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Itiscoccus(sphericalshaped),gram-positive,catalasenegative,Find,readandcitealltheresearchyouneedIntotal,%ofstrainswerefromtheMitisgroup,and theremainingstrainswerefromtheSanguinisgroup(14%),Anginosusgroup(3%),andSalivariusgroup(3%).ThegroupofMitisstreptococci,includedamong Viridansstreptococci(VGS)[1],includescurrentlyaboutdifferentspecies[2,3],whichisfoundinhumanstestedmitisgroupstreptococciforamoxicillin/ampicillin, cefotax-ime/ceftriaxone,andmeropenemTheneighbor-joiningradialtreewasgeneratedStreptococcusmitisisaviridansstreptococcusandanormalcommensal ofthehumanoropharynxacaseofUTIcausedbyanunusualpathogenStreptococcusmitis,amemberoftheviridansgroupStreptococci(VGS)Thegroupof Mitisstreptococci[1,2]encompassesspeciesthatsignificantlydifferintheirpathogenicbest-knownrepresentativeofthegroup,Streptococcuspneumoniae (pneumococcus),isresponsibleforahighburdenofrespiratorytractandinvasiveinfections,especiallyinchildrenandtheelderly[]withcancer;Streptococcus mitis(patients)andS.ora-lis(patients)werethemostfrequentlyidentifiedstrains.However,S.mitiscanescapefromthisnicheandcauseavarietyofinfectious complicationsStreptococcusmitis,anormalinhabitantoftheoralcavity,isamemberofViridansGroupStreptococci(VGS).Ayearolddiabeticfemaleattended theAlthoughtheVGSisaknowncommensalorganisminthehumanmucosaoftheoralcavity,upperrespiratorytract,femalegenitaltract,andgastrointestinal tract;ithasbeenIntroductionBasedontheaccumulationofbloodstreaminfections(BSI)causedbySmitis/oralisinagroupofStreptococcusmitisisa mesophilicalpha-hemolyticspeciesofStreptococcusthatinhabitstheoralcavityMitisgroupStreptococcusarehumanobligatebacteriaresidinginthe nasopharynxandoralcavityHowever,ithasbeencalculatedthatintheISIS-ARdatabase,datafromSmitisandSoralisareclassifiedundertheSmitisgroup (6)Goto:Abstractmitisstrains,patientsinfectedwithSmitisstrainsweremorelikelytohavemoderateorsevereclinicaldisease(eg,VGSshocksyndrome) However,ithasbeencalculatedthatintheISIS-ARdatabase,datafromlaboratoriesadequatelyreflectsthesituationinTheNetherlands(datanotpublished). Generallyrecognizedasacausativeagentofinvasivediseasesinimmunocompromisedpatients,Smitisisconsideredtohavelowpathogenicpotentialin immunocompetentindividualsStreptococcusmitis:AnUnusualCausativeAgentforUrinaryTractInfectionSir,Urinarytractinfection(UTI)isoneofthefrequent bacterialinfectionobservedinclinicalpracticeandisusuallycausedbymembersoftheEnterobacteriaceaefamily,inparticularEscherichiacoliandGrampositive coccisuchastestedmitisgroupstreptococciforamoxicillin/ampicillin,cefotax-ime/ceftriaxone,andmeropenemTherefore,weexpectthattheresultsfor amoxicillin/ampicillinandAssociatedDataFigureMultilocussequenceanalysis(MLSA)ofviridansgroupstreptococci(VGS)strainscausingbacteremiainpatients withcancerCombinedwiththesequencedataTheStreptococcusmitisgroupiscomprisedofspeciesincludingsomeofthemostcommonhumanoralcolonizers suchasS.mitis,S.oralis,S.sanguinisandS.gordoniiaswellasspeciessuchTheycomprisebothcommensalandpathogenicspecieswiththemostwell-known beingStreptococcuspneumoniae–aleadingcauseofmeningitisandpneumoniaIntroductionComparedwithpatientsinfectedwithnon–SSupplementary Materials