Infective endocarditis: Importance of molecular biological techniques in etiological diagnosis

2016 ◽  
Vol 88 (11) ◽  
pp. 62-67 ◽  
Author(s):  
E O Kotova ◽  
E A Domonova ◽  
Yu L Karaulova ◽  
A S Milto ◽  
A S Pisaryuk ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Venous Blood ◽  
Bacteriological Examination ◽  
Etiological Diagnosis ◽  
Causative Agents ◽  
Pathogen Dna ◽  
Dna Pcr ◽  
Culture Negative ◽  
Molecular Biological Techniques

Aim. To investigate the specific features of conventional bacteriological methods and current molecular biological techniques for the etiological diagnosis of infective endocarditis (IE). Subjects and methods. Examinations were made in 53 patients treated at City Clinical Hospital Sixty-Four, Moscow Healthcare Department, in 2012—2015 who underwent simultaneous bacteriological and molecular biological (polymerase chain reaction (PCR) or PCR with further sequencing) examinations of blood or resected cardiac valve tissues. Results. The investigation included 53 patients (31 men; median age, 62 years) with IE (Duke 2009); its primary form was observed in 32 (60.4%) patients. Blood bacteriological tests and PCR assays were positive in 28 (52.8%) and 34 (64.2%) patients, respectively. There were concordant results in 21 of the 28 positive blood culture cases and discordant results in 7 (25%); at the same time 3 cases showed a compete discordance in the detected causative agents (the growth of Enterococcus spp. was revealed by bacteriological examination and that of Staphylococcus spp., Streptococcus spp., and Escherichia coli by DNA PCR) and a pathogen could not be identified by DNA PCR in 4 patients who had positive blood bacteriological results. The positive PCR results for cocci and fungi were obtained in 10 of the 25 (47.2%) examinees with culture-negative IE. Rare causative agents were not revealed. The tissues obtained from 8 resected damaged heart valves displayed a wider spectrum of pathogens than did blood samples, which was associated with the formation of bacterial films. Conclusion. The etiological agent of IE was revealed in venous blood by bacteriological examination in 52.8% of the examinees, by PCR in 64.2%, and by either in 71.7%. There were concordant and discordant results in 67.9 and 32.1% of the patients, respectively; among whom 18.9% were found to have pathogen DNA revealed by PCR in culture-negative IE.

scholarly journals Virulence factors in streptococcal infective endocarditis

2005 ◽  
Vol 26 (3) ◽  
pp. 114
Author(s):  
Derek W S Harty
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Blood Stream ◽  
Mutans Streptococci ◽  
Oral Streptococci ◽  
Streptococcus Anginosus ◽  
Streptococcus Oralis ◽  
Causative Agents ◽  
Life Threatening ◽  
Micro Organisms

Infective endocarditis (IE) is a life threatening, endovascular infection occurring when bacteria enter the blood stream and adhere to heart valves. Mortality rates remain in the range of 11-27%. The most common infecting micro-organisms are now the staphylococci (44%) although streptococci (31%) and particularly the oral streptococci (21%) are still major causative agents. Many different oral streptococci have been isolated from IE cases, the most common being Streptococcus sanguinis, Streptococcus oralis, Streptococcus gordonii, Streptococcus mitis, Streptococcus anginosus group and mutans streptococci.

Infective and inflammatory cardiac conditions

2010 ◽  
pp. 191-224
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Clinical Practice ◽  
Infective Endocarditis ◽  
Heart Valves ◽  
Antimicrobial Prophylaxis ◽  
Current Clinical Practice ◽  
Cardiac Tissues ◽  
Prosthetic Valves ◽  
Fungal Endocarditis ◽  
Culture Negative

Infective endocarditis 192 Treatment of endocarditis 194 Enterococcal endocarditis 204 Endocarditis caused by HACEK organisms 210 Fungal endocarditis 212 Culture-negative endocarditis 214 Antimicrobial prophylaxis 218 Pericarditis 220 Myocarditis 223 Infective endocarditis is an infection of the endocardium which usually involves the heart valves. In current clinical practice, endocarditis encompasses a heterogeneous collection of infections that may involve native cardiac tissues, prosthetic valves, pacing systems, and a variety of intracardiac implants. Endocarditis is mainly caused by bacteria, but fungi are occasionally implicated....

Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study

2021 ◽  
pp. 1-9
Author(s):  
Lorenzo Roberto Suardi ◽  
Arístides de Alarcón ◽  
María Victoria García ◽  
Antonio Plata Ciezar ◽  
Carmen Hidalgo Tenorio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Culture Negative ◽  
Spanish Cohort

scholarly journals Ehrlichia species as possible causative agents of blood culture-negative endocarditis

1995 ◽  
Vol 1 (2) ◽  
pp. 148-150 ◽  
Author(s):  
Philippe Brouqui ◽  
Didier Raoult ◽  
Jean Marc Durand
Keyword(s):  
Blood Culture ◽  
Causative Agents ◽  
Culture Negative

scholarly journals Antimicrobial Treatment of Infective Endocarditis, Caused by Enterococcus Faecalis

2019 ◽  
Vol 15 (4) ◽  
pp. 586-592
Author(s):  
E. V. Shikh ◽  
T. E. Morozova ◽  
V. N. Drozdov ◽  
N. B. Lazareva ◽  
D. A. Shatsky ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Enterococcus Faecalis ◽  
Heart Valves ◽  
Antimicrobial Treatment ◽  
Mortality Data ◽  
Efficacy And Safety ◽  
Beta Lactam ◽  
Antibacterial Drugs ◽  
Native Studies ◽  
Treatment Regimens

The frequency of infective endocarditis (IE) has increased 3 times over the past 30 years. The incidence of IE morbidity is recorded in all countries of the world and in the Russian Federation more than 40 people per 1 million population get sick. One of the most frequent causative agents of infective endocarditis is Enterococcus faecalis (E. faecalis), which takes the third place in the structure of the frequency of IE pathogens. Enterococcal IE remains a disease with high mortality, despite the emergence of new groups of antibacterial drugs. This review includes the results of studies of the efficacy and safety of various antimicrobial regimens of IE caused by E. faecalis. The analysis of data from foreign and native studies of antimicrobial treatment in patients with infective endocarditis, accompanied by enterococcal bacteremia is presented in the review. The search for literature performed by using medical databases: MEDLINE, EMBASE, eLIBRARY. The current review included studies of the efficacy and safety of antimicrobial treatment. The main antibiotic therapy regimens of IE caused by E. faecalis include 2 beta-lactam antibiotics or a combination of ampicillin and gentamicin, according to the results of 5 found studies. Found antimicrobial regimens significantly did not affect mortality. Data from international registries testify to the efficacy and safety of daptomycin monotherapy for enterococcal endocarditis. Linezolid and daptomycin are the main drugs of treating infective endocarditis caused by vancomycin-resistant enterococci. Native studies report of a high level of resistance of enterococcal strains to beta-lactam antibacterial drugs. The duration of fever, the frequency of surgical heart valves interventions, the duration of bacteremia are not fully represented in each of the studies, and it is difficult to evaluate these factors. Ampicillin+ceftriaxone and ampicillin+gentamicin are the main antimicrobial treatment regimens of enterococcal endocarditis. Efficacy of these regimens is not significantly different. Treatment of IE should be carried out taking into the epidemiological situation and the strain resistance.

scholarly journals Gram Stain, Culture, and Histopathological Examination Findings for Heart Valves Removed because of Infective Endocarditis

2003 ◽  
Vol 36 (6) ◽  
pp. 697-704 ◽  
Author(s):  
Arthur J. Morris ◽  
Dragana Drinkovic ◽  
Sudha Pottumarthy ◽  
Marianne G. Strickett ◽  
Donald MacCulloch ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Heart Valves ◽  
Histopathological Examination ◽  
Gram Stain

scholarly journals Myocarditis in Crohn’s disease: a case report

2020 ◽  
Vol 4 (4) ◽  
pp. 1-6
Author(s):  
Lucy McGrath-Cadell ◽  
Nicole K Bart ◽  
Linda Lin ◽  
Simon Ghaly ◽  
Cameron J Holloway
Keyword(s):  
Crohn’S Disease ◽  
Infective Endocarditis ◽  
Crohn's Disease ◽  
Blood Cultures ◽  
Empirical Treatment ◽  
Diagnostic Process ◽  
Treatment Paradigm ◽  
History Of ◽  
Culture Negative ◽  
Valvular Lesions

Abstract Background Mobile valvular masses are often considered pathognomonic for infective endocarditis. We present a case of a young patient with mobile valvular masses in the context of myocarditis likely secondary to active ileal Crohn’s disease. Cardiac magnetic resonance (CMR) imaging was crucial in diagnosing and monitoring our patient. Case summary A 27-year-old woman presented with pleuritic chest pain, dyspnoea, and a 3-day history of fevers. She also reported a 2-month history of intermittent visual loss in her right eye. She had a history of histologically proven ileal Crohn’s disease, diagnosed 5 months prior. She was haemodynamically unstable on presentation. Abnormalities on a transthoracic echocardiogram necessitated a transoesophageal echocardiogram. After blood cultures were sent, the patient was commenced on empirical treatment for infective endocarditis with gentamicin and flucloxacillin. Eight days after her initial presentation, all blood cultures remained negative and she was changed to empirical treatment for culture negative endocarditis with ceftriaxone and vancomycin, according to local protocol. Despite 8 days of treatment for infective endocarditis she remained febrile. A CMR was organized on Day 9 and this showed myocarditis, which changed the treatment paradigm. She responded swiftly to steroids and anti-coagulation. Discussion In this case, echo-dense valvular lesions are not pathognomonic for infective endocarditis and a careful diagnostic process involving multi-modality imaging, including CMR, occurred to arrive at a diagnosis of myocarditis likely secondary to Crohn’s disease.

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