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Streptococcus mitis

Streptococcus mitis is a Gram-positive, facultatively anaerobic coccus belonging to the Mitis group of the genus Streptococcus, characterized by its spherical or ovoid shape (0.6–0.8 μm in diameter) and arrangement in pairs or short chains.^[1] It is a common commensal bacterium that primarily colonizes the oral cavity, including the teeth, mucosa, and saliva, as well as the upper respiratory tract, gastrointestinal tract, and genital tract in humans.^[1] As part of the normal human microbiota, S. mitis plays a role in ecological balance but can act as an opportunistic pathogen, particularly in immunocompromised individuals, causing infections such as bacteremia, infective endocarditis, and rarely meningitis.^[2]^[3] Taxonomically, S. mitis is classified within the phylum Firmicutes, class Bacilli, order Lactobacillales, family Streptococcaceae, and is distinguished from closely related species like Streptococcus pneumoniae through genetic and phenotypic analyses, including multilocus sequence typing based on seven housekeeping genes.^[4]^[5] Morphologically, it exhibits α-hemolysis on blood agar, producing small, translucent colonies with a greenish tint, and biochemically ferments carbohydrates such as glucose, maltose, sucrose, and lactose, while being catalase-negative and non-motile.^[1] The bacterium's genome shows high genetic diversity, often forming a species complex with variable virulence factors like IgA1 protease and pili-like structures that aid in adherence to host tissues.^[3] Clinically, S. mitis is implicated in up to 25–30% of viridans group streptococcal infective endocarditis cases, with a one-year mortality rate of 25–30%, often associated with dental procedures or mucosal disruptions that lead to transient bacteremia.^[3]^[6] In pediatric and neutropenic patients, it has emerged as a cause of severe infections, including orbital cellulitis and sepsis, highlighting its pathogenic potential despite its commensal nature.^[7] Laboratory identification relies on culture on selective media, biochemical tests, and molecular methods like 16S rRNA sequencing to differentiate it from other oral streptococci. Overall, S. mitis exemplifies the dual role of oral microbiota in health and disease, underscoring the importance of oral hygiene in preventing opportunistic infections.^[2]

Taxonomy

Classification History

Streptococcus mitis was initially described in 1906 by Andrewes and Horder as a species of streptococcus frequently isolated from patients with subacute infective endocarditis, noting its relatively low virulence and association with the human oropharynx. This description placed it within the genus Streptococcus, established by Rosenbach in 1884 based on morphological characteristics such as chain-forming cocci. Early classifications relied on phenotypic traits observed on blood agar, where S. mitis demonstrated alpha-hemolysis—producing a greenish discoloration around colonies—distinguishing it from beta-hemolytic pyogenic streptococci. In 1937, Sherman formalized the "viridans" group to encompass alpha-hemolytic, non-pathogenic streptococci like S. mitis, emphasizing their ecological role in the oral cavity and lack of Lancefield group antigens typical of more virulent species. The family Streptococcaceae, to which S. mitis belongs, was delineated around this period based on shared Gram-positive, catalase-negative, and facultatively anaerobic properties.^[8] By the mid-20th century, biochemical tests further subdivided viridans streptococci into physiological groups, with S. mitis assigned to the "mitis" subgroup alongside species exhibiting similar fermentation patterns and enzyme profiles, such as weak mannitol fermentation and arginine hydrolysis negativity.^[9] The application of 16S rRNA gene sequencing in the 1990s and 2000s provided phylogenetic confirmation of S. mitis within the Mitis group, revealing sequence similarities of over 98% with related viridans species while distinguishing it from the pyogenic group (e.g., S. pyogenes) and anginosus group (e.g., S. anginosus) through nucleotide divergences exceeding 3%. Kawamura et al. (1995) analyzed 16S rRNA sequences from multiple streptococcal type strains, solidifying the Mitis group's monophyletic nature within the genus. An emended description by Kilian et al. in 1989 integrated these emerging molecular insights with phenotypic data, refining species boundaries. Prior to 2025, S. mitis was recognized at the species level without formal subspecies, though its substantial intraspecies genetic diversity—particularly overlap with S. oralis in genomic analyses—presented ongoing challenges for precise delineation using traditional markers.

Current Taxonomy

In 2025, the taxonomy of Streptococcus mitis underwent significant revision based on whole-genome sequencing analyses that revealed extensive genetic diversity surpassing conventional species thresholds, leading to its subdivision into two subspecies: the type subspecies S. mitis subsp. mitis and the novel S. mitis subsp. carlssonii subsp. nov. This reclassification was proposed to better reflect phylogenetic boundaries within the species, with S. mitis subsp. carlssonii distinguished by specific genomic markers and average nucleotide identity (ANI) values below 95-96% relative to the type subspecies, while maintaining shared core genomic features.^[10] The 2025 study also demonstrated that several related species, including Streptococcus oralis, Streptococcus dentisani, and Streptococcus thalassemiae, are later heterotypic synonyms of S. mitis, based on core genome alignments and ANI thresholds that revealed a genetic continuum rather than discrete boundaries. These adjustments highlight the dynamic nature of streptococcal taxonomy, emphasizing whole-genome approaches over phenotypic traits to delineate boundaries in this genetically heterogeneous group.^[10] Phylogenetically, S. mitis occupies a position within the diverse genus Streptococcus, which encompasses over 50 recognized species, primarily assessed through ANI and core genome multilocus sequence analysis that positions it closely alongside Streptococcus pneumoniae in the Mitis group. Despite this proximity, S. mitis lineages lack the pneumococcal capsule biosynthesis genes characteristic of S. pneumoniae, underscoring their distinction as commensal oral streptococci rather than primary pathogens.

