Population genomics of Streptococcus mitis in UK and Ireland bloodstream infection and infective endocarditis cases

Akuzike Kalizang’oma, Damien Richard, Brenda Kwambana-Adams, Juliana Coelho, Karen Broughton, Bruno Pichon, Katie L. Hopkins, Victoria Chalker, Sandra Beleza, Stephen D. Bentley, Chrispin Chaguza and Robert S. Heyderman ()
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Akuzike Kalizang’oma: University College London
Damien Richard: University College London
Brenda Kwambana-Adams: University College London
Juliana Coelho: Colindale
Karen Broughton: Colindale
Bruno Pichon: Colindale
Katie L. Hopkins: Colindale
Victoria Chalker: NHS Blood and Transplant
Sandra Beleza: Department of Genetics and Genome Biology
Stephen D. Bentley: Wellcome Sanger Institute
Chrispin Chaguza: University College London
Robert S. Heyderman: University College London

Nature Communications, 2024, vol. 15, issue 1, 1-15

Abstract: Abstract Streptococcus mitis is a leading cause of infective endocarditis (IE). However, our understanding of the genomic epidemiology and pathogenicity of IE-associated S. mitis is hampered by low IE incidence. Here we use whole genome sequencing of 129 S. mitis bloodstream infection (BSI) isolates collected between 2001–2016 from clinically diagnosed IE cases in the UK to investigate genetic diversity, antimicrobial resistance, and pathogenicity. We show high genetic diversity of IE-associated S. mitis with virtually all isolates belonging to distinct lineages indicating no predominance of specific lineages. Additionally, we find a highly variable distribution of known pneumococcal virulence genes among the isolates, some of which are overrepresented in disease when compared to carriage strains. Our findings suggest that S. mitis in patients with clinically diagnosed IE is not primarily caused by specific hypervirulent or antimicrobial resistant lineages, highlighting the accidental pathogenic nature of S. mitis in patients with clinically diagnosed IE.

Date: 2024
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DOI: 10.1038/s41467-024-52120-z

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