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Pagotto A, Campanile F, Conti P, Prataviera F, Della Siega P, Flammini S, Giuliano S, Martini L, Pecori D, Sartor A, Screm M, Semenzin T, Tascini C. An Aminoglycoside-Sparing Regimen with Double Beta-Lactam to Successfully Treat Granulicatella adiacens Prosthetic Aortic Valve Endocarditis-Time to Change Paradigm? Infect Dis Rep 2024; 16:249-259. [PMID: 38525767 PMCID: PMC10961776 DOI: 10.3390/idr16020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
(1) Background: Granulicatella adiacens is a former nutritionally variant streptococci (NVS). NVS infective endocarditis (IE) is generally characterized by a higher rate of morbidity and mortality, partially due to difficulties in choosing the most adequate microbiological culture method and the most effective treatment strategy, and partially due to higher rates of complications, such as heart failure, peripheral septic embolism, and peri-valvular abscess, as well as a higher rate of valve replacement. Depending on the affected valve (native valve endocarditisNVE, or prosthetic valve endocarditisPVE), the American Heart Association (AHA) 2015 treatment guidelines (GLs) suggest penicillin G, ampicillin, or ceftriaxone plus gentamicin (2 weeks for NVE and up to 6 weeks for PVE), while vancomycin alone may be a reasonable alternative in patients who are intolerant of β-lactam therapy. The European Society of Cardiology (ESC) 2023 GLs recommend treating NVE with penicillin G, ceftriaxone, or vancomycin for 6 weeks, suggesting combined with an aminoglycoside (AG) for at least the first 2 weeks only for PVE; likewise, the same recommendations for IE due to Enterococcus faecalis. (2) Methods: Starting from the case of a 51-year-old man with G. adiacens aortic bio-prosthesis IE who was successfully treated with aortic valve replacement combined with double beta-lactams, an AG-sparing regimen, we performed microbiology tests in order to validate this potential treatment change. (3) Results: As for E. faecalis IE, we found that the combination of ampicillin plus cephalosporines (like ceftriaxone or ceftobiprole) showed a synergistic effect in vitro, probably due to wider binding to penicillin-binding proteins (PBPs), thus contributing to enhanced bacterial killing and good clinical outcome, as well as avoiding the risk of nephrotoxicity due to AG association therapy. (4) Conclusions: Further studies are required to confirm this hypothesis, but double beta-lactams and an adequate sourcecontrol could be a choice in treating G. adiacens IE.
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Affiliation(s)
- Alberto Pagotto
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, Italy; (F.C.); (P.C.)
| | - Paola Conti
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, Italy; (F.C.); (P.C.)
| | - Francesca Prataviera
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Paola Della Siega
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Sarah Flammini
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Simone Giuliano
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Luca Martini
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Davide Pecori
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Assunta Sartor
- Microbiology Unit, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (A.S.); (M.S.)
| | - Maria Screm
- Microbiology Unit, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (A.S.); (M.S.)
| | - Tosca Semenzin
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
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Zhang Y, Zhou Y, Cui W, Wang Z, Wang X, Wu F, Wang P, Wang T, Yu W, Wang L, Shang J, Zhao Z. Characterization and diagnostic value of the gut microbial composition in patients with minimal change disease. Front Physiol 2022; 13:1070569. [PMID: 36561217 PMCID: PMC9763583 DOI: 10.3389/fphys.2022.1070569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Background: Minimal change disease (MCD) is one of the most common causes of primary nephrotic syndrome with high morbidity. This study aimed to explore the typical alterations of gut microbiota in MCD and establish a non-invasive classifier using key gut microbiome. We also aimed to evaluate the therapeutic efficiency of gut microbiota intervention in MCD through animal experiments. Methods: A total of 222 stool samples were collected from MCD patients and healthy controls at the First Affiliated Hospital of Zhengzhou University and Shandong Provincial Hospital for 16S rRNA sequencing. Optimum operational taxonomic units (OTUs) were obtained for constructing a diagnostic model. MCD rat models were established using doxorubicin hydrochloride for exploring the therapeutic efficiency of gut microbial intervention through fecal microbiota transplantation (FMT). Results: The α-diversity of gut microbiota decreased in MCD patients when compared with healthy controls. The relative abundance of bacterial species also changed significantly. We constructed a diagnostic model based on eight optimal OTUs and it achieved efficiency of 97.81% in discovery cohort. The high efficiency of diagnostic model was also validated in the patients with different disease states and cross-regional cohorts. The treatment partially recovered the gut microbial dysbiosis in patients with MCD. In animal experiments, likewise, the gut microbiota changed sharply in MCD rats. However, gut microbial interventions did not reduce urinary protein or pathological kidney damage. Conclusion: Gut Microbiota shifts sharply in both patients and rats with MCD. Typical microbial changes can be used as biomarkers for MCD diagnosis. The gut microbiota compositions in patients with MCD tended to normalize after treatment. However, the intervention of gut microbiota seems to have no therapeutic effect on MCD.
