Rothia Species Infections in Clinical Settings

Rothia species are Gram-positive, catalase-positive coccobacilli that form part of the normal oral and upper respiratory tract microbiota. Historically regarded as low-virulence commensals, they have emerged as opportunistic pathogens in both immunocompromised and, less commonly, immunocompetent individuals. Clinical manifestations include endocarditis, pneumonia, meningitis, peritonitis, ocular and soft-tissue infections, and device-associated biofilm formation. The rising incidence of invasive disease is driven by expanding use of indwelling medical devices, broader immunosuppressive therapies and enhanced microbial identification techniques. Rothia isolates often exhibit susceptibility to β-lactams and glycopeptides, but treatment failures have been attributed to biofilm-mediated tolerance and variable intrinsic resistance profiles. Rapid and accurate diagnostic methods, including matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry and molecular assays, have improved detection rates. Nevertheless, management remains challenging due to a lack of standardised antimicrobial susceptibility breakpoints and consensus guidelines. Ongoing research focuses on understanding species-specific pathogenic mechanisms, host–microbe interactions in vulnerable patient groups and development of novel antimicrobial strategies to prevent and disrupt biofilms. Globally, recognition of Rothia infections is increasing, underscoring their clinical importance and the need for collaborative surveillance to inform therapeutic decision-making.

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Rothia Species Infections in Clinical Settings publication trend

The graph below shows the total number of articles in rothia species infections in clinical settings across all publications each year (not limited to Nature Index journals).

Technical terms

Opportunistic pathogen: A microorganism that causes disease primarily in hosts with compromised immune defences.

Endolysin: A bacteriophage-derived enzyme that degrades bacterial cell walls, enabling targeted antibacterial activity without broad microbiome disruption.

Biofilm: A structured community of bacterial cells enclosed in a self-produced extracellular matrix, often exhibiting increased tolerance to antibiotics.

Commensal bacterium: An organism that resides harmlessly on or within the human body under normal conditions.

References

1. New Phage-Derived Antibacterial Enzyme PolaR Targeting Rothia spp.. Cells (2023).
2. Terapeutic Remission of Community Acquired Pneumonia Caused by Rothia Mucilaginosa in an Adult Patient with Idiopathic Pulmonar Fibrosis. American Journal of Internal Medicine (2023).
3. Rothia dentocariosa endocarditis with brain abscess and splenic abscess: case report and brief review. Frontiers in Cardiovascular Medicine (2024).