Characteristics

Morphology

Streptococcus mitis consists of Gram-positive cocci that are spherical or elliptical in shape, measuring approximately 0.6–0.8 μm in diameter. These cells typically arrange in pairs or chains and are non-motile and non-spore-forming.^[11]^[12] The bacterium is catalase-negative, distinguishing it from related genera.^[12] On blood agar, S. mitis displays alpha-hemolysis, producing a greenish zone of partial hemoglobin breakdown surrounding the colonies, often 1–2 mm wide.^[13]^[14] Colonies of S. mitis on blood agar are small (0.5–1 mm in diameter), smooth, convex, translucent, and non-pigmented with entire margins. Growth on nutrient agar is comparatively poor, yielding pinpoint-sized, translucent colonies that can appear mucoid or non-mucoid depending on the strain.^[15]^[12]

Physiology and Biochemistry

Streptococcus mitis is a facultative anaerobe capable of growth under aerobic conditions enhanced by 5% CO₂, though it tolerates low oxygen levels but is inhibited by strict anaerobiosis or high oxygen tension.^[16] As a mesophile, it exhibits optimal growth at 37°C, corresponding to human body temperature, with a preferred pH range of 6.5 to 7.5 for metabolic activity.^[12] Growth is supported on enriched media such as blood agar, where it forms small, pinpoint colonies after 24–48 hours of incubation.^[15] Biochemically, S. mitis is catalase-negative and oxidase-negative, traits typical of the Streptococcus genus that distinguish it from related genera like Staphylococcus.^[17]^[18] It performs homolactic fermentation, metabolizing carbohydrates via glycolysis to yield lactic acid as the primary end product. Representative examples include positive fermentation of glucose, fructose, galactose, lactose, and sucrose, while mannitol and sorbitol fermentation varies by strain.^[11]^[15] The organism does not hydrolyze esculin or produce hydrogen sulfide, further aiding in its differentiation from other streptococci.^[19] In terms of environmental responses, S. mitis demonstrates sensitivity to osmotic stress, with most strains unable to grow in media containing greater than 6.5% NaCl, though some tolerate up to 4% NaCl.^[19] This salt intolerance reflects its adaptation to the low-salt environment of the human oral cavity.^[15]

Ecology

Habitats

Streptococcus mitis is predominantly found in the human oral cavity, where it colonizes surfaces such as saliva, dental plaque, and the nasopharynx, establishing itself as a key commensal shortly after birth and persisting throughout life.^[20]^[21] It is also commonly present in the throat, upper respiratory tract, and extends to other mucosal sites including the genital tract and gastrointestinal tract.^[22] Additionally, S. mitis can be detected on human skin surfaces as part of the normal microbiota.^[23] While primarily associated with humans, non-human habitats for S. mitis are rare, with occasional isolations reported from the oral flora of animals, underscoring its obligate human affiliation.^[24]^[25] Beyond natural niches, S. mitis demonstrates environmental persistence, surviving in dental aerosols generated during procedures and on fomites such as prosthetic devices, which can lead to contamination events in clinical settings.^[26]^[27]

Microbiome Role

Streptococcus mitis serves as a pioneer colonizer in the formation of oral biofilms, adhering to the salivary pellicle on dental surfaces through specific surface proteins such as pili and adhesins, which facilitate the initial attachment and create a foundation for the co-adhesion of secondary colonizers like Actinomyces species and other oral bacteria.^[28] This early colonization establishes a structured microbial community that promotes ecological stability in the oral microbiome.^[29] As a primary inhabitant of the oral cavity, S. mitis contributes to the development of multi-species biofilms essential for normal oral homeostasis.^[30] In microbial interactions, S. mitis produces bacteriocins, including competence-associated bacteriocins, which enable contact-dependent fratricide to lyse susceptible neighboring cells, thereby regulating population dynamics and preventing overdomination by pathogenic species within the biofilm. This competitive mechanism helps maintain microbiome balance by promoting nutrient release and limiting the expansion of less adapted competitors.^[31] Additionally, S. mitis modulates host immune responses by activating the aryl hydrocarbon receptor (AhR) in oral epithelial cells, which induces anti-inflammatory cytokine production and enhances barrier integrity against invaders.^[32] Dysbiosis involving S. mitis often manifests as overgrowth following antibiotic perturbations that selectively deplete anaerobic competitors, leading to shifts in oral community composition and potential predisposition to imbalances.^[33]

