scholarly journals Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

2021 ◽  
Author(s):  
Anna Bläckberg ◽  
Christian Morenius ◽  
Lars Olaison ◽  
Andreas Berge ◽  
Magnus Rasmussen
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Haemophilus Influenzae ◽  
Comparative Study ◽  
Clinical Characteristics ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Common Cause ◽  
Prosthetic Valves

AbstractInfective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.

scholarly journals Long-term Outcome of Patients With Nonoperated Prosthetic Valve Infective Endocarditis: Is Relapse the Main Issue?

2019 ◽  
Vol 71 (5) ◽  
pp. 1316-1319 ◽  
Author(s):  
Raphaël Lecomte ◽  
Jean-Baptiste Laine ◽  
Nahéma Issa ◽  
Matthieu Revest ◽  
Benjamin Gaborit ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rate ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Main Issue ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Risk Of Relapse

Abstract In nonoperated prosthetic valve endocarditis (PVE), long-term outcome is largely unknown. We report the follow-up of 129 nonoperated patients with PVE alive at discharge. At 1 year, the mortality rate was 24%; relapses and reinfection were rare (5% each). Enterococcal PVE was associated with a higher risk of relapse.

scholarly journals Clinical Features and Outcome of Infective Endocarditis in a University Hospital in Romania

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 158
Author(s):  
Emilia Elena Babeș ◽  
Diana Anca Lucuța ◽  
Codruța Diana Petcheși ◽  
Andreea Atena Zaha ◽  
Cristian Ilyes ◽  
...  
Keyword(s):  
Heart Failure ◽  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
University Hospital ◽  
Hospital Death ◽  
Coagulase Negative Staphylococcus ◽  
Index Number ◽  
Duke Criteria

Background and Objectives: Characterization of patients with endocarditis regarding demographic, clinical, biological and imagistic data, blood culture results and possible correlation between different etiologic factors and host status characteristics. Material and methods: This is a retrospective observational descriptive study conducted on patients older than 18 years admitted in the past 10 years, in the Cardiology Clinic of the Clinical County Emergency Hospital Oradea Romania, with clinical suspicion of bacterial endocarditis. Demographic data, clinical, paraclinical investigations and outcome were registered and analyzed. Results: 92 patients with definite infective endocarditis (IE) according to modified Duke criteria were included. The mean age of patients was 63.80 ± 13.45 years. A percent of 32.6% had health care associated invasive procedure performed in the 6 months before diagnosis of endocarditis. Charlson’s comorbidity index number was 3.53 ± 2.029. Most common clinical symptoms and signs were: shortness of breath, cardiac murmur, fever. Sixty-six patients had native valve endocarditis, 26 patients had prosthetic valve endocarditis and one patient was with congenital heart disease. Blood cultures were positive in 61 patients. Among positive culture patient’s staphylococcus group was the most frequently involved: Staphylococcus aureus (19.6%) and coagulase negative Staphylococcus (18.5%). Most frequent complications were heart failure, acute renal failure and embolic events. Conclusions: Staphylococcus aureus IE was associated with the presence of large vegetations, prosthetic valve endocarditis and intracardiac abscess. Coagulase negative Staphylococcus (CoNS) infection was associated with prosthetic valve dysfunction. Streptococcus gallolyticus etiology correlated with ischemic embolic stroke and the presence of large vegetations. Cardiovascular surgery was recommended in 67.4% of patients but was performed only on half of them. In hospital death occurred in 33.7% of patients and independent predictors of mortality were congestive heart failure and septic shock.

scholarly journals Bacteriological Profile of Heart Valves Resected from Infective Endocarditis Patients

1970 ◽  
Vol 7 (2) ◽  
pp. 108-111
Author(s):  
S Manandhar ◽  
S Basnyat ◽  
J Sharma ◽  
BM Pokhrel ◽  
B Koirala
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Heart Valve ◽  
Prosthetic Valve ◽  
Heart Valves ◽  
Significant Risk ◽  
Prosthetic Heart Valve ◽  
Prosthetic Valve Endocarditis ◽  
Diffusion Method ◽  
Post Surgery

