NUTRITIONALLY VARIANT STREPTOCOCCI BACTEREMIA IN CANCER PATIENTS: A RETROSPECTIVE STUDY, 1999-2014

Main Article Content

Abraham Tareq Yacoub
Jayasree Krishnan
Ileana M. Acevedo
Joseph Halliday
John Norman Greene *
(*) Corresponding Author:
John Norman Greene | john.greene@moffitt.org

Abstract

Backgound

Nutritionally variant Streptococci (NVS), Abiotrophia and Granulicatella are implicated in causing endocarditis and blood stream infections more frequently than other sites of infection. Neutropenia and mucositis are the most common predisposing factors for infection with other pathogens in cancer patients. In this study we investigated the clinical characteristics of NVS bacteremia in cancer patients and identified risk factors and outcomes associated with these infections.

 Materials and Methods

We retrospectively reviewed all cases of NVS bacteremia occurring from June 1999 to April 2014 at H. Lee Moffitt Cancer Center and Research Institute. The computerized epidemiology report provided by the microbiology laboratory identified thirteen cancer patients with NVS bacteremia. We collected data regarding baseline demographics and clinical characteristics such as age, sex, underlying malignancy, neutropenic status, duration of neutropenia, treatment, and outcome.

Results

Thirteen patients were identified with positive NVS blood stream infection. Ten patients (77%) had hematologic malignancies, including chronic lymphocytic leukemia (CLL) (1), multiple myeloma (MM) (1), acute myelogenous leukemia (AML) (4), and non Hodgkin’s lymphoma (NHL) (4).  The non-hematologic malignancies included esophageal cancer (2) and bladder cancer (1).

Conclusion

NVS should be considered as a possible agent of bacteremia in cancer patients with neutropenia and a breach in oral, gastrointestinal and genitourinary mucosa (gingivitis/mucositis).


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Article Details

Author Biography

John Norman Greene, Section Chief, Division of Infectious Diseases and Tropical Medicine - Moffitt Cancer Center, Tampa FL Professor of Medicine

BIOGRAPHICAL SKETCH

Provide the following information for the Senior/key personnel and other significant contributors in the order listed on Form Page 2.
Follow this format for each person.  DO NOT EXCEED FOUR PAGES.

 

NAME

John N. Greene MD FACP

POSITION TITLE

 

Professor, Division of Infectious Disease & International Medicine

 

eRA COMMONS USER NAME (credential, e.g., agency login)

 

EDUCATION/TRAINING  (Begin with baccalaureate or other initial professional education, such as nursing, include postdoctoral training and residency training if applicable.)

INSTITUTION AND LOCATION

DEGREE

(if applicable)

MM/YY

FIELD OF STUDY

College of William and Mary, Williamsburg, Virginia

BS

1982

Biology and Psychology

University of South Florida College of Medicine,

Tampa, Florida

MD

1986

Medicine

University of South Florida College of Medicine, Tampa, Florida

Residency

1986-1989

Internal Medicine

University of South Florida College of Medicine, Tampa, Florida

Fellowship

1989-1991

Infectious Disease

     

A.        Personal Statement

Dr. John N. Greene received his medical degree from the University of South Florida College of Medicine, Tampa, Florida.  He is a Professor of Medicine and currently the Section Chief, Division of Infectious Diseases and Tropical Medicine and Senior Member of the Blood & Marrow Transplant department at Moffitt Cancer Center, Tampa, FL.  He is affiliated with numerous committees, community outreach projects, associations, and boards.  He is an accomplished speaker and writer, having published over 166 manuscripts in peer reviewed journals and has been a speaker for over 160 invited presentations.  He has written and published one book, and written over 30 chapters in other books.  Dr. Greene has been a mentor to hundreds of medical students throughout his career and has taken many students with him on his yearly medical mission trips to third world countries

 

B.        Positions and Honors

 

1994-present               “Moffitt Angel” Award (Patients’ Family Request).

1996-present               Citation, “The Best Doctors in America: Southeast Region.”

1997                                        Physician of the Year, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL

1998                                        “Doctor of the Day”, Florida Senate, Tallahassee, FL

2003                                        Nomination for “Outstanding Sophomore Instructor” by the graduating class, University                                                                                of South Florida College of Medicine, Tampa, FL

2003                                        “The Leonard Tow 2003 Humanism in Medicine” Award, “In Recognition of Exemplary                                                                              Compassion, Competence and Respect in the Delivery of Care,” The Arnold P. Gold

                                                            Foundation.

