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 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 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 Infective Endocarditis Related to Unusual Microorganisms: A Prospective Population-Based Study

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Silvia Limonta ◽  
Emmanuelle Cambau ◽  
Marie-Line Erpelding ◽  
Caroline Piau-Couapel ◽  
François Goehringer ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Heart Valve ◽  
Prosthetic Valve ◽  
Heart Valves ◽  
Population Based ◽  
Population Based Study ◽  
Molecular Microbiology ◽  
Cutibacterium Acnes ◽  
Vertebral Biopsy

Abstract Background Increased access to heart valves through early surgery and progress in molecular microbiology have reduced the proportion of infective endocarditis (IE) with no microbiological documentation and increased the proportion of IE associated with unusual microorganisms. Methods We performed an ancillary study of a large prospective population-based survey on IE. Unusual-microorganism IE was defined as definite IE (Duke-Li criteria) due to microorganisms other than streptococci, staphylococci, or enterococci. Results Of 471 cases of documented IE, 46 (9.8%) were due to unusal microorganisms; the following were involved in >1 case: Candida albicans (n = 4), Cutibacterium acnes (n = 4), Pseudomonas aeruginosa (n = 3), Cardiobacterium hominis (n = 3), and Coxiella burnetii (n = 2). Cases were documented with blood cultures (n = 37, 80.4%), heart valve polymerase chain reaction (PCR; n = 5), heart valve culture (n = 2), PCR on vertebral biopsy (n = 1), or serology (n = 1). As compared with IE due to staphylococci, streptococci, or enterococci (n = 420), IE due to unusual microorganisms occurred more frequently in patients with previously known heart disease (69.0% vs 44.3%; P = .002), prosthetic valve (40.5% vs 18.1%; P = .0006), longer duration of fever (mean, 35.1 ± 46.8 days vs 12.5 ± 17.8; P = .003), and who were more often nosocomial (38.1% vs 20.2%; P = .02). Conclusions In this population-based study, 9.8% of IE cases were due to unusual microorganisms, with a predominance of anaerobes, yeast, and gram-negative bacilli. As compared with IE related to staphylococci, streptococci, or enterococci, IE cases related to unusual microorganisms were associated with previously known heart disease, prosthetic valve, longer duration of fever, and nosocomial acquisition. Trial registration ORCID 0000-0003-3617-5411

scholarly journals Antimicrobial Activity of Prosthetic Heart Valve Sewing Cuffs Coated With Minocycline and Rifampin

2002 ◽  
Vol 46 (2) ◽  
pp. 543-545 ◽  
Author(s):  
Rabih O. Darouiche ◽  
Vance G. Fowler ◽  
Karim Adal ◽  
Marcia Kielhofner ◽  
David Mansouri ◽  
...  
Keyword(s):  
Antimicrobial Activity ◽  
Heart Valve ◽  
Staphylococcus Epidermidis ◽  
Prosthetic Valve ◽  
Prosthetic Heart Valve ◽  
Prosthetic Valve Endocarditis ◽  
Clinical Isolates ◽  
Zones Of Inhibition

ABSTRACT Prosthetic heart valve sewing cuffs coated with minocycline and rifampin exhibited in vitro zones of inhibition against all 52 tested clinical isolates responsible for prosthetic valve endocarditis. An in vitro elution study of these coated sewing cuffs demonstrated residual zones of inhibition against Staphylococcus epidermidis for at least 4 weeks.

99mTc-Labelled Anti NCA-95 Antibodies in Prosthetic Heart Valve Endocarditis

1991 ◽  
Vol 30 (04) ◽  
pp. 149-150 ◽  
Author(s):  
H.-J. Bair ◽  
H.-J. Volkholz ◽  
F. Wolf ◽  
W. Becker
Keyword(s):  
Mitral Valve ◽  
Heart Valve ◽  
Prosthetic Valve ◽  
Clinical Signs ◽  
Prosthetic Heart Valve ◽  
Prosthetic Valve Endocarditis ◽  
Aortic Valves ◽  
Radionuclide Uptake ◽  
Echocardiographic Findings

A 54-y old women with earlier replacement of the mitral and aortic valves and clinical signs of localized endocarditis was studied with 99mTc-labelled anti NCA-95 antibody. Whereas echocardiographic findings were negative, increased radionuclide uptake was observed left parasternal over the mitral valve as a sign of prosthetic valve endocarditis. This result could be confirmed by a similar study with leukocytes labelled in vitro with 111ln-oxine.