Genetics

Genome Structure

The genome of Streptococcus mitis typically consists of a single circular chromosome with a size ranging from approximately 1.8 to 2.2 Mb and a G+C content of 39-40%.^[34]^[35]^[36] Plasmids are not commonly observed in S. mitis strains.^[35]^[34] This chromosome encodes roughly 1,800 to 2,000 protein-coding genes, reflecting a compact organization adapted to its commensal lifestyle in the human oral cavity.^[35]^[37] Among these, genes for potential virulence factors such as zinc metalloproteases (e.g., homologs of ZmpB, ZmpC, and IgA1 protease) are present, contributing to tissue invasion and immune evasion capabilities, though their expression varies by strain.^[24]^[38] Many S. mitis strains possess cps loci similar to those in Streptococcus pneumoniae, enabling capsule production associated with certain serotypes (e.g., 5, 19A), though not all strains are encapsulated; this distinguishes variable encapsulation from the typically encapsulated pathogen S. pneumoniae.^[24]^[35]^[39]^[40] Population genomic analyses reveal high intraspecies diversity in S. mitis, driven by frequent recombination events. A study of 129 bloodstream infection (BSI) isolates from the UK and Ireland (collected 2001-2016) demonstrated extensive genetic variation, with nearly all isolates forming distinct lineages and identifying recombination hotspots in regions associated with adhesins and metabolic genes, underscoring the species' opportunistic pathogenic potential. Recent analyses of 322 genomes (as of 2022) confirm this diversity and variable presence of cps loci, with capsules linked to invasive strains.^[39]^[3] Similarly, ancient S. mitis-like strains recovered from a 5,700-year-old chewed birch pitch sample in Denmark exhibited a lack of cps genes, aligning with some modern commensal profiles, yet retained zinc metalloproteases and other virulence-associated elements, suggesting long-term stability in core genomic architecture despite host adaptation.^[24] Key reference genomes include the complete sequence of strain SVGS_061 (2.17 Mb, 1,986 protein-coding genes), isolated from a neutropenic patient in 2016 and notable for its integrative conjugative element carrying resistance genes.^[35] A broader global dataset of 322 genomes, assembled in 2022, further highlights this diversity, with 93% confirmed as S. mitis via multilocus sequence typing and revealing variable distribution of pneumococcal-like virulence genes across clades.^[3]

Natural Transformation

Streptococcus mitis exhibits natural competence, a physiological state that enables the uptake and integration of exogenous DNA, under specific environmental conditions such as nutrient limitation during early exponential growth phase.^[41] This competence is transiently induced through quorum sensing mediated by competence-stimulating peptides (CSPs), which are secreted signaling molecules that accumulate at high cell densities to trigger the process.^[42] The core regulatory system involves the comCDE operon, where comC encodes the precursor for CSP, comD specifies the histidine kinase receptor that binds CSP, and comE codes for the response regulator that, upon phosphorylation, activates downstream genes including the alternative sigma factor sigX.^[42] Optimal induction occurs with synthetic CSP concentrations of 210–300 nM added to cells grown in semi-defined media like C+Y, achieving transformation efficiencies exceeding 30% for constructs with sufficient homology arms.^[41] The transformation mechanism in S. mitis begins with the binding and uptake of exogenous double-stranded DNA via type IV pili, also known as the transformasome, which extend from the cell surface to capture DNA and retract it into the cell.^[42] Once internalized, the DNA is processed by nucleases and RecA-mediated homologous recombination integrates it into the genome, facilitating genetic exchange.^[43] A key source of this donor DNA is predatory fratricidal killing, where competent cells produce murein hydrolases like CbpD to selectively lyse non-competent sibling cells or closely related streptococci, releasing genomic DNA for uptake by the killers, which are protected by immunity factors such as ComM.^[42] This fratricide mechanism, coregulated with competence genes, significantly boosts DNA availability and transformation rates.^[43] Transformation frequency in S. mitis is notably enhanced within biofilms, where close cell proximity and localized DNA release from lysed cells promote efficient gene transfer compared to planktonic cultures.^[44] The comCDE system plays a central role in this regulation, with SigX directing the expression of late competence genes involved in DNA uptake (e.g., comAB, comEA) and processing, while strain-specific variations may include additional bacteriocin operons that support fratricide without being essential for transformation.^[42] Evolutionarily, natural transformation in S. mitis drives horizontal gene transfer within the oral microbiome, allowing acquisition of adaptive traits such as antibiotic resistance or enhanced biofilm formation, thereby contributing to genetic diversity and resilience in this competitive niche.^[45] This process underscores the species' role in interspecies genetic exchange among oral streptococci, promoting long-term ecological adaptation.^[45]

Clinical Significance

Commensal Functions

Streptococcus mitis is a normal inhabitant of the human oral microflora, serving as a key commensal bacterium in healthy individuals. It is primarily found in the oral cavity, colonizing surfaces such as the tongue, buccal mucosa, and dental plaque. As part of the viridans streptococci group, S. mitis comprises a significant proportion of the streptococcal population in saliva, often representing one of the most prevalent species among oral streptococci.^[16]^[11] In the oral microbiome, S. mitis contributes to biofilm homeostasis by acting as an early colonizer that promotes balanced microbial communities. It produces hydrogen peroxide and other metabolites that competitively inhibit the growth of pathogenic species, such as Streptococcus mutans and Candida albicans, thereby preventing dysbiosis and supporting overall oral health. This competitive role helps maintain the structural integrity of biofilms on tooth surfaces and mucosal tissues, fostering a stable environment dominated by commensals.^[46] S. mitis also plays a role in immune modulation within the oral mucosa. As an oral commensal, it activates the aryl hydrocarbon receptor (AhR) in human oral epithelial cells, leading to the regulation of inflammatory mediators like chemokines and prostaglandin E2 (PGE2). This AhR-mediated pathway stimulates anti-inflammatory responses, downregulating pro-inflammatory signaling and promoting tolerance to the commensal microbiota. Such interactions help sustain immune homeostasis in the absence of disease.^[32] The prevalence of S. mitis in healthy individuals is high, with detection in a majority of oral samples from asymptomatic subjects, underscoring its role as a stable component of the core oral microbiome without pathogenic associations.^[16]

