scholarly journals Streptobacillus moniliformis mitral valve endocarditis and septic arthritis: the challenges of diagnosing rat-bite fever endocarditis

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Daisy Torres-Miranda ◽  
Madhi Moshgriz ◽  
Marc Siegel
Keyword(s):  
United States ◽  
Mitral Valve ◽  
Blood Culture ◽  
The United States ◽  
Blood Cultures ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Streptobacillus Moniliformis ◽  
Rat Bite Fever ◽  
Mitral Valve Vegetation

Streptobacillus moniliformis, the cause of rat-bite fever (RBF) in the United States, has rarely been reported as a cause of infectious endocarditis. In the majority of previously reported cases, the diagnosis was clinically based in patients with underlying valvular abnormalities in the setting of positive blood culture for Streptobacillus moniliformis. We report a case of native valve endocarditis secondary to Streptobacillus moniliformis in a woman with a mitral valve vegetation but negative blood cultures where the diagnosis was established using molecular diagnostics on the valvular tissue.

scholarly journals Native valve endocarditis withStaphylococcus warneri

2019 ◽  
Vol 12 (6) ◽  
pp. e229546 ◽  
Author(s):  
Rodica Diaconu ◽  
Elvira Golumbeanu ◽  
Anca Constantin ◽  
Ionut Donoiu
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Heart Disease ◽  
Mitral Valve ◽  
Valvular Heart Disease ◽  
Rare Case ◽  
Blood Cultures ◽  
Invasive Treatment ◽  
Native Valve ◽  
Native Valve Endocarditis

We report a rare case of native valve endocarditis caused byStaphylococcus warneriin an immunocompetent 79-year-old man with known degenerative valvular heart disease but no previous risk factors such as recent invasive treatment or medical implant. The patient presented with heart failure, due to perforation of the mitral valve, and lacked any signs of infection. The diagnosis of endocarditis withS. warneriwas established by echocardiography and positive blood cultures.

scholarly journals Emergence of high rates of antimicrobial resistance among viridans group streptococci in the United States.

1996 ◽  
Vol 40 (4) ◽  
pp. 891-894 ◽  
Author(s):  
G V Doern ◽  
M J Ferraro ◽  
A B Brueggemann ◽  
K L Ruoff
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Rank Order ◽  
The United States ◽  
Medical Centers ◽  
Streptococcus Milleri ◽  
Intermediate Resistance ◽  
High Level ◽  
Viridans Group Streptococci

Three hundred fifty-two blood culture isolates of viridans group streptococci obtained from 43 U.S. medical centers during 1993 and 1994 were characterized. Included were 48 isolates of "Streptococcus milleri," 219 S. mitis isolates, 29 S. salivarius isolates, and 56 S. sanguis isolates. High-level penicillin resistance (MIC, > or = 4.0 micrograms/ml) was noted among 13.4% of the strains; for 42.9% of the strains, penicillin MICs were 0.25 to 2.0 micrograms/ml (i.e., intermediate resistance). In general, amoxicillin was slightly more active than penicillin. The rank order of activity for five cephalosporins versus viridans group streptococci was cefpodoxime = ceftriaxone > cefprozil = cefuroxime > cephalexin. The percentages of isolates resistant (MIC, > or = 2 micrograms/ml) to these agents were 15, 17, 18, 20, and 96, respectively. The rates of resistance to erythromycin, tetracycline, and trimethoprim-sulfamethoxazole were 12 to 38%. Resistance to either chloramphenicol or ofloxacin was uncommon (i.e., < 1%). In general, among the four species, S. mitis was the most resistant and "S. milleri" was the most susceptible.

scholarly journals 847. The Effect of Antimicrobial Administration on Blood Culture Positivity in Patients with Severe Manifestations of Sepsis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S15-S16
Author(s):  
Matthew P Cheng ◽  
Robert Stenstrom ◽  
Katryn Paquette ◽  
Sarah Stabler ◽  
Murtaza Akhter ◽  
...  
Keyword(s):  
Blood Culture ◽  
Antimicrobial Therapy ◽  
Diagnostic Yield ◽  
The United States ◽  
Blood Cultures ◽  
Microbial Pathogens ◽  
Absolute Difference ◽  
Recovery Rates ◽  
Pathogen Recovery ◽  
Antimicrobial Administration

