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Impact of Valve Culture Positivity on Prognosis in Patients with Infective Endocarditis Who Underwent Valve Surgery. Infect Dis Ther 2022; 11:1253-1265. [PMID: 35489001 PMCID: PMC9124244 DOI: 10.1007/s40121-022-00642-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/11/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Infective endocarditis (IE) is a severe and fatal infection with high in-hospital and overall mortality rates of approximately up to 30%. Valve culture positivity was associated with in-hospital mortality and postoperative complications; however, few studies have analyzed the relationship between valve cultures and overall mortality over a long observation period. This study aimed to compare the association of valve culture positivity with overall mortality in patients with IE who underwent valve surgery. Methods A total of 416 IE patients admitted to a tertiary hospital in South Korea from November 2005 to August 2017 were retrospectively reviewed. A total of 202 IE patients who underwent valve surgery and valve culture were enrolled. The primary endpoint was long-term overall mortality. Kaplan–Meier curve and Cox proportional hazards model were used for survival analysis. Results The median follow-up duration was 63 (interquartile range, 38–104) months. Valve cultures were positive in 22 (10.9%) patients. The overall mortality rate was 15.8% (32/202) and was significantly higher in valve culture-positive patients (36.4%, p = 0.011). Positive valve culture [hazard ratio (HR) 3.921, p = 0.002], Charlson Comorbidity Index (HR 1.181, p = 0.004), Coagulase-negative staphylococci (HR 4.233, p = 0.001), new-onset central nervous system complications (HR 3.689, p < 0.001), and new-onset heart failure (HR 4.331, p = 0.001) were significant risk factors for overall mortality. Conclusions Valve culture positivity is a significant risk factor for long-term overall mortality in IE patients who underwent valve surgery. The importance of valve culture positivity needs to be re-evaluated, as the valve culture positivity rate increases with increasing early surgical intervention.
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Noshak MA, Rezaee MA, Hasani A, Mirzaii M. The Role of the Coagulase-negative Staphylococci (CoNS) in Infective Endocarditis; A Narrative Review from 2000 to 2020. Curr Pharm Biotechnol 2020; 21:1140-1153. [PMID: 32324510 DOI: 10.2174/1389201021666200423110359] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/12/2020] [Accepted: 04/02/2020] [Indexed: 12/15/2022]
Abstract
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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Affiliation(s)
- Mohammad A Noshak
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad A Rezaee
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alka Hasani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Mirzaii
- Department of Microbiology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
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Embolic Stroke and Meningitis Secondary to Staphylococcus lugdunensis Native Valve Endocarditis. Case Rep Infect Dis 2019; 2019:7910262. [PMID: 31183228 PMCID: PMC6512069 DOI: 10.1155/2019/7910262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/01/2019] [Accepted: 04/16/2019] [Indexed: 11/23/2022] Open
Abstract
Staphylococcus lugdunensis is a coagulase-negative staphylococcus that leads to destructive infective endocarditis. The clinical course of S. lugdunensis endocarditis is usually aggressive with a high mortality rate compared to endocarditis caused by other coagulase-negative staphylococcal species. Despite that, it is usually sensitive to Penicillin G, and surgical intervention is sometimes warranted. Here, we report a case of S. lugdunensis endocarditis complicated by both embolic stroke and meningitis.
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Marcos-Garcés V, Santas E, Pellicer M, Ruiz-Granell R, Chorro FJ. Unusual Hydatid Cyst-Like Images Caused by Staphylococcus Lugdunensis Infective Endocarditis. Heart Lung Circ 2019; 28:e16-e18. [DOI: 10.1016/j.hlc.2018.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/22/2018] [Indexed: 12/11/2022]
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Ainoda Y, Takeshita N, Hase R, Mikawa T, Hosokawa N, Kawamura I, Kurai H, Abe M, Kimura M, Araoka H, Fujita T, Totsuka K, Mezaki K, Sekiya N, Ohmagari N. Multicenter Study of the Clinical Presentation of Staphylococcus lugdunensis Bacteremia in Japan. Jpn J Infect Dis 2016; 70:405-407. [PMID: 28003590 DOI: 10.7883/yoken.jjid.2016.130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Staphylococcus lugdunensis (SL) is a bacterium with a highly pathogenicity than most other coagulase-negative Staphylococcus spp. (CoNS). In Japan, data on this pathogen are sparse, and the current prevalence of SL bacteremia is unknown. Therefore, we investigated the prevalence of SL in blood culture specimens in a prospective multicenter study across 5 facilities. A total of 3,284 patients had positive blood cultures, and 2,478 patients had bacteremia. Among the patients with bacteremia, 7 patients (0.28%) had SL bacteremia. A total of 281 patients had CoNS bacteremia, with SL accounting for 2.49% of these cases. Of the 7 patients with SL bacteremia, 1 patient (14.3%) had infective endocarditis, and 1 patient (14.3%) died within 30 days. In this study, SL resulted in the development of bacteremia in select patients. Clinicians in Japan should be aware of the prevalence of SL and the complications of SL bacteremia.