Infections and Pathogenicity

Streptococcus mitis, a member of the viridans group streptococci (VGS), is typically a commensal in the oral cavity but acts as an opportunistic pathogen, causing invasive infections primarily in immunocompromised individuals. It is a leading cause of bacteremia among neutropenic patients with hematologic malignancies, where VGS account for a significant proportion of bloodstream infections due to mucosal barrier injury from chemotherapy. Other primary infections include infective endocarditis, urinary tract infections (UTI), sinusitis, meningitis, and rare cases of cerebral sino-venous thrombosis (CSVT) in pediatric patients. In endocarditis, S. mitis contributes to vegetation formation on heart valves, with a one-year mortality rate of 25–30%.^[47]^[48]^[49]^[3] Bacteremia caused by S. mitis often originates from oral translocation and is particularly prevalent in patients undergoing intensive chemotherapy for hematologic malignancies, leading to complications such as septic shock in up to 18% of cases. Infective endocarditis due to S. mitis is less common in neutropenic settings but remains a serious risk in patients with underlying heart conditions, where the pathogen's ability to evade immune clearance exacerbates outcomes. UTI and sinusitis are infrequent but documented, often linked to ascending or local spread in vulnerable hosts. In pediatrics, a 2023 systematic review identified 95 cases of invasive S. mitis infections, including 14 instances of meningitis and one of CSVT complicating sinusitis in an immunocompetent child with poor oral hygiene, highlighting its emerging role beyond immunosuppression. Of these pediatric cases, 88 patients recovered fully, while 7 fatalities occurred, two unrelated to the infection. A 2024 genomic study highlighted the clonal diversity of S. mitis strains in UK and Ireland infective endocarditis cases, indicating ongoing adaptation and potential for increased virulence.^[47]^[49]^[23]^[39] Key risk factors for S. mitis infections include immunosuppression from chemotherapy or underlying malignancies, which impair neutrophil function and mucosal integrity, as well as dental procedures that facilitate transient bacteremia. High prevalence is noted in hematologic malignancies, where S. mitis/oralis bloodstream infections occur frequently during neutropenic phases. Poor oral hygiene further increases susceptibility, as seen in the 2023 pediatric case of sinusitis progressing to meningitis and CSVT following untreated dental issues. Daily activities like toothbrushing can also induce low-level bacteremia, but invasive dental interventions elevate the risk significantly in at-risk populations.^[50]^[23]^[51] Virulence factors of S. mitis enable its pathogenicity, particularly in endocarditis, where phage-encoded adhesins such as PblA and PblB promote binding to human platelets and endothelial cells, facilitating vegetation formation and immune evasion. These surface proteins mediate platelet aggregation, a critical step in thrombus development on damaged heart valves, enhancing bacterial persistence. Additionally, the serine-rich glycoprotein GspB contributes to fibrinogen binding, further supporting adherence to host tissues. An emerging association links S. mitis bacteremia to colon adenocarcinoma, as reported in cases where the infection coincided with undiagnosed colorectal tumors, potentially indicating translocation from the gastrointestinal tract in malignancy.^[52]^[53]^[54]^[55] Some S. mitis strains exhibit tolerance to penicillin, characterized by slow bactericidal activity despite susceptibility in minimum inhibitory concentration tests, which can complicate therapeutic outcomes in severe infections like endocarditis and bacteremia. This tolerance, observed in strains from immunocompromised patients, underscores the pathogen's adaptability and potential for treatment failure.^[48]^[56]

