{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T10:04:50Z","timestamp":1773482690339,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T00:00:00Z","timestamp":1750896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Meningitis due to the species Streptococcus is a severe central nervous system infection caused by various microorganisms belonging to Streptococcus spp. Its accurate identification is critical for effective clinical management. This study aimed to identify Streptococcus spp. causing meningitis in Greece over a nine-year period using PCR and sequencing-based methods. Methods: A total of 189 clinical samples, collected between 2015 and 2024 from patients suffering from meningitis and\/or septicemia, were analyzed by the use of a combination of multiplex polymerase chain reaction (PCR) assays and tuf gene sequencing for further species identification. Results: Sample analysis identified 70 samples as S. pyogenes (18.52%) (GAS) and S. agalactiae (18.52%) (GBS), while 119 (62.96%) were recorded as non-typable Streptococcus spp. Further analysis using sequencing methods revealed that the most frequent Streptococcus spp. belonged to the mitis group (42.86%) and the pyogenic group (20.17%). A higher prevalence was observed in children aged 0\u201314 years old and adults over 50 years old. Conclusions: This study highlights the use of molecular diagnostics in identifying other Streptococcus spp., providing insights into age-related susceptibility and epidemiological trends. Future studies are needed to explore the pathogenic role of the identified Lactococcus spp.<\/jats:p>","DOI":"10.3390\/diagnostics15131632","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T11:15:23Z","timestamp":1750936523000},"page":"1632","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Molecular Identification of Meningitis\/Septicemia Due to Streptococcus spp. in Greece (2015\u20132024)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9538-5868","authenticated-orcid":false,"given":"Constantinos","family":"Karamalis","sequence":"first","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 1152 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2959-8216","authenticated-orcid":false,"given":"Athanasia","family":"Xirogianni","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 1152 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4553-8467","authenticated-orcid":false,"given":"Stelmos","family":"Simantirakis","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 1152 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Delegkou","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 1152 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasia","family":"Papandreou","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 1152 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1773-2833","authenticated-orcid":false,"given":"Georgina","family":"Tzanakaki","sequence":"additional","affiliation":[{"name":"National Meningitis Reference Laboratory, Department of Public Health Policy, School of Public Health, University of West Attica, 1152 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.clp.2014.10.004","article-title":"Bacterial meningitis in infants","volume":"42","author":"Ku","year":"2015","journal-title":"Clin. Perinatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3036","DOI":"10.1016\/S0140-6736(16)30654-7","article-title":"Acute bacterial meningitis in adults","volume":"388","author":"McGill","year":"2016","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1097\/QCO.0000000000000417","article-title":"Epidemiology of community-acquired bacterial meningitis","volume":"31","author":"Brouwer","year":"2018","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1212\/CON.0000000000000660","article-title":"Acute Bacterial Meningitis","volume":"24","author":"Davis","year":"2018","journal-title":"Contin. Lifelong Learn. Neurol."},{"key":"ref_5","unstructured":"Ma\u0144dziuk, J., and Kuchar, E.P. (2024, December 20). Streptococcal Meningitis, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554448\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e01406","DOI":"10.1016\/j.idcr.2022.e01406","article-title":"Bacterial meningitis due to the Streptococcus mitis group in children with cerebrospinal fluid leak","volume":"27","author":"Fukayama","year":"2022","journal-title":"IDCases"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Spellerberg, B., and Brandt, C. (2015). Streptococcus. Manual of Clinical Microbiology, John Wiley & Sons, Ltd.","DOI":"10.1128\/9781555817381.ch22"},{"key":"ref_8","unstructured":"Centers for Disease Control and Prevention (2024, December 20). Bacterial Meningitis, Available online: https:\/\/www.cdc.gov\/meningitis\/about\/bacterial-meningitis.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/meningitis\/bacterial.html."