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Kawase K, Okamoto K, Harada S, Nomura Y, Shimada S, Komae H, Kuroda R, Ideyama M, Soma K, Mizoguchi M, Higurashi Y, Ukai K, Adachi-Katayama M, Miwa T, Wakimoto Y, Oyabu T, Jubishi D, Hashimoto H, Okugawa S, Ono M, Doi K, Ushiku T, Tsutsumi T. A case of hypervirulent K1-ST23 Klebsiella pneumoniae endocarditis and papillary muscle rupture secondary to multiple site abscesses. J Infect Chemother 2024; 30:154-158. [PMID: 37776972 DOI: 10.1016/j.jiac.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/15/2023] [Accepted: 09/26/2023] [Indexed: 10/02/2023]
Abstract
Hypervirulent Klebsiella pneumoniae (hvKP) causes multisite infections and abscesses. However, endocarditis is a rare presentation of hvKP infection. Herein, we report a case of K. pneumoniae native valve infective endocarditis secondary to community-acquired liver and prostate abscesses. The patient developed papillary muscle rupture, leading to mitral regurgitation, and underwent emergent mitral valve replacement. The diagnosis of endocarditis was confirmed microbiologically and histologically. The causative strain belonged to the hypermucoid K1 capsular genotype and possessed the rmpA gene. The genome sequence was deposited in GenBank under the accession number JAQZBZ000000000.
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Affiliation(s)
- Kyotaro Kawase
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan.
| | - Sohei Harada
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Yusuke Nomura
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Shogo Shimada
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Hyoe Komae
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryohei Kuroda
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Mana Ideyama
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Katsura Soma
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Miyuki Mizoguchi
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Yoshimi Higurashi
- Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
| | - Kohei Ukai
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Maho Adachi-Katayama
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshiki Miwa
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuji Wakimoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Tatsunori Oyabu
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Daisuke Jubishi
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Hideki Hashimoto
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Shu Okugawa
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Minoru Ono
- Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Takeya Tsutsumi
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan; Department of Infection Control and Prevention, University of Tokyo Hospital, Tokyo, Japan
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2
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Sebillotte M, Boutoille D, Declerck C, Talarmin JP, Lemaignen A, Piau C, Revest M, Tattevin P, Gousseff M. Non-HACEK gram-negative bacilli endocarditis: a multicentre retrospective case-control study. Infect Dis (Lond) 2023; 55:599-606. [PMID: 37353977 DOI: 10.1080/23744235.2023.2226212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) caused by non-HACEK gram-negative bacilli (GNB) is poorly characterised and may be emerging as a consequence of medical progress. METHODS We performed an observational retrospective case-control study. Cases were non-HACEK GNB IE, definite or possible (modified Duke criteria), diagnosed in adults between 2007 and 2020 in six French referral hospitals. Two controls were included for each case (IE due to other bacteria, matched by sites and diagnosis date). RESULTS Non-HACEK GNB were identified in 2.4% (77/3230) of all IE during the study period, with a mean age of 69.2 ± 14.6 years, and a large male predominance (53/77, 69%). Primary pathogens were Escherichia coli (n = 33), Klebsiella sp. (n = 12) and Serratia marcescens (n = 9), including eight (10%) multidrug-resistant GNB. Compared to controls (n = 154: 43% Streptococcus sp., 41% Staphylococcus sp. and 12% Enterococcus sp.), non-HACEK GNB IE were independently associated with intravenous drug use (IVDU, 8% vs. 2%, p = .003), active neoplasia (15% vs. 6%, p = .009), haemodialysis (9% vs. 3%, p = .007) and healthcare-associated IE (36% vs. 18%, p = .002). Urinary tract was the main source of infection (n = 25, 33%) and recent invasive procedures were reported in 29% of cases. Non-HACEK GNB IE were at lower risk of embolism (31% vs. 47%, p = .002). One-year mortality was high (n = 28, 36%). Comorbidities, particularly malignant hemopathy and cirrhosis, were associated with increased risk of death. CONCLUSIONS Non-HACEK GNB are rarely responsible for IE, mostly as healthcare-associated IE in patients with complex comorbidities (end-stage renal disease, neoplasia), or in IVDUs.