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.

Prosthetic valve endocarditis

ESC CardioMed ◽  
2018 ◽  
pp. 1720-1723
Author(s):  
José A. San Román ◽  
Javier López
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Antibiotic Treatment ◽  
Prosthetic Valve ◽  
Photon Emission ◽  
Clinical Manifestations ◽  
Prosthetic Valve Endocarditis ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Duke Criteria

Prosthetic valve endocarditis (PVE) complicates the clinical course of 1–6% of patients with prosthetic valves and it is one of the types of infective endocarditis with the worst prognosis. In early-onset PVE (that occurs within the first year after surgery), the microbiological profile is dominated by staphylococci. In late-onset PVE, the microorganisms are similar to native valve endocarditis. Clinical manifestations are very variable and depend on the causative microorganism. The diagnosis is established with the modified Duke criteria although they yield lower diagnostic accuracy than in native valve endocarditis. Transoesophageal echocardiography is the main imaging technique in everyday clinical practice in PVE as the sensitivity is higher than transthoracic echocardiography. The findings of other techniques, as cardiac computed tomography (CT), positron emission tomography/CT, or single-photon emission computed tomography/CT have been recently recognized as new major diagnostic criteria and can be very useful in cases with a high level of clinical suspicion and negative echocardiography. Empirical antibiotic treatment should cover the most frequent microorganisms, especially staphylococci. Once the microbiological diagnosis is made, the antibiotic treatment is similar to native valve infective endocarditis, except for the addition of rifampicin in staphylococcal PVE and a longer length (up to 6 weeks) of the treatment. Surgical indications are also similar to native valve endocarditis, heart failure being the most common and embolic prevention the most debatable. Prognosis is bad, and during the follow-up, a team experienced with endocarditis is needed. Patients with a history of PVE should receive antibiotic prophylaxis if they undergo invasive dental manipulations.

scholarly journals Hemodynamic Performance of Dysfunctional Prosthetic Heart Valve with the Concomitant Presence of Subaortic Stenosis: In Silico Study

2020 ◽  
Vol 7 (3) ◽  
pp. 90
Author(s):  
Othman Smadi ◽  
Anas Abdelkarim ◽  
Samer Awad ◽  
Thakir D. Almomani
Keyword(s):  
Early Detection ◽  
Heart Valve ◽  
Heart Valves ◽  
Cfd Simulation ◽  
Treatment Plan ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Subaortic Stenosis ◽  
Prosthetic Heart Valves ◽  
The Impact

The prosthetic heart valve is vulnerable to dysfunction after surgery, thus a frequent assessment is required. Doppler electrocardiography and its quantitative parameters are commonly used to assess the performance of the prosthetic heart valves and provide detailed information on the interaction between the heart chambers and related prosthetic valves, allowing early detection of complications. However, in the case of the presence of subaortic stenosis, the accuracy of Doppler has not been fully investigated in previous studies and guidelines. Therefore, it is important to evaluate the accuracy of the parameters in such cases to get early detection, and a proper treatment plan for the patient, at the right time. In the current study, a CFD simulation was performed for the blood flow through a Bileaflet Mechanical Heart Valve (BMHV) with concomitant obstruction in the Left Ventricle Outflow Tract (LVOT). The current study explores the impact of the presence of the subaortic on flow patterns. It also investigates the accuracy of (BMHV) evaluation using Doppler parameters, as proposed in the American Society of Echocardiography (ASE) guidelines.

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