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Affiliation(s)
- Yiding Zhang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Yukun Zhou
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Wen Cui
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhihui Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Xuemei Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feng Wu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Peipei Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Ting Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Yu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China
| | - Li Wang
- Biobank of The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jin Shang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China,Laboratory Animal Platform of Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China,Laboratory of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Zhanzheng Zhao, ; Jin Shang,
| | - Zhanzheng Zhao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,School of Medicine, Zhengzhou University, Zhengzhou, Henan, China,Laboratory Animal Platform of Academy of Medical Sciences, Zhengzhou University, Zhengzhou, Henan, China,Laboratory of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China,*Correspondence: Zhanzheng Zhao, ; Jin Shang,
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Chen J, Yang Y, Yu N, Sun W, Yang Y, Zhao M. Relationship between gut microbiome characteristics and the effect of nutritional therapy on glycemic control in pregnant women with gestational diabetes mellitus. PLoS One 2022; 17:e0267045. [PMID: 35427393 PMCID: PMC9012359 DOI: 10.1371/journal.pone.0267045] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/31/2022] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to explore the relationship between the characteristics of gut microbiome and the effect of medical nutrition therapy (MNT) on glycemic control in pregnant women with gestational diabetes mellitus (GDM). Seventy-four pregnant women newly diagnosed with GDM received MNT for one-week. The effect of glycemic control was evaluated by fasting and 2-hour postprandial blood glucose; and stool samples of pregnant women were collected to detect the gut microbiome before and after MNT. We used a nested case-control study design, with pregnant women with GDM who did not meet glycemic standards after MNT as the ineffective group and those with an age difference of ≤5 years, matched for pre-pregnancy body mass index (BMI) 1:1, and meeting glycemic control criteria as the effective group. Comparison of the gut microbiome characteristics before MNT showed that the ineffective group was enriched in Desulfovibrio, Aeromonadales, Leuconostocaceae, Weissella, Prevotella, Bacillales_Incertae Sedis XI, Gemella and Bacillales, while the effective group was enriched in Roseburia, Clostridium, Bifidobacterium, Bifidobacteriales, Bifidobacteriaceae, Holdemania and Proteus. After treatment, the effective group was enriched in Bifidobacterium and Actinomycete, while the ineffective group was enriched in Holdemania, Proteus, Carnobacteriaceae and Granulicatella. In conclusion, the decrease in the abundance of characteristic gut microbiome positively correlated with blood glucose may be a factor influencing the poor hypoglycemic effect of MNT in pregnant women with GDM. Abundance of more characteristic gut microbiome negatively correlated with blood glucose could help control blood glucose in pregnant women with GDM.
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Affiliation(s)
- Jing Chen
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Yuying Yang
- Division of Life Sciences and Medicine, Department of Nursing, Hefei Ion Medical Center, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui Province, The people’s Republic of China
| | - Ningning Yu
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Wanxiao Sun
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Yuanyuan Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
| | - Mei Zhao
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, The people’s Republic of China
- * E-mail:
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Purohit G, Mishra B, Sahoo S, Mahapatra A. Granulicatella adiacens as an Unusual Cause of Empyema: A Case Report and Review of Literature. J Lab Physicians 2022; 14:343-347. [PMID: 36119420 PMCID: PMC9473932 DOI: 10.1055/s-0042-1744236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Granulicatella adiacens
, a nutritionally variant
Streptococcus
(NVS), is part of the normal commensal flora of human mouth, genital, and intestinal tracts and rarely causes disease. It has been mostly reported from bacteremia and endocarditis cases, but rarely can cause vertebral osteomyelitis, pancreatic abscess, otitis media, and endovascular, central nervous system, ocular, oral, bone and joint, and genitourinary infections. Due to requirement of fastidious culture conditions and non-specific colony morphology, serious diagnostic difficulties may arise in cases of NVS infections. Here, we are reporting a rare fatal infection of
G. adiacens
presented with empyema complicated to sepsis and necrotizing fasciitis.
Clinicians should be aware of the pathogenic potential of
Granulicatella adiacens
(a normal commensal flora of human mouth, genital and intestinal tracts). Appropriate supplemented media and a reliable detection system should be used to identify these fastidious organisms. We present this rare case to bring awareness among clinicians regarding such a rare but potentially fatal infection.
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Affiliation(s)
- Geetarani Purohit
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
- Department of Microbiology and Infection Control, Vikash Multispeciality Hospital, Bargarh, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Satyajeet Sahoo
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Ashoka Mahapatra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India
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