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Affiliation(s)
- Marine Sebillotte
- Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - David Boutoille
- Maladies Infectieuses, CIC 1413 INSERM, Hôtel Dieu, Centre Hospitalier Universitaire, Nantes, Nantes, France
| | - Charles Declerck
- Maladies Infectieuses, Hôpital Larrey, Centre Hospitalier Universitaire, Angers, Angers, France
| | | | - Adrien Lemaignen
- Maladies Infectieuses, EA 7505 Education-Ethics-Health, Hôpital Bretonneau, Centre Hospitalier Universitaire, Tours, Tours, France
| | - Caroline Piau
- Bactériologie, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - Matthieu Revest
- Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - Pierre Tattevin
- Maladies infectieuses et Réanimation médicale, Hôpital Pontchailllou, Centre Hospitalier Universitaire, Rennes, Rennes, France
| | - Marie Gousseff
- Maladies infectieuses, Centre Hospitalier Bretagne-Atlantique, Vannes, France
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3
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de Sousa LP, Fortes CQ, Damasco PV, Barbosa GIF, Golebiovski WF, Weksler C, Garrido RQ, Siciliano RF, Lamas CDC. Infective Endocarditis due to Non-HACEK Gram-Negative Bacilli: Clinical Characteristics and Risk Factors from a Prospective Multicenter Brazilian Cohort. Trop Med Infect Dis 2023; 8:tropicalmed8050283. [PMID: 37235331 DOI: 10.3390/tropicalmed8050283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Background: Non-HACEK Gram-negative bacilli (NGNB) infective endocarditis (IE) has a growing frequency. We aimed to describe cases of NGNB IE and find associated risk factors. Methods: We conducted a prospective observational study of consecutive patients with definitive IE according to the modified Duke criteria in four institutions in Brazil. Results: Of 1154 adult patients enrolled, 38 (3.29%) had IE due to NGNB. Median age was 57 years, males predominated, accounting for 25/38 (65.8%). Most common etiologies were Pseudomonas aeruginosa and Klebsiella spp. (8 episodes, 21% each). Worsening heart failure occurred in 18/38 (47.4%). Higher prevalence of embolic events was found (55,3%), mostly to the central nervous system 7/38 (18.4%). Vegetations were most commonly on aortic valves 17/38 (44.7%). Recent healthcare exposure was found in 52.6% and a central venous catheter (CVC) in 13/38 (34.2%). Overall mortality was 19/38 (50%). Indwelling CVC (OR 5.93; 95% CI, 1.29 to 27.3; p = 0.017), hemodialysis (OR 16.2; 95% CI, 1.78 to 147; p = 0.008) and chronic kidney disease (OR 4.8; 95% IC, 1.2 to 19.1, p = 0.049) were identified as risk factors for mortality. Conclusions: The rate of IE due to NGNB was similar to that in previous studies. Enterobacterales and P. aeruginosa were the most common etiologies. NGNB IE was associated with central venous catheters, prosthetic valves, intracardiac devices and hemodialysis and had a high mortality rate.
