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 Therapy for Enterococcus faecalis Infective Endocarditis in the Era of A Dual Beta-Lactam Regimen: An Institutional Experience 2008–2015

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Abdelghani El Rafei ◽  
Daniel C. Desimone ◽  
Muhammad R. Sohail ◽  
James Steckelberg ◽  
Walter R. Wilson ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Enterococcus Faecalis ◽  
Beta Lactam ◽  
Institutional Experience

scholarly journals Differential ampicillin/ceftriaxone susceptibility among diverse Enterococcus faecalis from infective endocarditis

2021 ◽  
Author(s):  
Kevin J Westbrook ◽  
Gayatri Shankar Chilambi ◽  
Hayley R Nordstrom ◽  
Alina Iovleva ◽  
Niyati H Shah ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Enterococcus Faecalis ◽  
Medical Center ◽  
Genomic Diversity ◽  
Beta Lactam ◽  
University Of Pittsburgh ◽  
Need To Evaluate ◽  
The University ◽  
Sequence Types

Enterococcus faecalis is a leading cause of infective endocarditis (IE), especially among older patients with comorbidities. Here we investigated the genomic diversity and antimicrobial susceptibility of 33 contemporary E. faecalis isolates from definite or probable IE cases at the University of Pittsburgh Medical Center (UPMC) between 2018 and 2020. Isolates belonging to two multi-locus sequence types (STs), ST6 and ST179, were isolated from nearly 40% of IE patients. Both of these dominant STs carried known beta-lactam resistance-associated mutations affecting the low-affinity penicillin-binding protein 4 (PBP4). We assessed the ability of ampicillin and ceftriaxone (AC) both alone and in combination to inhibit genetically diverse E. faecalis IE isolates in checkerboard synergy assays and an in vitro one-compartment pharmacokinetic-pharmacodynamic (PK-PD) model of AC treatment. ST6 isolates as well as an isolate with a mutation in the PP2C-type protein phosphatase IreP had higher ceftriaxone MICs compared to other isolates, and showed diminished in vitro synergy of AC. Additionally, both ST6 and ST179 isolates exhibited regrowth after 48 hours of humanized exposures to AC. Overall, we found evidence for diminished in vitro AC activity among E. faecalis IE isolates with PBP4 and IreP mutations. This study highlights the need to evaluate alternate antibiotic combinations in clinical practice against diverse contemporary E. faecalis IE isolates.

scholarly journals Ampicillin Plus Ceftriaxone Regimen against Enterococcus faecalis Endocarditis: A Literature Review

2021 ◽  
Vol 10 (19) ◽  
pp. 4594
Author(s):  
Andrea Marino ◽  
Antonio Munafò ◽  
Aldo Zagami ◽  
Manuela Ceccarelli ◽  
Rosaria Di Mauro ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Clinical Settings ◽  
Drug Resistant ◽  
Efficacy And Safety ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Therapeutic Approaches ◽  
Resistant Strains ◽  
Changing Demographics ◽  
Drug Resistant Strains

Enterococcus faecalis infective endocarditis (EFIE) continues to represent a potentially fatal infectious disease characterized by elevated morbidity and mortality. Despite advances in antimicrobial therapy, changing demographics and the reduced availability of useful antibiotics combined with the dissemination of multi-drug resistant strains, the mortality rate remained unchanged in the last decades. Nowadays, optimizing the antibiotic regimen is still of paramount importance. Historically, aminoglycosides were considered as a cornerstone for treatment even though their use is associated with a high risk of kidney failure. It is against this background that, in recent years, several studies have been carried in order to assess the validity of alternative therapeutic approaches, including combinations of beta-lactams, that, acting synergistically, have yielded useful results in different clinical settings. In this scenario, we searched and critically report clinical studies assessing the efficacy and safety of double beta-lactam therapy in treating EFIE.

scholarly journals What does 16S rRNA gene-targeted next generation sequencing contribute to the study of infective endocarditis in valve tissue?

2021 ◽  
Author(s):  
Paula Santibáñez ◽  
Aránzazu Portillo ◽  
Sonia Santibáñez ◽  
Lara García-Álvarez ◽  
María de Toro ◽  
...  
Keyword(s):  
Next Generation Sequencing ◽  
Infective Endocarditis ◽  
16S Rrna ◽  
16S Rrna Gene ◽  
Heart Valves ◽  
Antimicrobial Treatment ◽  
Rrna Gene ◽  
Microbiological Diagnosis ◽  
Next Generation ◽  
Generation Sequencing

AbstractInfective endocarditis (IE) is a severe and life-threatening disease. Identification of infectious etiology is essential for establishing the appropriate antimicrobial treatment and decreasing mortality. The aim of this study was to explore potential utility of metagenomics for improving microbiological diagnosis of IE. In this work, next-generation sequencing (NGS) of V3-V4 region of the 16S rRNA gene was performed in 27 heart-valve tissues (18 natives, 5 intravascular devices, and 4 prosthetics) of patients diagnosed by IE. Initial microbiological diagnosis, blood culture (BC) and/or PCR, was compared with NGS-based diagnosis. Metagenomics matched with conventional techniques diagnosis in 24/27 cases (88.9%). The same bacterial family was assigned to 24 cases, the same genus to 23 cases, and the same specie for 13 cases. In 22 of them, the etiological agent was represented by percentages >99% of the reads and in two by ∼70%. Staphylococcus aureus was detected in a previously undiagnosed patient, making the microbiological diagnosis possible in one more sample than with previously used techniques. The remaining two patients showed no coincidence between traditional and NGS microbiological diagnoses. Minority records verified mixed infections in four cases and suggested confections in two cases, supported by clinical data. In conclusion: 16S rRNA gene-targeted NGS allowed to diagnose one case of IE without microbiological entity based on traditional techniques. However, the application of metagenomics to the study of IE in resected heart valves provides no benefits in comparison with BC and/or PCR. More studies are needed before implementation of NGS for the diagnosis of IE.