Background: Early prosthetic valve endocarditis is a serious life threatening infection of newly implanted prosthetic heart valve. A positive post-surgery heart valve culture is a significant risk factor for development of early prosthetic valve endocarditis. Methods: A prospective bacteriological investigation was done in intraoperatively suspected and preoperatively diagnosed infective endocarditis patients undergoing heart valve replacement surgery. The valve samples were cultured after prior homogenization by sterile scalpel method. The bacterial isolates were identified by standard microbiological techniques and their antibiotic susceptibility profile was determined in vitro by Kirby Bauer disc diffusion method. Results: Of 31 heart valve samples cultured, 3 (9.67%) were culture positive which constituted 2 (13.33%) from preoperatively diagnosed infective endocarditis patients from which Staphylococcus aureus and Enterococcus faecalis were isolated and 1 (6.25%) from intraoperatively suspected infective endocarditis patient from which Staphylococcus aureus was isolated. All three isolates were sensitive to antibiotics Vancomycin and Ciprofloxacin and resistant to Penicillin and Amoxycillin. The isolates obtained from preoperatively diagnosed patients were more resistant to antibiotics tested than that from suspected patients. Conclusions: The bacteriological examination of heart valves resected from preoperatively diagnosed and intraoperatively suspected infective endocarditis patients revealed higher degree of culture positivity. Hence routine microbiological examination of all heart valves from diagnosed and suspected IE patients is required to rule out active endocardial infection to reduce the chance of early prosthetic valve endocarditis. Key words: bacteriology; heart valves; infective endocarditis DOI: 10.3126/jnhrc.v7i2.3017 Journal of Nepal Health Research Council Vol.7(2) Apr 2009 108-111

scholarly journals Corynebacterium freneyi as a cause of early prosthetic valve endocarditis

2021 ◽  
Vol 14 (11) ◽  
pp. e245152
Author(s):  
Bjørnar Grenne ◽  
Håvard Dalen ◽  
Dag Ole Nordhaug ◽  
Torgeir Sand-Aas ◽  
Espen Holte ◽  
...  
Keyword(s):  
Decision Making ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Human Infection ◽  
Causative Pathogen ◽  
Life Threatening ◽  
Threatening Situation

Infective endocarditis (IE) is associated with severe complications and a high mortality rate. Identification of the causative pathogen is crucial to optimise treatment. We present a case of prosthetic valve endocarditis caused by Corynebacterium freneyi, a very rare cause of human infection and not previously reported as a cause of IE. Despite proper antibiotic therapy, the patient eventually needed surgery after progression of the infection. After surgery, he quickly recovered without evidence of relapse during an 8-month follow-up period. This report highlights critical decision making in a complex and potentially life-threatening situation, where neither guidelines nor previous clinical or microbiological experience were able to give clear treatment recommendations.

scholarly journals Infective Endocarditis – An Observational Study

2015 ◽  
Vol 21 (2) ◽  
pp. 87-94
Author(s):  
Brindusa Tilea ◽  
Simona Teches ◽  
S. Voidazan ◽  
Klara Brinzaniuc ◽  
I. Tilea
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Observational Study ◽  
Prosthetic Valve Endocarditis ◽  
Etiologic Agent ◽  
Clinical Aspects ◽  
Coagulase Negative Staphylococci ◽  
Streptococcus Gallolyticus ◽  
Prosthetic Valves