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Affiliation(s)
- Leonardo Paiva de Sousa
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
| | - Cláudio Querido Fortes
- Serviço de Doenças Infecciosas e Parasitárias, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro 21941-901, Brazil
| | - Paulo Vieira Damasco
- Serviço de Doenças Infecciosas e Parasitárias, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Brazil
- Departamento de Doenças Infecciosas, Universidade Federal do Estado do Rio de Janeiro (Unirio), Rio de Janeiro 20270-004, Brazil
| | - Giovanna Ianini Ferraiuoli Barbosa
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil
- Serviço de Doenças Infecciosas e Parasitárias, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Brazil
| | | | - Clara Weksler
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil
| | | | | | - Cristiane da Cruz Lamas
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro 21040-900, Brazil
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4
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Peralta DP, Chang AY. Escherichia coli: A Rare Cause of Prosthetic Valve Endocarditis. Cureus 2023; 15:e38402. [PMID: 37265906 PMCID: PMC10231899 DOI: 10.7759/cureus.38402] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 06/03/2023] Open
Abstract
Prosthetic valve endocarditis (PVE) is a complication of valve replacement associated with high morbidity and mortality. Escherichia coli (E. coli) is rarely associated with infective endocarditis (IE), accounting for less than 1% of the cases reported. The low frequency is attributed to the organism's low affinity to adhere to the endocardial endothelium. Risk factors that may play a role in developing IE by E. coli include age above 70, diabetes mellitus, a genitourinary source of infection, female sex, healthcare contact, implanted endovascular devices, and immunosuppression. We present a 70-year-old Hispanic woman who arrived with constitutional symptoms and persistent urinary complaints. She had diabetes mellitus, recurrent urinary tract infections, and native mitral valve IE treated with antibiotic therapy and tissue valve replacement. The valve was replaced with a mechanical valve a second time due to malfunctioning. The patient was found to have E. coli bacteremia and ultimately diagnosed with PVE. She was treated solely with ceftriaxone and gentamicin combination therapy resulting in complete resolution of valve vegetations. Our case represents the 11th report of this uncommon disease and illustrates its epidemiology and associated risk factors. We summarize the previous 10 cases reported and highlight the lack of prospective trial data to define optimal therapy for managing PVE caused by E. coli.
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Affiliation(s)
- Diego P Peralta
- Division of Infectious Diseases, Texas Tech University Health Sciences Center, El Paso, USA
| | - Aymara Y Chang
- Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA
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5
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Abstract
PURPOSE OF REVIEW Gram-negative bacilli (GNB) cause between 1% and 10% of infective endocarditis (IE). Most episodes are caused by microorganisms of the Haemophilus spp., Aggregatibacter spp. Cardiobacterium spp., Eikenella spp., and Kingella spp (HACEK) group. The frequency of IE caused by non-HACEK (GNB-IE) has increased in recent years. Uncertainties persist regarding its best medical treatment and the appropriateness and timing of surgical treatment. In addition, there are new drugs with activity against multiresistant microorganisms, of which there is little experience in this disease. We review this topic by answering the most frequently asked questions that arise among our colleagues. RECENT FINDINGS HACEK microorganisms cause 1.5-2% of IE with only a 2% mortality. In contrast, non-HACEK GNB-IE accounts for 2.5-3% of all IE cases and is associated with nosocomial acquisition, advanced age, solid organ transplantation and 20-30% mortality. Drug addiction is important in areas with epidemic opioid abuse. SUMMARY The frequency of IE caused by GNB has been modified in recent years. HACEK episodes are no longer treated with ampicillin and aminoglycosides. In non-HACEK GNB-IE, combination therapy with a beta-lactam and a quinolone or aminoglycoside is recommended. The surgical indication and its value are evident in many patients. Management should rely on a collaborative group with experience in this disease.