Bi-microbial Healthcare-Associate Endocarditis caused by Enterococcus faecalis and Burkholderia cepacia: A Case Report and literature review

2020 ◽  
Vol 02 ◽  
Author(s):  
Masood Ghori ◽  
Nadya O. Al Matrooshi ◽  
Samir Al Jabbari ◽  
Ahmed Bafadel ◽  
Gopal Bhatnagar
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Literature Review ◽  
Enterococcus Faecalis ◽  
Surgical Management ◽  
Burkholderia Cepacia ◽  
Clinical Presentation ◽  
Complicated Course ◽  
Healthcare Associated ◽  
Echocardiographic Findings

: Infective Endocarditis (IE), a known complication of hemodialysis (HD), has recently been categorized as Healthcare-Associated Infective Endocarditis (HAIE). Single pathogen bacteremia is common, polymicrobial endocardial infection is rare in this cohort of the patients. We report a case of endocarditis caused by Enterococcus faecalis (E. faecalis) and Burkholderia cepacia (B. cepacia), a first ever reported combination of a usual and an unusual organism, respectively, in a patient on HD. Clinical presentation of the patient, its complicated course ,medical and surgical management ,along with microbial and echocardiographic findings is presented herein. The authors believe that presentation of this case of HAIE may benefit and contribute positively to cardiac science owing to the rare encounter of this organism as a pathogen in infective endocarditis and the difficulties in treating it.

Review on the Clinical Pharmacology of Hydroxychloroquine Sulfate for the Treatment of COVID-19

2020 ◽  
Vol 21 (6) ◽  
pp. 427-435 ◽  
Author(s):  
Cheng Cui ◽  
Siqi Tu ◽  
Valerie Sia Jie En ◽  
Xiaobei Li ◽  
Xueting Yao ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Clinical Efficacy ◽  
Relevant Literature ◽  
The United States ◽  
Efficacy And Safety ◽  
Open Label ◽  
Infected People ◽  
Treatment Regimens ◽  
Therapeutic Drugs

Background: As the number of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infected people is greatly increasing worldwide, the international medical situation becomes very serious. Potential therapeutic drugs, vaccine and stem cell replacement methods are emerging, so it is urgent to find specific therapeutic drugs and the best treatment regimens. After the publications on hydroxychloroquine (HCQ) with anti- SARS-COV-2 activity in vitro, a small, non-randomized, open-label clinical trial showed that HCQ treatment was significantly associated with reduced viral load in patients with coronavirus disease-19 (COVID-19). Meanwhile, a large prophylaxis study of HCQ sulfate for COVID-19 has been initiated in the United States. HCQ offered a promising efficacy in the treatment of COVID-19, but the optimal administration is still being explored. Methods: We used the keyword "hydroxychloroquine" to conduct a literature search in PubMed to collect relevant literature on the mechanism of action of HCQ, its clinical efficacy and safety, pharmacokinetic characteristics, precautions for clinical use and drug interactions to extract and organize information. Results: This paper reviews the mechanism, clinical efficacy and safety, pharmacokinetic characteristics, exposureresponse relationship and precautions and drug interactions of HCQ, and summarizes dosage recommendations for HCQ sulfate. Conclusion: It has been proved that HCQ, which has an established safety profile, is effective against SARS-CoV-2 with sufficient pre-clinical rationale and evidence. Data from high-quality clinical trials are urgently needed worldwide.

scholarly journals Bacterial superinfections among persons with coronavirus disease 2019:A comprehensive review of data from postmortem studies

2021 ◽  
Author(s):  
Cornelius J Clancy ◽  
Ilan S Schwartz ◽  
Brittany Kula ◽  
M Hong Nguyen
Keyword(s):  
Rank Order ◽  
Diffuse Alveolar Damage ◽  
Antimicrobial Treatment ◽  
Beta Lactam ◽  
Quality Of Data ◽  
Major Objective ◽  
Postmortem Studies ◽  
Lung Infections ◽  
Histopathologic Findings

Abstract Background Limited clinical data suggest ~16% prevalence of bacterial superinfections among critically ill patients with coronavirus disease 2019 (COVID-19). Methods We reviewed postmortem studies of patients with COVID-19 published in English through 26 September 2020 for histopathologic findings consistent with bacterial lung infections. Results Worldwide, 621 patients from 75 studies were included. The quality of data was uneven, likely because identifying superinfections was not a major objective in 96% (72/75) of studies. Histopathology consistent with potential lung superinfection was reported in 32% (200/621) of patients (22-96 years old; 66% men). Types of infections were pneumonia (95%), abscesses or empyema (3.5%), and septic emboli (1.5%). Seventy-three percent of pneumonias were focal rather than diffuse. Predominant histopathologic findings were intra-alveolar neutrophilic infiltrations that were distinct from those typical of COVID-19-associated diffuse alveolar damage. In studies with available data, 79% of patients received antimicrobial treatment; most common agents were beta-lactam/beta-lactamase inhibitors (48%), macrolides (16%), cephalosoprins (12%), and carbapenems (6%). Superinfections were proven by direct visualization or recovery of bacteria in 25.5% (51/200) of potential cases, and 8% of all patients in postmortem studies. In rank order, pathogens included Acinetobacter baumannii, Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae. Lung superinfections were causes of death in 16% of potential cases, and 3% of all patients with COVID-19. Conclusions Potential bacterial lung superinfections were evident at postmortem examination in 32% of persons who died with COVID-19 (proven, 8%; possible, 24%), but they were uncommonly the cause of death.

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