Abstract Background Current guidelines recommend obtaining blood cultures prior to antimicrobial therapy in patients with sepsis. Administering antimicrobials immediately without waiting for blood cultures could potentially decrease time to treatment and improve outcomes, but it is unclear the degree to which this strategy impacts diagnostic yield. Methods We performed a patient-level, single-arm, diagnostic trial. Seven urban emergency departments affiliated with academic medical centers across Canada and the United States participated in the study. Adults ≥18 years of age presenting to the emergency department with evidence of severe manifestations of sepsis, including a systolic blood pressure <90 mmHg and/or a serum lactate ≥4 mmol/L were included. Study participants had 2 sets of blood cultures drawn prior to and immediately following antimicrobial administration. The primary outcome was the difference in blood culture pathogen recovery rates before and after administration of antimicrobial therapy. Results Of the 3,164 participants screened, 325 were included in the study (mean age, 65.6 years; 63.0% men) and had repeat blood cultures drawn after the initiation of antimicrobial therapy (median time of 70 minutes, IQR 50 to 110 minutes). Pre-antimicrobial blood cultures were positive for one or more microbial pathogens in 102/325 (31.4%) patients. Fifty-four participants (52.9%) had matching blood culture results after initiation of antimicrobial treatment. The absolute difference in pathogen recovery rates was 14.5% ([95% CI 8.0 to 21.0%]; P < 0.0001) between pre- and post-antimicrobial blood cultures. Results were consistent in an analysis of the per-protocol population (absolute difference, 13.3% [95% CI 6.1 to 20.4%]; P < 0.0001). Including the results of other microbiological cultures done as part of routine care, microbial pathogens were recovered in 69 of 102 (67.7%) participants (absolute difference, 10.2% [95% CI 3.4 to 16.8%]; P < 0.0001). Conclusion Among patients with severe manifestations of sepsis, the administration of empiric antimicrobial therapy significantly reduces the yield of pathogen recovery when blood cultures are drawn shortly after treatment initiation. Disclosures All Authors: No reported Disclosures.

Early vs late cardiac surgery in patients with native valve endocarditis—United States Nationwide Inpatient database

2020 ◽  
Vol 35 (10) ◽  
pp. 2611-2617
Author(s):  
Omar Kousa ◽  
Ryan W. Walters ◽  
Mohammed Saleh ◽  
Dana Awad ◽  
Abdallah Qasim ◽  
...  
Keyword(s):  
United States ◽  
Cardiac Surgery ◽  
Native Valve ◽  
Native Valve Endocarditis ◽  
Inpatient Database

scholarly journals Patient and Hospital Characteristics of Mitral Valve Surgery in the United States

2019 ◽  
Vol 4 (11) ◽  
pp. 1149 ◽  
Author(s):  
Sreekanth Vemulapalli ◽  
Maria Grau-Sepulveda ◽  
Robert Habib ◽  
Vinod Thourani ◽  
Joseph Bavaria ◽  
...  
Keyword(s):  
United States ◽  
Mitral Valve ◽  
The United States ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Hospital Characteristics

Rat-Bite Fever: Updated Recommendations For Culture And Isolation Of Streptobacillus Moniliformis Using An Automated Continuous Blood Culture Instrument In A Clinical Setting

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S132-S132
Author(s):  
A M Szewc ◽  
M E Bell ◽  
A J Kelly ◽  
J R McQuiston
Keyword(s):  
Blood Culture ◽  
Blood Volume ◽  
Clinical Setting ◽  
Culture System ◽  
Culture Media ◽  
Culture Bottle ◽  
Blood Culture System ◽  
Streptobacillus Moniliformis ◽  
Rat Bite Fever ◽  
Time Required

Abstract Introduction/Objective Rat-bite fever and Haverhill fever are difficult to diagnose in a clinical setting due mostly to clinicians and laboratory professionals being unable to culture the causative agent-Streptobacillus moniliformis. SPS in blood culture bottles has historically been implicated as the complicating factor. Methods Utilizing the BDFX40 automated continuous blood culture bottle system and novel quantitative PCR data, we present how blood volume is critical in order to consistently detect, isolate and grow the organism in the presence of SPS using modern laboratory instrumentation in a clinical setting. Results We demonstrate here that 10ml of blood was determined to provide optimal results for detection and growth of S. moniliformis in 0.05% SPS. For all isolates tested, 100% (n=56) were detected or alerted as positive by the instrument, with the longest time required for detection being 102 hours (n=1) and the fastest time to detection being recorded at 13.4 hours. (n=1) with an average time of 26.5 hours (n=56). Conclusion During the course of this study, we determined that blood inoculum volume played a significant role in organism growth and detection. We found that in 100% of the isolates tested (and all the variations of testing within), SPS (up to a concentration of 0.05% w/v) in blood culture media appeared to be counteracted, allowing for the growth detection and culturing of S. moniliformis using an automated continuous blood culture system when 10ml of blood was used as an inoculum. This is the first study to report and suggest that a specific blood volume is critical when utilizing a closed commercial blood culture system to detect S. moniliformis, this research is the largest study of Streptobacillus moniliformis isolates to date.

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