Abstract Introduction: Despite all the progresses made in the management of infectious and cardiovascular diseases, the incidence of infective endocarditis remains high. Aim: the assessment of etiological, clinical, therapeutic aspects in patients with endocarditis. Material and method: A retrospective observational study in 40 patients with infective endocarditis was conducted, over a period of 5 years. Parameters related to demographic, risk factors, clinical aspects, nature and location of valve damage, bacteriological and therapeutic parameters were assessed. Echocardiography was used to confirm the location of the endocarditis; the aetiology of the disease was identified through the isolation of bacteria from blood cultures by using an automatic BacT/ALERT® system. Results: Patients’ age ranged between 31 - 84 years old. The disease was present predominantly in male patients (67.5%). 70% of the patients were positively diagnosed with endocarditis and 30% with possible endocarditis; the most frequent localization was the native valves in 75% of the cases, compared to the localization in the prosthetic valves, 25%; the aortic valve was involved in 60% of the cases, mitral valve in 40% of the patients. Aetiology of endocarditis was confirmed in 55% of cases as follows: Enterococcus fecalis, speciae, Staphylococcus epidermidis, Escherichia coli, Streptococcus gallolyticus, coagulase-positive methicillin resistant Staphylococcus aureus, coagulasepositive methicillin sensitive Staphylococcus aureus, Staphylococcus lungdunensis, coagulase-negative staphylococci, Streptococcus gordonii, viridans, agalactiae. Antibiotic treatment was administered according to the antibiogram in 55% of the cases. Conclusions: Staphylococcus speciae was the most frequent etiologic agent both in case of native and prosthetic valve endocarditis, with aortic valve predominance.

The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020

2020 ◽  
Vol 21 (12) ◽  
pp. 1140-1153 ◽  
Author(s):  
Mohammad A. Noshak ◽  
Mohammad A. Rezaee ◽  
Alka Hasani ◽  
Mehdi Mirzaii
Keyword(s):  
Foreign Body ◽  
Infective Endocarditis ◽  
Prosthetic Valve ◽  
Human Life ◽  
Prosthetic Valve Endocarditis ◽  
Surgical Site Infections ◽  
Coagulase Negative Staphylococci ◽  
Native Valve ◽  
Native Valve Endocarditis

Coagulase-negative staphylococci (CoNS) are part of the microbiota of human skin and rarely linked with soft tissue infections. In recent years, CoNS species considered as one of the major nosocomial pathogens and can cause several infections such as catheter-acquired sepsis, skin infection, urinary tract infection, endophthalmitis, central nervous system shunt infection, surgical site infections, and foreign body infection. These microorganisms have a significant impact on human life and health and, as typical opportunists, cause peritonitis in individuals undergoing peritoneal dialysis. Moreover, it is revealed that these potential pathogens are mainly related to the use of indwelling or implanted in a foreign body and cause infective endocarditis (both native valve endocarditis and prosthetic valve endocarditis) in patients. In general, approximately eight percent of all cases of native valve endocarditis is associated with CoNS species, and these organisms cause death in 25% of all native valve endocarditis cases. Moreover, it is revealed that methicillin-resistant CoNS species cause 60 % of all prosthetic valve endocarditis cases. In this review, we describe the role of the CoNS species in infective endocarditis, and we explicated the reported cases of CoNS infective endocarditis in the literature from 2000 to 2020 to determine the role of CoNS in the process of infective endocarditis.

scholarly journals Infective Endocarditis Due to Corynebacterium Species: Clinical Features and Antibiotic Resistance

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Anna Bläckberg ◽  
Linn Falk ◽  
Karl Oldberg ◽  
Lars Olaison ◽  
Magnus Rasmussen
Keyword(s):  
Antibiotic Resistance ◽  
Infective Endocarditis ◽  
Prosthetic Valve Endocarditis ◽  
Penicillin G ◽  
Severe Condition ◽  
Ionization Time ◽  
Prosthetic Valves ◽  
Corynebacterium Species ◽  
Corynebacterium Striatum

