteria normally responsible for a simple sore throat.

The theory is that some people experience an extreme immune response to the Streptococcus bacteria, an immune response so severe that their bodies start attacking themselves.

So did they manage to crack one of the biggest medical mysteries looming over humanity? Many believe so.

However, their theory leaves many questions unanswered.

This trial evaluated whether a clinical response-tailored antibiotic management strategy in the treatment of infective endocarditis can shorten treatment duration without compromising safety.

508 adults in stable condition with infective endocarditis caused by Staphylococcus aureus Enterococcus faecalis or Streptococcus species were randomly assigned to receive either response-tailored or standard-duration antibiotic therapy.

Before randomization, all the patients received at least the pre-specified 2-4 weeks of therapy and met criteria for clinical stabilization.

After randomization, patients in the tailored therapy group discontinued antibiotics, and those in the standard therapy group continued standard treatment, total duration 4 to 6 weeks.

Once a patient has responded appropriately, and we can talk about what appropriately means, do they actually need the rest of the antibiotic course at all? So this was an international open-label randomized trial of 508 adults with left-sided infective endocarditis.

Three pathogens, Staph aureus, Enterococcus faecalis, and Streptococcus, grouped together.

Importantly, these weren't patients at the beginning of treatment.

So before randomization, everybody had to receive a pre-specified two to four weeks of appropriate antibiotics.

Yeah, the traffic light system is a great mental shortcut.

Green signifies gram-positive bacteria like Staphylococcus and Streptococcus.

Meaning go ahead, the wall is the main target.

Right.

Okay.

The empiric logic here is driven by the structural diversity of the likely pathogens.

If someone has severe CAP, you have to assume they might be infected by typical bacteria like Streptococcus pneumoniae or, uh, Haemophilus influenzae.

But they could also be infected by atypical pathogens like Legionella or Mycoplasma.

We're coming a full circle today because I have Chris back with me, who appeared on our first Dissecting Animal Diseases podcast.

Chris, you're here to talk about disease due to Streptococcus suis in pigs, and we'll discuss a really exciting project that we at APHA have been working on for the last couple of years.

Chris, we heard last time that you were a farm vet in practice for many years and then joined us as a veterinary investigation officer at our first Veterinary Investigation Center two years ago now.

So, Chris, it's been a year since we last spoke on the podcast.

But yeah, no, it's been, it's been a good year so far.

Brilliant.

So Chris, can you kick us off then by telling us a bit about this bug? So this, this bug called Streptococcus suis that I guess for the rest of the podcast we, we can refer to as Strep suis, which is kind of common parlance in the UK, isn't it? So can you tell us about what disease problems it can cause in pigs?

Absolutely.