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Purpose   Streptococcus gallolyticus  subspecies  gallolyticus  ( SGG ) is an opportunistic pathogen causing invasive infections in the elderly often associated with colon neoplasia. The prevalence of  SGG  in the stools of patients with normal colonoscopy (control) was compared with patients with colorectal adenomas (CRA) or with carcinomas (CRC) from stages I to IV. The presence of the  pk s island encoding colibactin as well as other CRC-associated bacteria such as toxicogenic  Bacteroides fragilis ,  Fusobacterium nucleatum , and  Parvimonas micra  was also investigated.    Patients and Methods  Fecal samples collected in France between 2011 and 2016 from patients with normal colonoscopy ( n  = 25), adenoma ( n  = 23), or colorectal cancer at different stages ( n  = 81) were tested by PCR for the presence of  SGG ,  B. fragilis ,  F. nucleatum ,  P. micra , and the  pks  island. Relative quantification of  SGG ,  F. nucleatum , and  P. micra  in stools was performed by qPCR.    Results   SGG  prevalence was significantly increased in the CRC group. Our results also revealed i) a strong and significant increase of toxinogenic  B. fragilis  in patients with early-stage adenoma and of  pks  island at late-stage CRC and ii) increased levels of  F. nucleatum  and  P. micra  in the stools of CRC patients. Furthermore, the simultaneous detection of these five bacterial markers was only found in CRC patients.    Conclusions  Our results indicate that the prevalence or relative levels of CRC-associated bacteria vary during CRC development. Among them,  B. fragilis  ( bft +) was singled out as the sole pathobiont detected at the early adenoma stage.

frontiers in cellular and infection microbiology

Detection of Streptococcus gallolyticus and Four Other CRC-Associated Bacteria in Patient Stools Reveals a Potential “Driver” Role for Enterotoxigenic Bacteroides fragilis