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6
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Calderón Parra J, De Castro-Campos D, Muñoz García P, Olmedo Samperio M, Marín Arriaza M, De Alarcón A, Gutierrez-Carretero E, Fariñas Alvarez MC, Miró Meda JM, Goneaga Sanchez MÁ, Rodriguez García R, Ojeda Burgos G, Valcarce-Gonzalez Z, Ramos-Martinez A. Non-HACEK gram negative bacilli endocarditis: Analysis of a national prospective cohort. Eur J Intern Med 2021; 92:71-78. [PMID: 33980395 DOI: 10.1016/j.ejim.2021.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Infective endocarditis (IE) due to non-HACEK bacilli (Haemophilus species, Actinobacillus, Cardiobacterium, Eikenella, or Kingella) is uncommon and poorly described. The objectives of this study were to describe non-HACEK Gram-Negative Bacilli (GNB) IE cases and compare characteristic of IE produced by Enterobacterales and non-fermenting (NF) GNB. METHODS From January 2008 to December 2018, 3910 consecutive patients with definitive IE diagnosis, defined with Modified Duke criteria, either clinical or pathological criteria (e.g. demonstration of non-HACEK GNB in valve culture)were prospectively included. RESULTS A total of 104 IE cases were caused by non-HACEK GNB (2.6%). Compared to IE due to other microorganisms (excluding HACEK GNB), patients with non-HACEK GNB IE presented with higher age (71 years [IQR 62-78] vs 68 years [IQR: 57-77]; p = 0.026), higher proportion of women (52% vs 31.5%, p < 0.001), higher Charlson Index (5 [IQR: 4-8] vs 4 [IQR 3-7], p = 0.003) and higher in-hospital mortality (36.5% vs 27.1%, p = 0.034). Enterobacterales cases were more frequently associated with genitourinary focus (32.8% vs 5.0%, p = 0.001). NFGNB endocarditis more frequently affected right valves (20.0% vs. 6.3%, p = 0.033), had more common healthcare-related acquisition (67.5% vs. 43.7%, p = 0.030) and venous catheter as focus (40.0% vs. 17.2%, p = 0.019). In the multivariant model, factors related with hospital mortality were: age (OR 1.05, 95%CI 1.00-1.09, p = 0.042), prosthetic valve (OR 2.31, 95%CI 0.90-5.88, p = 0.080), and not performing surgery when indicated (OR 3.60, 95%CI 1.17-11.05, p = 0.025).Patients treated with quinolone combination had lower mortality (OR 0.29; 95%CI 0.09-0.96; p = 0.043). CONCLUSION Non-HACEK GNB IE is a rare infection characterized by affecting elderly patients with high comorbidity, nosocomial acquisition and unfavorable outcome. Age, prosthetic valve and not performing surgery when indicated are associated with mortality.
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Affiliation(s)
- Jorge Calderón Parra
- Infectious Diseases Unit, Internal Medicine Department, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - Patricia Muñoz García
- Clinical Microbiology and Infectious Diseases Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Maria Olmedo Samperio
- Clinical Microbiology and Infectious Diseases Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Mercedes Marín Arriaza
- Clinical Microbiology and Infectious Diseases Department, Hospital Gregorio Marañón, Madrid, Spain
| | - Aristides De Alarcón
- Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | | | - Guillermo Ojeda Burgos
- Infectious Diseases, Microbiology and Preventive Medicine Unit, Hospital Virgen de la Victoria, Malaga, Spain
| | | | - Antonio Ramos-Martinez
- Infectious Diseases Unit, Internal Medicine Department, Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
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7
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Serrano R, Rello J. New insights in endocarditis caused by Gram negative bacilli not included in the HACEK group. Eur J Intern Med 2021; 92:36-37. [PMID: 34503887 DOI: 10.1016/j.ejim.2021.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Ricardo Serrano
- Critical Care Department, Hospital de Hellín, Gerencia Atención Integrada de Hellín, Albacete, Spain.