Diagnosis and Treatment

Diagnosis of Streptococcus mitis infections typically begins with isolation from clinical specimens such as blood or other sterile sites, where the organism exhibits alpha-hemolysis on blood agar, producing a characteristic greenish discoloration around colonies due to partial hemolysis of red blood cells.^[57] Definitive identification relies on advanced methods including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), which provides rapid and accurate species-level detection, or 16S rRNA gene sequencing for molecular confirmation in complex cases. Biochemical panels, such as the API 20 Strep system, can also aid identification, noting variable fermentation of mannitol as a distinguishing trait among viridans group streptococci. The 2023 Duke-International Society for Cardiovascular Infectious Diseases (ISCVID) criteria update the diagnostic framework for infective endocarditis, incorporating imaging and microbiological evidence.^[58]^[59] These approaches are essential given S. mitis's similarity to other mitis group species, and susceptibility testing is recommended to guide therapy, particularly in immunocompromised patients with bacteremia or endocarditis. Treatment of S. mitis infections follows guidelines for viridans group streptococci (VGS), with penicillin-susceptible strains (minimum inhibitory concentration [MIC] ≤0.12 μg/mL) managed using aqueous penicillin G at 12–18 million units intravenously (IV) every 24 hours for 4 weeks in native valve endocarditis (NVE), or ceftriaxone 2 g IV or intramuscularly (IM) daily as an alternative for 4 weeks in uncomplicated NVE with symptoms less than 3 months' duration.^[60] For bacteremia without endocarditis, shorter courses of ceftriaxone 2 g IV daily for 2–4 weeks are often sufficient, while prosthetic valve endocarditis or symptoms exceeding 3 months requires 6 weeks of therapy.^[14] In cases of relative penicillin resistance (MIC >0.12–<0.5 μg/mL), high-dose penicillin G (24 million units IV daily) combined with gentamicin (3 mg/kg IV/IM daily) for 2 weeks, followed by penicillin alone for 4 weeks total, is recommended; vancomycin 30 mg/kg IV daily serves as an alternative for penicillin-allergic patients or resistant strains.^[60] Long-term high-dose ampicillin (e.g., for 8 weeks in severe endocarditis) achieves recovery rates of 40–60%, though ceftriaxone or penicillin regimens are preferred when susceptible.^[11] Antibiotic resistance trends in S. mitis warrant caution, with a 2024 study reporting low penicillin susceptibility (approximately 27% resistance) among oral and bloodstream isolates, particularly in pediatric populations, alongside reduced ceftriaxone susceptibility in up to 26% of cases.^[61] Conversely, high susceptibility is observed to levofloxacin and moxifloxacin (>90% in clinical isolates), making them viable options for resistant strains, though monitoring for penicillin tolerance is advised in endocarditis due to potential for suboptimal bactericidal activity.^[62] The Infectious Diseases Society of America (IDSA) 2015 guidelines for infective endocarditis emphasize prompt antimicrobial therapy tailored to susceptibility (treatment regimens unchanged in subsequent updates), with echocardiography playing a key role: transthoracic echocardiography (TTE) is recommended initially for all suspected cases, followed by transesophageal echocardiography (TEE) if TTE is nondiagnostic or complications are suspected, to assess vegetations, abscesses, or embolic risk.^[60] Empiric vancomycin is suggested pending susceptibilities in high-risk settings like bloodstream infections.^[61]

Historical Notes

Discovery

Streptococcus mitis was first described in 1906 by F.W. Andrewes and T.J. Horder as part of their study on streptococci pathogenic to humans, during investigations into acute infections including subacute endocarditis. The bacterium was isolated from throat swabs of patients and healthy individuals, where it appeared as a common commensal organism in the upper respiratory tract. Andrewes and Horder noted its chain-forming morphology and alpha-hemolytic properties on blood agar, distinguishing it from more virulent streptococci like Streptococcus pyogenes.^[63] The name "Streptococcus mitis" was chosen to reflect its observed low virulence, with "mitis" derived from the Latin word meaning "mild," as the organism rarely caused severe disease in experimental animals and was associated with less aggressive clinical presentations compared to other streptococcal species. Early observations highlighted its role in subacute rather than acute infections, such as endocarditis, underscoring its relatively benign nature in most hosts. This nomenclature emphasized the contrast with highly pathogenic groups, positioning S. mitis as a milder member of the genus.^[63] From the 1920s through the 1950s, S. mitis gained recognition as a key component of the viridans streptococci group, primarily isolated from oral cavity samples including saliva and dental plaques. This period saw increased focus on its classification within non-hemolytic, oral streptococci, with studies emphasizing its ecological niche in the human mouth. A pivotal contribution came from James M. Sherman in 1937, who proposed a physiological classification system for streptococci, placing S. mitis in the viridans division based on criteria such as lack of beta-hemolysis, sensitivity to environmental stresses, and fermentation patterns of carbohydrates like mannitol and sorbitol. Sherman's framework helped solidify S. mitis's identity among oral isolates, facilitating its differentiation from enteric and pyogenic streptococci.^[64] In the early 2000s, molecular techniques provided definitive confirmation of S. mitis's taxonomy through 16S rRNA gene sequencing, which resolved ambiguities in its phylogenetic position and distinguished it from closely related species like S. sanguinis. This approach revealed high sequence similarity within the mitis group but sufficient nucleotide differences—typically 1-2% divergence—to delineate S. mitis as a distinct entity, based on alignments of the 16S rRNA gene. Such analyses, building on earlier phenotypic classifications, affirmed its placement in the Streptococcus mitis phylogenetic cluster and highlighted its evolutionary proximity to other oral streptococci.^[65]

