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 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 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.

scholarly journals Relationship between Glycopeptide Production and Resistance in the Actinomycete Nonomuraea sp. ATCC 39727

2014 ◽  
Vol 58 (9) ◽  
pp. 5191-5201 ◽  
Author(s):  
Giorgia Letizia Marcone ◽  
Elisa Binda ◽  
Lucia Carrano ◽  
Mervyn Bibb ◽  
Flavia Marinelli
Keyword(s):  
Antibiotic Resistance ◽  
Gene Dosage ◽  
Antibiotic Production ◽  
Resistance Mechanism ◽  
Biosynthetic Gene Cluster ◽  
Penicillin G ◽  
Glycopeptide Resistance ◽  
Content Type ◽  
High Level

ABSTRACTGlycopeptides and β-lactams inhibit bacterial peptidoglycan synthesis in Gram-positive bacteria; resistance to these antibiotics is studied intensively in enterococci and staphylococci because of their relevance to infectious disease. Much less is known about antibiotic resistance in glycopeptide-producing actinomycetes that are likely to represent the evolutionary source of resistance determinants found in bacterial pathogens.Nonomuraeasp. ATCC 39727, the producer of A40926 (the precursor for the semisynthetic dalbavancin), does not harbor the canonicalvanHAXgenes. Consequently, we investigated the role of the β-lactam-sensitived,d-peptidase/d,d-carboxypeptidase encoded byvanYn, the onlyvan-like gene found in the A40926 biosynthetic gene cluster, in conferring immunity to the antibiotic inNonomuraeasp. ATCC 39727. Taking advantage of the tools developed recently to genetically manipulate this uncommon actinomycete, we variedvanYngene dosage and expressedvanHatAatXatfrom the teicoplanin producerActinoplanes teichomyceticusinNonomuraeasp. ATCC 39727. Knocking outvanYn, complementing avanYnmutant, or duplicatingvanYnhad no effect on growth but influenced antibiotic resistance and, in the cases of complementation and duplication, antibiotic production.Nonomuraeasp. ATCC 39727 was found to be resistant to penicillins, but its glycopeptide resistance was diminished in the presence of penicillin G, which inhibits VanYnactivity. The heterologous expression ofvanHatAatXatincreased A40926 resistance inNonomuraeasp. ATCC 39727 but did not increase antibiotic production, indicating that the level of antibiotic production is not directly determined by the level of resistance. ThevanYn-based self-resistance inNonomuraeasp. ATCC 39727 resembles the glycopeptide resistance mechanism described recently in mutants ofEnterococcus faeciumselectedin vitrofor high-level resistance to glycopeptides and penicillins.

scholarly journals Antibiotic resistance pattern of Bacteroides fragilis isolated from clinical and colorectal specimens

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Seyedesomaye Jasemi ◽  
Mohammad Emaneini ◽  
Zahra Ahmadinejad ◽  
Mohammad Sadegh Fazeli ◽  
Leonardo A. Sechi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Active Agent ◽  
Bacteroides Fragilis ◽  
Penicillin G ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Dilution Method ◽  
Agar Dilution Method ◽  
Antibiotic Resistance Pattern

Abstract Background Bacteroides fragilis is a part of the normal gastrointestinal flora, but it is also the most common anaerobic bacteria causing the infection. It is highly resistant to antibiotics and contains abundant antibiotic resistance mechanisms. Methods The antibiotic resistance pattern of 78 isolates of B. fragilis (22 strains from clinical samples and 56 strains from the colorectal tissue) was investigated using agar dilution method. The gene encoding Bacteroides fargilis toxin bft, and antibiotic resistance genes were targeted by PCR assay. Results The highest rate of resistance was observed for penicillin G (100%) followed by tetracycline (74.4%), clindamycin (41%) and cefoxitin (38.5%). Only a single isolate showed resistance to imipenem which contained cfiA and IS1186 genes. All isolates were susceptible to metronidazole. Accordingly, tetQ (87.2%), cepA (73.1%) and ermF (64.1%) were the most abundant antibiotic-resistant genes identified in this study. MIC values for penicillin, cefoxitin and clindamycin were significantly different among isolates with the cepA, cfxA and ermF in compare with those lacking such genes. In addition, 22.7 and 17.8% of clinical and GIT isolates had the bft gene, respectively. Conclusions The finding of this study shows that metronidazole is highly in vitro active agent against all of B. fragilis isolates and remain the first-line antimicrobial for empirical therapy.

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.

