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• W2897016741 abstract "We read with great interest on the studies by Kwong et al1Kwong T.N.Y. et al.Gastroenterology. 2018; 155: 383-390Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar that observed an increased risk of colorectal carcinoma among hospitalized patients in Hong Kong with bacteremia from, among others, the Streptococcus bovis group. Members of the S bovis group comprise S gallolyticus subspecies gallolyticus (SGG), S gallolyticus subspecies pasteurianus (SGP), S infantarius, and S lutetiensis.2Jans C. et al.Infect Genet Evol. 2015; 33: 419-436Crossref PubMed Scopus (78) Google Scholar A significant association between colorectal carcinoma and bacteremia with S gallolyticus was found, but was not found with the other members within the S bovis group.1Kwong T.N.Y. et al.Gastroenterology. 2018; 155: 383-390Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar Nonetheless, the nature of the information did not allow the authors to stratify the risk by SGG and SGP.1Kwong T.N.Y. et al.Gastroenterology. 2018; 155: 383-390Abstract Full Text Full Text PDF PubMed Scopus (135) Google Scholar We concur with the author’s recommendation that a high index of suspicion is necessary to look for underlying causes of bacteremia with thorough investigation including colonoscopy. In fact, a close association of S bovis group bacteremia and colonic carcinoma has been reported by us in asymptomatic blood donors.3Lee C.K. et al.Transfusion. 2013; 53: 2207-2210PubMed Google Scholar In our original series, a total of 16 asymptomatic blood donors, that is, an estimate of 1 in 110,800 donations, were found to have S bovis group bacteremia among 369,477 bacterial surveillance cultures performed over a period of 14 years. Molecular methods were used to identify the isolates to subspecies level.2Jans C. et al.Infect Genet Evol. 2015; 33: 419-436Crossref PubMed Scopus (78) Google Scholar, 3Lee C.K. et al.Transfusion. 2013; 53: 2207-2210PubMed Google Scholar There was only 1 case of SGG but, 4 cases of SGP. At the time of the report, out of 8 donors who underwent colonoscopy, 2 had colonic carcinoma and 4 had benign polyps. Given that the average annual incidence rate for colonic carcinoma per 100,000 males and females in Hong Kong was around 75 and 52, respectively, over the same period of time, our observed rate is very high.4Hong Kong Cancer Registry, Hospital Authority. Available at: www3.ha.org.hk/cancereg/default.asp. Accessed May 25, 2018.Google Scholar A standard protocol was established in the Blood Transfusion Service to refer all donors with S bovis group bacteremia for thorough investigations. Within the last 5 years, another 7 asymptomatic donors were found to have S bovis group bacteremia; 4 with SGP and 1 SGG. Upon investigation, 4 donors had benign polys and 1 had normal a colonoscopy; the remaining 2 declined follow-up. It seems that bacteremia from either SGG or SGP is closely associated with underlying colonic pathology in patients and asymptomatic blood donors. Irrespective of the subspecies, detection of S bovis bacteremia should prompt a thorough workup for early detection of colonic adenoma and carcinoma, which we hope will improve clinical outcomes. Association Between Bacteremia From Specific Microbes and Subsequent Diagnosis of Colorectal CancerGastroenterologyVol. 155Issue 2PreviewColorectal cancer (CRC) development has been associated with increased proportions of Bacteroides fragilis and certain Streptococcus, Fusobacterium, and Peptostreptococcus species in the intestinal microbiota. We investigated associations between bacteremia from specific intestinal microbes and occurrence of CRC. Full-Text PDF ReplyGastroenterologyVol. 156Issue 1PreviewWe appreciate Wong et al’s interest in our recent publication. Their clinical observations of higher incidence rate of colorectal neoplasia in Streptococcus bovis group bacteremia patients is valuable and echoes the strong correlation between colorectal cancer (CRC) and CRC-enriched microbiota. We concur that a thorough colon workup should be considered for these patients for better clinical outcomes. Full-Text PDF" @default.
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• W2897016741 date "2019-01-01" @default.
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• W2897016741 title "Streptococcus gallolyticus Bacteremia and Colorectal Carcinoma" @default.
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