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04 Feb 2019

Colonoscopies for people with an enterococcal infection should become routine, according to the authors of new research published in the Medical Journal of Australia.

Recent international research has shown an association between Enterococcus faecalis bacteraemia and colorectal neoplasia (cancer). The link between Streptococcus gallolyticus (previously S. bovis) bacteraemia with infective endocarditis and colorectal neoplasia has been recognised for many years, resulting in routine colonoscopies for those patients. 

  1. faecalis is a gram positive bacterium which can cause urinary tract infections, endocarditis, and wound infections.

The MJA research, led by Professor Eugene Athan, Director of Barwon Health, set out to investigate the association of enterococcal infection with colorectal cancer in the Barwon region of southwestern Victoria, using data from 376 patients diagnosed with E. faecalis from 2010 to 2017. 

“Of 180 patients for whom we had detailed medical records, 12 had been referred for colonoscopy solely because E. faecalis bacteraemia (seven cases) or infective endocarditis (five cases) had been diagnosed,” Prof Athan and colleagues wrote.

“Colonoscopy identified previously undiagnosed colorectal neoplasias in nine patients (75 per cent) … including two instances of adenocarcinoma and nine of adenoma (two with high-grade dysplasia, five with moderate-grade dysplasia, and two with low-grade dysplasia). 

“Our study is the first in Australia to identify the importance of evaluating patients with E. faecalis bacteraemia for underlying colorectal neoplasia.

“Routine colonoscopy should be considered for patients with either S. gallolyticus or E. faecalis bacteraemia or infective endocarditis with an unclear source of infection.”

Published: 04 Feb 2019