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Association between Streptococcus bovis and Colon Cancer

2009; American Society for Microbiology; Volume: 47; Issue: 2 Linguagem: Inglês

10.1128/jcm.01755-08

1098-660X

Annemarie Boleij, Renée M. J. Schaeps, Harold Tjalsma,

Diphtheria, Corynebacterium, and Tetanus

We read with great interest the article by Marcella Beck and colleagues (1). We fully support their recommendation that proper distinction between the “Streptococcus bovis” strains belonging to Streptococcus gallolyticus and Streptococcus infantarius (previously biotypes I and II/2, respectively) should be made in future studies to obtain a clear picture of the disease associations of these opportunistic pathogens; above all, because proper bacterial classification and subsequent recognition of their association with colon cancer can be a life-saving event for S. bovis-infected individuals with undiagnosed colon cancer (4, 5, 8). We were therefore somewhat puzzled by the authors’ conclusion that the association between S. bovis bacteremia and colon cancer (7%) may not be as strong as previously thought. Beck and colleagues based their conclusion on the finding that 3 out of 46 individuals with S. bovis bacteremia presented with a coincidental colon carcinoma. The authors recognize, however, that only 15 of these 46 patients underwent full bowel examination and that in the other patients asymptomatic colon tumors could be missed. In two cited papers, Ruoff et al. (6) and Corredoira et al. (2) report respective associations of 100% and 57% for the association of S. bovis biotype I and colon cancer in patients that underwent colonoscopy. Importantly, these associations also took into account the presence of premalignant adenomas that are generally regarded as (earlystage) precursors of carcinomas. In fact, Corredoira et al. (3)