2005                      Election to the Gold Humanism Honor Society in Recognition of Exemplary Service to Others

2006                      USF Department of Internal Medicine Faculty Award for H. Lee Moffitt Resident Teaching Award.      

2007-2008             Selected by peers “Best Doctors in America® 2007-2008”

2008-2009                               Biographical candidate representing industry in the Who’s Who Among Executives and                                                                              Professionals “Honors Edition”

2009-2010                               Selected by peers “Best Doctors in America® 2009-2010”

2010-2011                               Who’s Who of Executives Professionals and Entrepreneurs 2010-2011

C.        Selected Peer-reviewed Publications

Marela Velez, Beata Casanas, John N. Greene*, Jose Morey, Dominick Mastroianni, Richard Oehler – Pasteurella multocida Infections in Cancer Patients - Asian Biomedicine Vol. 4 No. 3 June 2010; 449-455

 

Pham T, Greene JN*, Sandin RL, Vincent AL, Messina J. – A Chronic Nodular Hand and Forearm Lesion  - Infectious Diseases in Clinical Practices “Images in ID – What’s Your Diagnosis? – Vol. 18, No. 4, July 2010; 261-263

 

Knapp CF, Tucci VT, Keeler JA, Sandin RL, Greene JN*, - Primary Cutaneous Acremonium Infection in a Neutropenic Patient After Trauma – Infectious Diseases in Clinical Practices  – Vol. 18, No. 4, July 2010; 277-278

 

Choudhry A, Tucci V, Greene JN*, - Disseminated Bipolaris Infection – Review Article:  Infectious Diseases in Clinical Practices Vol. 18, No. 5, September 2010; 296-298

 

Li, Y, Greene JN, Sandin RL, - “Recurrent Soft Tissue Infection Seventy Years After Initial Trauma”.  – Images in ID – What’s the Diagnosis?  Infectious Diseases in Clinical Practice, November 2010:18:389-391

 

Greene JN – Prevention of Infections in Patients with Hematologic Malignancies – The spectrum of infections is changing as microbes take advantage of neutropenia – National Comprehensive Cancer Network (NCCN) 5th Annual Congress:  Hematologic Malignancies 2010, pages 30-33

 

Rivera, RJ, Alrabaa, SF, List, A, Greene, JN*.,  “Successful Treatment of Refractory Disseminated Mycobacterium Abscessus infection using Gamma Interferon” – Case Report - Infections Diseases in Clinical Practices –  Vol. 19, Issue 2,  March 2011;142-145

 

Prince MD, Suber JS, Aya-ay ML, Cone Jr. JD, Greene JN, Smith Jr. DJ, Smith PD, - “Prosthesis Salvage in Breast Reconstruction Patients with Periprosthetic Infection and Exposure” Plas. Reconstr. Surg. 129: 42, June 2012

 

Lortholary O, Obenga G, Biswa P, Cailott D, Chachaty E, Bienvenu AL, Cornet M, Greene JN, Herbert R, Lacroix C, Grenouillet F, Raad I, Sitbon K, Troke P; the French Mycoses Study Group – An International, Retrospective Analysis of 73 Cases of Invasive Fusariosis Treated  with Voriconazole – Antimicrobial Agents Chemotherapy, Vol. 54, No. 10, Oct. 2011, p. 4446-4450

 

Stein, M, Palumbo, B., Letson, DG, Bui, MM, Sandin, RL, Greene, JN – Case Report – “A Case of Coccidioides Synovitis of the Knee Presents Clinically as Pigmented Villonodular Synovitis” Infectious Diseases in Clinical Practice.  (1)6:439-441, November 2011

 

Osterndorf B., Oehler RL, Greene JN – Case Report “Human Staphylococcus intermedius Infection in a Patient with Post-radiation Changes – Infectious Diseases in Clinical Practices 19(6);426-427, November 2011

 

Prince MD, Suber JS, Aya-Ay ML, Cone JD Jr, Greene JN, Smith DJ Jr, Smith PD. Prosthesis salvage in breast reconstruction patients with periprosthetic infection and exposure. Plast Reconstr Surg. 2012 Jan;129(1):42-8. PubMed PMID: 22186499.

Manry, Matthew; Cox, Jennifer; Casanas, Beata; Quilitz, Rod; Greene, John N.  Rituximab-Associated Occurrence of Disseminated Miliary Tuberculosis Infectious Diseases in Clinical Practice. 20(1):82-84, January 2012.

 

Givins P, Velez AP, Sandin RL, Quilitz RE, Greene JN* – Development of Enteroviral Meningoencephalitis Following Rituximab Treatment for Non-Hodgkin’s Lymphoma - Infectious Diseases in Clinical Practice  - July 2012;20(4):291-293

 

Casanas BC, Kass J, Pathak A, Tucci V, Payor A, Vincent AL, Greene JN*, Sandin RL, - 1 Non-gastrointestinal Aeromonas Hydrophilia Infections in Cancer Patients –  Infectious Diseases in Clinical Practice – July 2012;20(4):268-271

D.        Research Support

None

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