Homograft versus Conventional Prosthesis for Surgical Management of Aortic Valve Infective Endocarditis

2018 ◽  
Vol 13 (3) ◽  
pp. 163-170 ◽  
Author(s):  
Bobby Yanagawa ◽  
Amine Mazine ◽  
Derrick Y. Tam ◽  
Peter Jüni ◽  
Deepak L. Bhatt ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Surgical Management ◽  
Meta Analysis ◽  
Prosthetic Valve Endocarditis ◽  
Prosthetic Valves ◽  
Mechanical Valves ◽  
All Cause Mortality ◽  
Mortality Incidence ◽  
Similar Survival

Objective Surgical management of aortic valve infective endocarditis (IE) with cryopreserved homograft has been associated with lower risk of recurrent IE, but there is equipoise with regard to the optimal prosthesis. This systematic review and meta-analysis were performed to compare outcomes between homograft and conventional prosthesis for aortic valve IE. Methods We searched MEDLINE database to September 2017 for studies comparing homograft versus conventional prosthesis. The main outcomes were all-cause mortality, recurrent IE, and reoperation. Results There were 18 included comparative observational studies with 2232 patients (median follow up = 5 [interquartile range: 2–7] years, 30% prosthetic valve endocarditis); four studies were adjusted for baseline differences. There were no differences in perioperative mortality or stroke despite a greater proportion of staphylococcal endocarditis, abscess, and root replacements but less multivalve involvement in the homograft group. Long-term outcomes of all-cause mortality [incidence rate ratio (IRR) = 1.03, 95% confidence interval (CI) = 0.81–1.31, P = 0.83, for unmatched, and IRR = 0.82, 95% CI = 0.36–1.84, P = 0.63, for matched studies], recurrent endocarditis (IRR = 1.01, 95% CI = 0.53–1.93, P = 0.96, for unmatched, and IRR = 1.04, 95% CI = 0.49–2.19, P = 0.92, for matched studies), and reoperation (IRR = 1.60, 95% CI = 0.80–3.21, P = 0.18, for unmatched, and IRR = 3.17, 95% CI = 0.52–19.44, P = 0.21, for matched studies) were not different comparing homograft versus conventional prosthesis. There was a significantly increased need for reoperation with homograft versus mechanical prosthetic valves, but this comparison was based on limited data. Conclusions Homografts and conventional prostheses offer similar survival and freedom from recurrent endocarditis and reoperation for aortic valve IE. Homografts may be associated with greater risk of reoperation compared with mechanical valves.

Pharmacokinetic Drug-drug Interaction of Antibiotics Used in Sepsis Care in China

2020 ◽  
Vol 21 ◽  
Author(s):  
Xuan Yu ◽  
Zixuan Chu ◽  
Jian Li ◽  
Rongrong He ◽  
Yaya Wang ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Penicillin G ◽  
Literature Mining ◽  
Human Pharmacokinetics ◽  
P450 Enzyme ◽  
Drug Drug Interaction ◽  
Pharmacokinetic Drug ◽  
Sepsis Care

Background: Many antibiotics have a high potential for having an interaction with drugs, as perpetrator and/or victim, in critically ill patients, and particularly in sepsis patients. Methods: The aim of this review is to summarize the pharmacokinetic drug-drug interaction (DDI) of 45 antibiotics commonly used in sepsis care in China. Literature mining was conducted to obtain human pharmacokinetics/dispositions of the antibiotics, their interactions with drug metabolizing enzymes or transporters, and their associated clinical drug interactions. Potential DDI is indicated by a DDI index > 0.1 for inhibition or a treated-cell/untreated-cell ratio of enzyme activity being > 2 for induction. Results: The literature-mined information on human pharmacokinetics of the identified antibiotics and their potential drug interactions is summarized. Conclusion: Antibiotic-perpetrated drug interactions, involving P450 enzyme inhibition, have been reported for four lipophilic antibacterials (ciprofloxacin, erythromycin, trimethoprim, and trimethoprim-sulfamethoxazole) and three lipophilic antifungals (fluconazole, itraconazole, and voriconazole). In addition, seven hydrophilic antibacterials (ceftriaxone, cefamandole, piperacillin, penicillin G, amikacin, metronidazole, and linezolid) inhibit drug transporters in vitro. Despite no reported clinical PK drug interactions with the transporters, caution is advised in the use of these antibacterials. Eight hydrophilic antibacterials (all β-lactams; meropenem, cefotaxime, cefazolin, piperacillin, ticarcillin, penicillin G, ampicillin, and flucloxacillin), are potential victims of drug interactions due to transporter inhibition. Rifampin is reported to perpetrate drug interactions by inducing CYP3A or inhibiting OATP1B; it is also reported to be a victim of drug interactions, due to the dual inhibition of CYP3A4 and OATP1B by indinavir. In addition, three antifungals (caspofungin, itraconazole, and voriconazole) are reported to be victims of drug interactions because of P450 enzyme induction. Reports for other antibiotics acting as victims in drug interactions are scarce.

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.

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