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Affiliation(s)
- Yusuke Ainoda
- Disease Control and Prevention Center, National Center for Global Health and Medicine.,Department of Infectious Diseases, Tokyo Metropolitan Health and Medical Corporation Ebara Hospital.,Department of Infectious Diseases, Tokyo Women's Medical University
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Ryota Hase
- Department of Infectious Diseases, Kameda Medical Center.,Department of Infectious Diseases, Narita Red Cross Hospital
| | - Takahiro Mikawa
- Department of Infectious Diseases, Kameda Medical Center.,Department of General Medicine and Infectious Diseases, Yamanashi Prefectural Central Hospital
| | - Naoto Hosokawa
- Department of Infectious Diseases, Kameda Medical Center
| | | | - Hanako Kurai
- Division of Infectious Diseases, Shizuoka Cancer Center
| | - Masahiro Abe
- Department of Infectious Diseases, Toranomon Hospital
| | | | - Hideki Araoka
- Department of Infectious Diseases, Toranomon Hospital
| | - Takahiro Fujita
- Department of Infectious Diseases, Tokyo Women's Medical University.,Center for Home Care Medicine, Faculty of Medicine, The University of Tokyo
| | - Kyoichi Totsuka
- Department of Infectious Diseases, Tokyo Women's Medical University.,Department of Internal Medicine, Kita-tama Hospital
| | - Kazuhisa Mezaki
- Disease Control and Prevention Center, National Center for Global Health and Medicine
| | - Noritaka Sekiya
- Department of Clinical Laboratory, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine
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Lin JF, Cheng CW, Kuo AJ, Liu TP, Yang CC, Huang CT, Lee MH, Lu JJ. Clinical experience and microbiologic characteristics of invasive Staphylococcus lugdunensis infection in a tertiary center in northern Taiwan. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2015; 48:406-12. [DOI: 10.1016/j.jmii.2013.12.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/18/2013] [Accepted: 12/18/2013] [Indexed: 11/27/2022]
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Multi-virulence-locus sequence typing of Staphylococcus lugdunensis generates results consistent with a clonal population structure and is reliable for epidemiological typing. J Clin Microbiol 2014; 52:3624-32. [PMID: 25078912 DOI: 10.1128/jcm.01370-14] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Staphylococcus lugdunensis is an emergent virulent coagulase-negative staphylococcus responsible for severe infections similar to those caused by Staphylococcus aureus. To understand its potentially pathogenic capacity and have further detailed knowledge of the molecular traits of this organism, 93 isolates from various geographic origins were analyzed by multi-virulence-locus sequence typing (MVLST), targeting seven known or putative virulence-associated loci (atlLR2, atlLR3, hlb, isdJ, SLUG_09050, SLUG_16930, and vwbl). The polymorphisms of the putative virulence-associated loci were moderate and comparable to those of the housekeeping genes analyzed by multilocus sequence typing (MLST). However, the MVLST scheme generated 43 virulence types (VTs) compared to 20 sequence types (STs) based on MLST, indicating that MVLST was significantly more discriminating (Simpson's index [D], 0.943). No hypervirulent lineage or cluster specific to carriage strains was defined. The results of multilocus sequence analysis of known and putative virulence-associated loci are consistent with a clonal population structure for S. lugdunensis, suggesting a coevolution of these genes with housekeeping genes. Indeed, the nonsynonymous to synonymous evolutionary substitutions (dN/dS) ratio, the Tajima's D test, and Single-likelihood ancestor counting (SLAC) analysis suggest that all virulence-associated loci were under negative selection, even atlLR2 (AtlL protein) and SLUG_16930 (FbpA homologue), for which the dN/dS ratios were higher. In addition, this analysis of virulence-associated loci allowed us to propose a trilocus sequence typing scheme based on the intragenic regions of atlLR3, isdJ, and SLUG_16930, which is more discriminant than MLST for studying short-term epidemiology and further characterizing the lineages of the rare but highly pathogenic S. lugdunensis.
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Tayebjee MH, Joy ER, Sandoe JA. Can implantable cardiac electronic device infections be defined as ‘early’ or ‘late’ based on the cause of infection? J Med Microbiol 2013; 62:1215-1219. [PMID: 23699068 DOI: 10.1099/jmm.0.057042-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Implantable cardiac electronic device (ICED) infections are a major cause of morbidity and mortality. Understanding the pathogenesis of these infections is important in their prevention and management. We hypothesized that ICED infections could be classified as ‘early’ or ‘late’, based on differences in microbiological cause within or beyond 1 year of implantation, respectively. A comprehensive review of the literature was undertaken to test this hypothesis. Prosthetic valve endocarditis cases were included for comparison. Articles were included if the time from device implantation to infection, definite evidence of infection (pocket/bacteraemia/endocarditis) and a positive microbiological diagnosis were included. There were no statistically significant differences in microbiology to support a 1 year cut-off between early and late ICED infection. Staphylococcus aureus and coagulase-negative staphylococci were the predominant causes of ICED infection both within and beyond 1 year of ICED implantation. To further assess the microbiological causes of ICEDs and their implications for pathogenesis a large-scale multi-centre study is required.
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Affiliation(s)
- Muzahir H. Tayebjee
- Department of Cardiology, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - Eleanor R. Joy
- Department of Cardiology, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
| | - Jonathan A. Sandoe
- Department of Microbiology, Leeds General Infirmary, Great George Street, Leeds, West Yorkshire LS1 3EX, UK
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Staphylococcus Lugdunensis, An Aggressive Coagulase-Negative Pathogen not to be Underestimated. Int J Artif Organs 2012; 35:742-53. [DOI: 10.5301/ijao.5000142] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2012] [Indexed: 01/06/2023]
Abstract
The new emerging coagulase-negative pathogen Staphylococcus lugdunensis is responsible for severe cardiac and joint infections. Since the biochemical phenotypic systems designed for the identification of CoNS do not appear to be species specific and are hardly reliable for the discrimination of S. lugdunensis from other staphylococci, its precise identification requires fine molecular methods. The pathogenic mechanisms by which S. lugdunensis causes severe infections are not yet completely elucidated and in this review its virulence and toxic determinants are surveyed as well as its adhesins and biofilm production.
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One-and-a-half syndrome: a less appreciated emergency in native valve infective endocarditis. Am J Emerg Med 2012; 31:459.e1-3. [PMID: 23083887 DOI: 10.1016/j.ajem.2012.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 08/01/2012] [Indexed: 11/21/2022] Open
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