Surveyor 3 Incident

During the Apollo 12 mission in November 1969, astronauts Charles Conrad and Alan Bean retrieved several components from the Surveyor 3 spacecraft, which had soft-landed in the Ocean of Storms on April 20, 1967. Among these was the remote-controlled television camera, whose interior polyurethane foam block within the housing was sampled and cultured upon return to Earth. Microbiological examination of this foam, conducted in early 1970, yielded a colony of viable Streptococcus mitis (strain designated KJ or B-1081), initially interpreted as evidence of bacterial survival after 31 months on the lunar surface. The bacterium was thought to have withstood extreme lunar conditions, including the vacuum of space (approximately 10^{-14} to 10^{-12} torr), temperature fluctuations from -171°C during the lunar night to +127°C in sunlight, exposure to cosmic rays and solar radiation doses estimated at 20-30 rads, and desiccation without access to nutrients or liquid water. This isolation occurred from one of 33 samples tested, with no other viable microbes recovered from the camera's interior or exterior surfaces across multiple sites. The finding was documented in NASA's official analysis report and a 1971 Lunar and Planetary Science Conference paper, attributing the organism's presence to pre-launch contamination on Earth that endured the journey. Later re-evaluations, particularly a 2011 analysis by NASA's planetary protection officer John Rummel and colleagues, concluded that the S. mitis most likely resulted from post-retrieval contamination during laboratory handling. Evidence included inadequate cleanroom protocols—such as technicians wearing short-sleeved garments with exposed arms, lack of negative controls, and potential airborne introduction via exhalation while manipulating the sample in a laminar-flow hood—along with the isolation of the same strain from Apollo 12 crew members' routine medical swabs. S. mitis, a common oral commensal bacterium, aligns with human-derived contamination sources.^[66] This incident highlighted critical challenges in spacecraft sterilization and forward contamination prevention under COSPAR guidelines, prompting refinements in NASA's planetary protection protocols for future missions. While it provided no indication of extraterrestrial life, it demonstrated the potential hardiness of terrestrial microbes under simulated space stressors in laboratory tests, informing astrobiology research on microbial survival limits.^[67]

