Epidemiology

• Formerly classified as nutritionally variant streptococci (see also Abiotrophia Abiotrophia, [[Abiotrophia]])
• Granulicatella and Abiotrophia species are normal flora in the mouth, urogenital tract, and intestine

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Members of Granulicatella Genus

• Granulicatella adiacens: formerly Abiotrophia adiacens
• Granulicatella balaenopterae: formerly Abiotrophia balaenopterae
• Granulicatella elegans: formerly Abiotrophia elegans

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Microbiology

• May be difficult to identify

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Clinical

• Endocarditis (see Endocarditis, [[Endocarditis]]): reported with Granulicatella adiacens and Granulicatella elegans
  • Approximately 5% of infective endocarditis cases are caused by nutritionally variant streptococci strains

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Treatment/Prognosis

• Clinical course with nutritionally variant streptococci strains is often more severe than that in cases caused by enterococci or viridans streptococci [MEDLINE]
• Infections are difficult to treat: relapse rate of 41%, despite appropriate antibiotics [MEDLINE]

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References

• Endocarditis due to nutritionally deficient streptococci: therapeutic dilemma. Rev Infect Dis. 1987;9:908–916 [MEDLINE]
• Granulicatella and Abiotrophia Species from Human Clinical Specimens. J Clin Microbiol. 2001 [MEDLINE]