| | - Jordi Rello
- Vall d'Hebron Institute of Research, Barcelona, Spain; Clinical Research, CHRU Nîmes, France
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8
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Lorenz A, Sobhanie MME, Orzel L, Coe K, Wardlow L. Clinical outcomes of combination versus monotherapy for gram negative non-HACEK infective endocarditis. Diagn Microbiol Infect Dis 2021; 101:115504. [PMID: 34375862 DOI: 10.1016/j.diagmicrobio.2021.115504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/07/2021] [Accepted: 07/18/2021] [Indexed: 11/18/2022]
Abstract
The objective of this single-center, retrospective cohort study was to identify whether combination therapy is associated with a lower rate of adverse outcomes for the treatment of Gram negative non-HACEK IE. The primary endpoint was a composite of 60-day all-cause mortality, readmission, or recurrence of bacteremia. Of the 60 patients included, 56.7% met the primary composite outcome, with 20% overall mortality at 60 days. There was no difference in the primary composite outcome of 60-day readmission, infection recurrence or mortality between groups, with 62% of patients in the monotherapy group and 50% of patients in the combination therapy group experiencing the composite outcome (P = 0.36). Despite the high mortality and complicated nature of non-HACEK Gram negative IE, this study showed no difference in 60-day bacteremia recurrence, readmission or mortality among patients treated with combination therapy or monotherapy, suggesting that monotherapy may lead to similar clinical outcomes.
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Affiliation(s)
- Ashley Lorenz
- Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Libby Orzel
- Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Kelci Coe
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Lynn Wardlow
- Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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9
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Ioannou P, Vougiouklakis G. Infective endocarditis by Proteus species: a systematic review. Germs 2020; 10:229-239. [PMID: 33134201 DOI: 10.18683/germs.2020.1209] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 01/04/2023]
Abstract
Proteus spp. are members of the Enterobacteriaceae family and are Gram-negative, rod-shaped bacteria known to mainly cause urinary tract infections (UTIs) in humans. However, even though scarce evidence exists suggesting their potential to cause infective endocarditis (IE), a study summarizing the existing evidence is lacking. The purpose of this study was to systemically review all published cases of IE by Proteus species in the literature. A systematic review of PubMed, Scopus and Cochrane Library (through 5th May 2020) for studies providing epidemiological, clinical and microbiological data as well as data on treatment and outcomes of IE by Proteus species was performed. A total of 16 studies, containing data of 16 patients, were included. A prosthetic valve was present in 25%, while the most common causative pathogen was P. mirabilis. Aortic valve was the most common infected site in 33.3%, followed by mitral valve in 26.7%. Diagnosis was set with transesophageal echocardiography in 37.5%, and transthoracic echocardiography in 25%, while the diagnosis was set at autopsy in 25%. Fever and sepsis were present in 100% and 84.6%, respectively. Aminoglycosides and cephalosporins were the most common antimicrobials used for treatment. Clinical cure was noted in 62.5%, while overall mortality was 43.8%. This systematic review describes IE by Proteus species in detail and provides information on epidemiology, clinical presentation, treatment and outcomes.
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Affiliation(s)
- Petros Ioannou
- MD, MSc, PhD, Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, Stavrakia and Voutes crossroad, Heraklion, PC 71110, Crete, Greece
| | - Georgios Vougiouklakis
- Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, Stavrakia and Voutes crossroad, Heraklion, PC 71110, Crete, Greece
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10
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Solsi A, Findakly D, Mihyawi N, Fath AR. An Unusual Case of Neisseria flavescens/subflava Group Tricuspid Valve Endocarditis in a Patient With Previously Treated Methicillin-Resistant Staphylococcus aureus Endocarditis. Cureus 2020; 12:e9752. [PMID: 32944467 PMCID: PMC7489790 DOI: 10.7759/cureus.9752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Infective endocarditis (IE) is classified as an infection of any cardiac valve or endocardial surface and is often associated with high morbidity and mortality. Certain bacteria such as gram-positive cocci and viridans group streptococci have high predilection for both naïve and damaged cardiac valvular tissues, accounting for the majority of IE cases. In very infrequent instances, gram-negative bacteria (GNB), more specifically non-meningococcal, non-gonococcal GNB, have been shown to cause IE. The following is a case of a young male diagnosed with Neisseria flavescens/subflava tricuspid valve endocarditis after being previously treated for Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis.
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