References

[1]
https://doi.org/10.1111/j.2041-1014.2010.00601.x
[2]
Streptococcus mitis: walking the line between commensalism and ...
Streptococcus mitis is a normal commensal of the oropharynx, but can cause infections like endocarditis, bacteraemia, and septicaemia.
[3]
Streptococcus mitis - ASM Journals
Dec 14, 2022 · Streptococcus mitis is a common oral commensal and an opportunistic pathogen that causes bacteremia and infective endocarditis; however, ...
[4]
Taxonomy browser Taxonomy Browser (Streptococcus mitis) - NCBI
THE NCBI Taxonomy database allows browsing of the taxonomy tree, which contains a classification of organisms.Missing: characteristics | Show results with:characteristics
[5]
Re-evaluation of the taxonomy of the Mitis group of the genus ...
The Mitis group of the genus Streptococcus currently comprises 20 species with validly published names, including the pathogen S. pneumoniae .
[6]
Streptococcus mitis Strains Causing Severe Clinical Disease ... - CDC
VGS cause a wide range of infections in humans, including bacteremia in patients with neutropenia, infective endocarditis, and orbital cellulitis (2–5). However ...<|control11|><|separator|>
[7]
Streptococcus mitis as a New Emerging Pathogen in Pediatric Age
Jul 23, 2023 · Streptococcus mitis, an important member of VGS [1], is found as part of the normal microbiota of the human skin as well as of the oropharynx, ...
[8]
https://doi.org/10.1128/cmr.15.4.613-630.2002
[9]
https://doi.org/10.1099/00222615-21-3-189
[10]
Streptococcus Mitis - an overview | ScienceDirect Topics
S. mitis can be detected in human saliva, oral mucosa, sputum, or excrement. It is a common oral Streptococcus and a member of the oral microflora.
[11]
Streptococcus - Medical Microbiology - NCBI Bookshelf - NIH
Streptococci are Gram-positive, nonmotile, nonsporeforming, catalase-negative cocci that occur in pairs or chains. Older cultures may lose their Gram-positive ...
[12]
Blood Agar Plates and Hemolysis: Streptocpccus
(A) Streptococcus mitis (alpha-hemolytic, growth noted by greening of the agar) shows no zone of inhibition indicating resistance to bacitracin. (B) ...Missing: green | Show results with:green
[13]
Streptococcus species | Johns Hopkins ABX Guide
Viridans group responsible for declining percentage of endocarditis compared to "enteric" strep such as S. gallolyticus subsp. gallolyticus and Enterococci ...
[14]
Streptococcus mitis- An Overview - Microbe Notes
Jan 6, 2022 · Streptococcus mitis is a commensal bacteria that mostly colonize the oral cavity along with the hard surfaces like the teeth and the mucosal ...Morphology of Streptococcus... · Biochemical characteristics of...
[15]
Biology of Oral Streptococci - PMC - PubMed Central - NIH
Therefore, most streptococci are considered facultative anaerobes and susceptible to growth inhibition by oxygen.
[16]
Use of Enzyme Tests in Characterization and Identification of ... - NIH
The usefulness of the catalase test for separating micrococci from streptococci has also been studied. ... biochemical tests for identification of viridans ...
[17]
Streptococcus - an overview | ScienceDirect Topics
They are catalase, oxidase, and nitrate negative. These bacteria depend largely on glycolysis for adenosine triphosphate (ATP) synthesis. Streptococci are ...
[18]
It's Not Easy Being Green: the Viridans Group Streptococci, with a ...
... Streptococcus mitis group” (14). This group has been poorly defined for many ... NaCl, and almost all species are negative for growth on bile esculin agar.
[19]
Population Dynamics of Streptococcus mitis in Its Natural Habitat - NIH
The purpose of this study was to examine the genetic structure of the typical commensal Streptococcus mitis biovar 1 in its natural habitat in the human ...
[20]
https://pmc.ncbi.nlm.nih.gov/articles/PMC98734/
[21]
Community-acquired Streptococcus mitis meningitis: a case report
Streptococcus mitis is prevalent in the normal flora of the oropharynx, the female genital tract, gastrointestinal tract, and skin. Although it is usually ...
[22]
Streptococcus mitis as a New Emerging Pathogen in Pediatric Age
Jul 23, 2023 · Streptococcus mitis, an important member of VGS [1], is found as part of the normal microbiota of the human skin as well as of the oropharynx, ...
[23]
A new perspective on ancient Mitis group streptococcal genetics
Mitis group Streptococcus are human obligate bacteria residing in the nasopharynx and oral cavity. They comprise both commensal and pathogenic species with the ...Missing: animals | Show results with:animals
[24]
Demystifying the mist: Sources of microbial bioload in dental aerosols
Hydrogen peroxide‐mediated antagonism against serratia marcescens by streptococcus mitis. Zentralbl Bakteriol Mikrobiol Hyg A. 1983;254:326‐332. [PubMed] ...
[25]
Long-term survival of salivary streptococci on dental devices made ...
Mar 16, 2012 · Nine primer sets was used for the detection of oral streptococci, including Streptococcus mitis, Streptococcus salivarius, Streptococcus ...
[26]
The Predominant Oral Microbiota Is Acquired Early in an Organized ...
Jul 22, 2019 · The S. mitis group was the earliest and most ubiquitous colonizer, and has been shown to inhibit the colonization of other species, including ...
[27]
The oral microbiome: Role of key organisms and complex networks ...
Pioneer microbial colonizers of the oral cavity, such as Streptococcus mitis, Streptococcus sanguinis, Streptococcus gordonii, and Streptococcus salivarius ...
[28]
Oral streptococci: modulators of health and disease - Frontiers
Streptococci are primary colonizers of the oral cavity where they are ubiquitously present and an integral part of the commensal oral biofilm microflora.
[29]
High-resolution profiles of the Streptococcus mitis CSP signaling ...
Jun 13, 2018 · As mentioned, fratricide has been demonstrated not only for pneumococcus, but also for commensal streptococci [30]. In the present analysis, the ...
[30]
[PDF] The Usual Suspects: A Review of Common Dysbiosis of the Human ...
May 13, 2025 · There is well documented instances of dysbiosis caused by the overgrowth species including Streptococcus mitis,. Lactobacillus species, and ...
[31]
The Genome of Streptococcus mitis B6 - What Is a Commensal? - PMC
The sequence of the circular genome covers 2,146,611 bp with an average GC content of 39.98% (40.74% for coding sequences) which is similar to the features of ...
[32]
Complete Genome Sequence of Streptococcus mitis Strain ...
We report here the first complete genome sequence of S. mitis strain SVGS_061, which caused VGS shock syndrome, to help elucidate the pathogenesis of severe VGS ...
[33]
1611627092 - Nucleotide Result - NCBI
Streptococcus mitis NCTC 12261 chromosome, complete genome 1,868,883 bp circular DNA CP028414.1 GI:1611627092.Missing: typical structure plasmids
[34]
Streptococcus mitis ATCC 6249 genome assembly ASM14658v1