Abstract Background Corynebacterium species are often dismissed as contaminants in blood cultures, but they can also cause infective endocarditis (IE), which is a severe condition. Antibiotic resistance of corynebacteria is increasing making treatment challenging. Reports on IE caused by Corynebacterium species are scarce and more knowledge is needed. Methods Cases of IE caused by Corynebacterium species were identified through the Swedish Registry of Infective Endocarditis. Isolates were collected for species redetermination by matrix-assisted laser desorption ionization-time of flight and for antibiotic susceptibility testing using Etests. Results Thirty episodes of IE due to Corynebacterium species were identified between 2008 and 2017. The median age of patients was 71 years (interquartile range, 60–76) and 77% were male. Corynebacterium striatum (n = 11) was the most common IE causing pathogen followed by Corynebacterium jeikeium (n = 5). Surgery was performed in 50% and in-hospital mortality rate was 13%. Patients with IE caused by Corynebacterium species were significantly more likely to have prosthetic valve endocarditis (70%), compared with patients with IE due to Staphylococcus aureus or non-beta-hemolytic streptococci (14% and 26%, respectively) (P < .0001). Vancomycin was active towards all Corynebacterium isolates, whereas resistance towards penicillin G was common. Conclusions Corynebacterium species cause IE, where prosthetic valves are mainly affected and surgery is often performed. Corynebacterium striatum is an important causative agent of IE within the genus. Antibiotic resistance of corynebacteria is relatively common but resistance towards vancomycin could not be detected in vitro.

scholarly journals 18F-FDG PET/CT in Infective Endocarditis: Indications and Approaches for Standardization

2021 ◽  
Vol 23 (9) ◽  
Author(s):  
D. ten Hove ◽  
R.H.J.A. Slart ◽  
B. Sinha ◽  
A.W.J.M. Glaudemans ◽  
R.P.J. Budde
Keyword(s):  
Infective Endocarditis ◽  
Fdg Pet ◽  
Prosthetic Valve Endocarditis ◽  
Cardiac Device ◽  
Native Valve ◽  
Prosthetic Valves ◽  
Cardiac Devices ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Disseminated Disease

Abstract Purpose of Review Additional imaging modalities, such as FDG-PET/CT, have been included into the workup for patients with suspected infective endocarditis, according to major international guidelines published in 2015. The purpose of this review is to give an overview of FDG-PET/CT indications and standardized approaches in the setting of suspected infective endocarditis. Recent Findings There are two main indications for performing FDG-PET/CT in patients with suspected infective endocarditis: (i) detecting intracardiac infections and (ii) detection of (clinically silent) disseminated infectious disease. The diagnostic performance of FDG-PET/CT for intracardiac lesions depends on the presence of native valves, prosthetic valves, or implanted cardiac devices, with a sensitivity that is poor for native valve endocarditis and cardiac device-related lead infections, but much better for prosthetic valve endocarditis and cardiac device-related pocket infections. Specificity is high for all these indications. The detection of disseminated disease may also help establish the diagnosis and/or impact patient management. Summary Based on current evidence, FDG-PET/CT should be considered for detection of disseminated disease in suspected endocarditis. Absence of intracardiac lesions on FDG-PET/CT cannot rule out native valve endocarditis, but positive findings strongly support the diagnosis. For prosthetic valve endocarditis, standard use of FDG-PET/CT is recommended because of its high sensitivity and specificity. For implanted cardiac devices, FDG-PET/CT is also recommended, but should be evaluated with careful attention to clinical context, because its sensitivity is high for pocket infections, but low for lead infections. In patients with prosthetic valves with or without additional aortic prosthesis, combination with CTA should be considered. Optimal timing of FDG-PET/CT is important, both during clinical workup and technically (i.e., post tracer injection). In addition, procedural standardization is key and encompasses patient preparation, scan acquisition, reconstruction, subsequent analysis, and clinical interpretation. The recommendations discussed here will hopefully contribute to improved standardization and enhanced performance of FDG-PET/CT in the clinical management of patients with suspected infective endocarditis.

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