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jemermed.2014.12.057","article-title":"Group C Streptococcus Causing Rheumatic Heart Disease in a Child","volume":"49","author":"Chandnani","year":"2015","journal-title":"J. Emerg. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e6162","DOI":"10.1002\/ccr3.6162","article-title":"Recurrent group G Streptococcus bacteremia: A case report and literature review","volume":"10","author":"Ghazanfar","year":"2022","journal-title":"Clin. Case Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/microbiolspec.GPP3-0002-2017","article-title":"Genetics and Pathogenicity Factors of Group C and G Streptococci","volume":"7","author":"Malke","year":"2019","journal-title":"Microbiol. Spectr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1084\/jem.57.4.571","article-title":"A serological differentiation of human and other groups of hemolytic streptococci","volume":"57","author":"Lancefield","year":"1933","journal-title":"J. Exp. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1128\/br.1.1.3-97.1937","article-title":"The Streptococci","volume":"1","author":"Sherman","year":"1937","journal-title":"Bacteriol. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1086\/324621","article-title":"Extension of the Lancefield Classification for Group A Streptococci by Addition of 22 New M Protein Gene Sequence Types from Clinical Isolates: emm103 to emm124","volume":"34","author":"Facklam","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/j.1574-6968.1984.tb01334.x","article-title":"Nucleic acid hybridization and cell wall composition studies of pyogenic streptococci","volume":"24","author":"Schleifer","year":"1984","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1099\/00221287-131-3-543","article-title":"The Phylogenetic Position of Streptococcus and Enterococcus","volume":"131","author":"Ludwig","year":"1985","journal-title":"Microbiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3686","DOI":"10.1128\/JCM.42.8.3686-3695.2004","article-title":"Use of tuf Sequences for Genus-Specific PCR Detection and Phylogenetic Analysis of 28 Streptococcal Species","volume":"42","author":"Picard","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Toit Mdu Huch, M., Cho, G.-S., and Franz, C.M.A.P. (2014). The genus Streptococcus. Lactic Acid Bacteria, John Wiley & Sons, Ltd.","DOI":"10.1002\/9781118655252.ch28"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.mimet.2017.07.015","article-title":"Current challenges in the accurate identification of Streptococcus pneumoniae and its serogroups\/serotypes in the vaccine era","volume":"141","author":"Varghese","year":"2017","journal-title":"J. Microbiol. Methods"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.1007\/s10096-020-03991-9","article-title":"Identification of Streptococcus pneumoniae and other Mitis streptococci: Importance of molecular methods","volume":"39","author":"Sadowy","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.ijbiomac.2018.05.085","article-title":"Polymerase chain reaction (PCR)-based methods: Promising molecular tools in dentistry","volume":"117","author":"Shahi","year":"2018","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.diagmicrobio.2008.09.017","article-title":"Development of a single-tube polymerase chain reaction assay for the simultaneous detection of Haemophilus influenzae, Pseudomonas aeruginosa, Staphylococcus aureus, and Streptococcus spp. directly in clinical samples","volume":"63","author":"Xirogianni","year":"2009","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.resmic.2005.01.010","article-title":"Rapid identification of Streptococcus pyogenes with PCR primers from a putative transcriptional regulator gene","volume":"156","author":"Liu","year":"2005","journal-title":"Res. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1099\/jmm.0.46244-0","article-title":"Simultaneous detection and serotype identification of Streptococcus agalactiae using multiplex PCR and reverse line blot hybridization","volume":"54","author":"Kong","year":"2005","journal-title":"J. Med. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1128\/JCM.01981-13","article-title":"Molecular Detection of Culture-Confirmed Bacterial Bloodstream Infections with Limited Enrichment Time","volume":"51","author":"Moore","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4818","DOI":"10.1039\/C6CS00693K","article-title":"Methods for the detection and identification of pathogenic bacteria: Past, present, and future","volume":"46","author":"Luo","year":"2017","journal-title":"Chem. Soc. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Colomba, C., Garbo, V., Boncori, G., Albano, C., Bagarello, S., Condemi, A., Giordano, S., Canduscio, L.A., Gallo, C., and Parrinello, G. (2023). Streptococcus mitis as a New Emerging Pathogen in Pediatric Age: Case Report and Systematic Review. Antibiotics, 12.","DOI":"10.3390\/antibiotics12071222"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"331","DOI":"10.3233\/NPM-17113","article-title":"Neonatal meningitis and maternal sepsis caused by Streptococcus oralis","volume":"11","author":"Poi","year":"2018","journal-title":"J. Neonatal-Perinat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e12133","DOI":"10.1002\/anr3.12133","article-title":"Streptococcus oralis endocarditis leading to central nervous system infection in pregnancy","volume":"9","author":"Wydall","year":"2021","journal-title":"Anaesth. Rep."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.meegid.2014.10.001","article-title":"Genomics of Streptococcus salivarius, a major human commensal","volume":"33","author":"Delorme","year":"2015","journal-title":"Infect. Genet. Evol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"457","DOI":"10.2169\/internalmedicine.1304-22","article-title":"Noniatrogenic Meningitis Caused by Streptococcus salivarius Associated with Early Esophageal Cancer and Early Gastric Cancer","volume":"63","author":"Yanagida","year":"2024","journal-title":"Intern. Med. Tokyo Jpn."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1007\/s13760-018-0891-2","article-title":"Streptococcus salivarius meningitis: A spontaneous case in a 74-year-old man","volume":"119","author":"Jovanovic","year":"2019","journal-title":"Acta Neurol. Belg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1749","DOI":"10.1016\/j.jiph.2020.07.017","article-title":"Streptococcus anginosus group infections: Management and outcome at a tertiary care hospital","volume":"13","author":"Aldrees","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_34","first-page":"210","article-title":"The Clinical View on Streptococcus anginosus Group\u2014Opportunistic Pathogens Coming Out of Hiding","volume":"37","author":"Sitkiewicz","year":"2022","journal-title":"Front. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"153","DOI":"10.25241\/stomaeduj.2015.2(2).art.8","article-title":"Streptococcus anginosus group\u2014Brief characterization and its contribution to the brain abscess pathogenesis","volume":"2","author":"Constantinescu","year":"2015","journal-title":"Stomatol. EDU J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1177\/08830738211052132","article-title":"Central Nervous System Infections Due to Streptococcus anginosus Group: A Single-Center Case Series","volume":"37","author":"Madathil","year":"2022","journal-title":"J. Child Neurol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/microbiolspec.GPP3-0016-2018","article-title":"Infections Caused by Group C and G Streptococcus (Streptococcus dysgalactiae subsp. equisimilis and Others): Epidemiological and Clinical Aspects","volume":"7","author":"Baracco","year":"2019","journal-title":"Microbiol. Spectr."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"209","DOI":"10.22364\/eeb.19.20","article-title":"Studies on the isolation and molecular characterization of Lactobacillus spp. from human breast milk and assessment of their probiotic potential","volume":"19","author":"Chathyushya","year":"2021","journal-title":"Environ. Exp. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1442-200X.2010.03240.x","article-title":"Bacterial meningitis and septicemia of neonate due to Lactococcus lactis","volume":"53","author":"Uchida","year":"2011","journal-title":"Pediatr. Int."},{"key":"ref_40","first-page":"9928238","article-title":"MALDI-TOF Mass Spectroscopy Applications in Clinical Microbiology","volume":"2021","author":"Alizadeh","year":"2021","journal-title":"Adv. Pharmacol. Pharm Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"80","DOI":"10.3390\/microbiolres14010008","article-title":"The Current Level of MALDI-TOF MS Applications in the Detection of Microorganisms: A Short Review of Benefits and Limitations","volume":"14","author":"Haider","year":"2023","journal-title":"Microbiol. Res."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Sancho, M., Vela, A.I., Garc\u00eda-Seco, T., Gottschalk, M., Dom\u00ednguez, L., and Fern\u00e1ndez-Garayz\u00e1bal, J.F. (2015). Assessment of MALDI-TOF MS as Alternative Tool for Streptococcus suis Identification. Front. Public Health, 3.","DOI":"10.3389\/fpubh.2015.00202"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/13\/1632\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:59:33Z","timestamp":1760032773000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/13\/1632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,26]]},"references-count":42,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["diagnostics15131632"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15131632","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,26]]}}}