RefSeq, GenBank. Genome size, 1.9 Mb, 1.9 Mb. Total ungapped length, 1.9 Mb, 1.9 Mb. Number of chromosomes, 1, 1. Number of scaffolds, 8, 8.
[35]
Occurrence and Evolution of the Paralogous Zinc Metalloproteases ...
Oct 2, 2012 · The paralogous zinc metalloproteases IgA1 protease, ZmpB, ZmpC, and ZmpD have been identified as crucial for virulence of the human pathogen Streptococcus ...
[36]
Population genomics of Streptococcus mitis in UK and Ireland ...
Sep 6, 2024 · We show high genetic diversity of IE-associated S. mitis with virtually all isolates belonging to distinct lineages indicating no predominance ...
[37]
Overcoming the Barrier of Low Efficiency during Genetic ...
Jul 5, 2016 · Most members of the Mitis group of streptococci are naturally competent for genetic transformation and produce competence pheromones, also ...
[38]
High-resolution profiles of the Streptococcus mitis CSP signaling ...
Jun 13, 2018 · Gene SMSK321_1184, coding for a hypothetical protein, was upregulated more than 100-fold in SK321 but has no orthologue in the type strain.
[39]
LytF contributes to pilus extrusion during natural competence in ...
An essential structure for DNA uptake is a DNA-binding type IV pilus, which extends from the cell surface to bring the transforming DNA into the DNA uptake ...
[40]
Competence in Streptococcus pneumoniae and Close Commensal ...
Apr 2, 2019 · Streptococcus pneumoniae and Streptococcus mitis are close relatives and share ~60–80% of orthologous genes, but still present striking differences in ...
[41]
Regulation of natural genetic transformation and acquisition of ...
Similarly, it was shown that the fratricide mechanism has a large positive impact on the efficiency of gene transfer from the commensals S. mitis and S. oralis ...
[42]
The impact of horizontal gene transfer on the adaptive ability of ... - NIH
Sep 8, 2014 · Horizontal gene transfer in the oral cavity gives some of the resident bacteria the opportunity to sample a truly enormous metagenome affording them ...
[43]
Oral Commensal Streptococci: Gatekeepers of the Oral Cavity - PMC
Oral commensal streptococci are primary colonizers of the oral cavity. These streptococci produce many adhesins, metabolites, and antimicrobials that modulate ...
[44]
The oral commensal Streptococcus mitis activates the aryl ... - NIH
Streptococcus mitis (S. mitis) is a pioneer commensal bacterial species colonizing many of the surfaces of the oral cavity in healthy individuals.
[45]
Streptococcus mitis Strains Causing Severe Clinical Disease ... - NIH
Bacterial isolates were identified as VGS on the basis of the following: presence of α-hemolysis, gram-positive reaction, coccus morphology arranged in ...
[46]
Streptococcus mitis. A cause of serious infection in adults - PubMed
This review suggests that S mitis can be an important pathogen in adults and may cause infections other than endocarditis.
[47]
Risk of Infective Endocarditis in Streptococcus mitis Bloodstream ...
Streptococcus mitis commonly causes bloodstream infections (BSIs) in neutropenic patients but infrequently results in infective endocarditis (IE) in this ...
[48]
Low penicillin susceptibility in Streptococcus mitis/oralis from ... - NIH
Oct 14, 2024 · Bloodstream infections attributed to S. mitis/oralis are particularly prevalent among children with hematological malignancies and tumors. ...Missing: procedures | Show results with:procedures
[49]
Streptococcus mitis Chorioamnionitis after Dental Scaling and Oral ...
Nov 2, 2020 · Oral sex and dental procedures may be risk factors for chorioamnionitis. 1. Introduction. Streptococcus mitis (S. mitis), a viridans group ...<|control11|><|separator|>
[50]
Streptococcus mitis Phage-Encoded Adhesins Mediate Attachment ...
The binding of pathogenic bacteria to platelets is thought to play a role in the virulence of these bacteria in infectious endocarditis (8, 11, 17, 22, 24).
[51]
Genetic Loci of Streptococcus mitis That Mediate Binding to Human ...
The direct binding of bacteria to platelets is a postulated major interaction in the pathogenesis of infective endocarditis.
[52]
Role of the serine-rich surface glycoprotein GspB of Streptococcus ...
The direct binding of bacteria to platelets is a central interaction in the pathogenesis of infective endocarditis. GspB is a serine-rich, cell wall ...
[53]
Colon Cancer with Streptococcus gallolyticus Aortic Valve ...
Jul 3, 2019 · Colonoscopy revealed colon cancer and high-grade adenoma; few hours after procedure, he presented with Streptococcus mitis bacteremia. In ...
[54]
In vitro activities of 22 beta-lactam antibiotics against penicillin ... - NIH
One hundred thirty-eight strains (33.6%) were resistant to penicillin with a MIC range of 0.25 to 8 micrograms/ml.
[55]
StreptoBase: An Oral Streptococcus mitis Group Genomic ... - NIH
May 3, 2016 · Alpha-hemolysis involves the bleaching of heme iron by streptococcal hydrogen peroxide (H2O2), resulting in a greenish tinge on blood agar [1].
[56]
Community-acquired Streptococcus mitis meningitis: a case report
S. mitis identification was initially performed using the API 20 STREP (bioMerieux). The identification was also confirmed by conventional biochemical tests ( ...
[57]
[PDF] infective-endocarditis-in-adults-diagnosis-antimicrobial-therapy-and ...
Oct 16, 2018 · Although it is preferred that gentamicin (3 mg/kg) be given as a single daily dose to adult patients with endocarditis caused by viridans group ...
[58]
Low penicillin susceptibility in Streptococcus mitis/oralis from ...
Oct 14, 2024 · Given the low susceptibility rates of penicillin and ceftriaxone, vancomycin may be considered as the empiric therapy for bloodstream infections ...
[59]
Streptococcus Mitis Group Infections: Epidemiology, Antibiotic ...
May 17, 2024 · oralis/ mitis was the predominant species with the highest detection rate (50.30%), coming from different sources, including blood (31%), urine ...
[60]
https://www.idsociety.org/globalassets/idsa/practice-guidelines/infective-endocarditis-in-adults-diagnosis-antimicrobial-therapy-and-management-of-complications.pdf
[61]
THE STREPTOCOCCI | Bacteriological Reviews - ASM Journals
THE STREPTOCOCCI. Author: James M. ShermanAuthors Info & Affiliations. https ... First page of PDF. Formats available. You can view the full content in the ...Missing: JM | Show results with:JM
[62]
https://acmcasereports.com/streptococcus-mitis-group-infections-epidemiology-antibiotic-susceptibility-profile-and-risk-factors-evaluation
[63]
[PDF] Streptococcus mitis on Surveyor III - Lunar and Planetary Institute
S. mitis was isolated from a colony that grew in the undiluted thioglycollate broth in which a piece of insulating polyurethane foam had been placed. But wait, ...Missing: 2011 | Show results with:2011
[64]
Moon Microbe Mystery Finally Solved | Space
May 2, 2011 · When NASA's Apollo 12 crew returned pieces of the Surveyor 3 probe to Earth in 1969, scientists found microbes inside.