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Danforth DR, Melloni M, Thorpe R, Cohen A, Voogt R, Tristano J, Mintz KP. Dual function of the O-antigen WaaL ligase of Aggregatibacter actinomycetemcomitans. Mol Oral Microbiol 2023; 38:471-488. [PMID: 37941494 PMCID: PMC10758912 DOI: 10.1111/omi.12444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/14/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
Protein glycosylation is critical to the quaternary structure and collagen-binding activity of the extracellular matrix protein adhesin A (EmaA) associated with Aggregatibacter actinomycetemcomitans. The glycosylation of this large, trimeric autotransporter adhesin is postulated to be mediated by WaaL, an enzyme with the canonical function to ligate the O-polysaccharide (O-PS) antigen with a terminal sugar of the lipid A-core oligosaccharide of lipopolysaccharide (LPS). In this study, we have determined that the Escherichia coli waaL ortholog (rflA) does not restore collagen binding of a waaL mutant strain of A. actinomycetemcomitans but does restore O-PS ligase activity following transformation of a plasmid expressing waaL. Therefore, a heterologous E. coli expression system was developed constituted of two independently replicating plasmids expressing either waaL or emaA of A. actinomycetemcomitans to directly demonstrate the necessity of ligase activity for EmaA collagen binding. Proper expression of the protein encoded by each plasmid was characterized, and the individually transformed strains did not promote collagen binding. However, coexpression of the two plasmids resulted in a strain with a significant increase in collagen binding activity and a change in the biochemical properties of the protein. These results provide additional data supporting the novel hypothesis that the WaaL ligase of A. actinomycetemcomitans shares a dual role as a ligase in LPS biosynthesis and is required for collagen binding activity of EmaA.
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Affiliation(s)
- David R. Danforth
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
| | - Marcella Melloni
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
| | - Richard Thorpe
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
| | - Avi Cohen
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
| | - Richard Voogt
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
| | - Jake Tristano
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
| | - Keith P. Mintz
- Department of Microbiology and Molecular Genetics, University of Vermont, Burlington, VT
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Salviatto LTC, Prates RA, Pavani C, Bussadori SK, Deana AM. The influence of growth medium on the photodynamic susceptibility of Aggregatibacter actinomycetemcomitans to antimicrobial blue light. Lasers Med Sci 2023; 38:274. [PMID: 37993626 DOI: 10.1007/s10103-023-03937-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/14/2023] [Indexed: 11/24/2023]
Abstract
The aim of this study was to investigate whether antimicrobial blue light (aBL) can cause the death of Aggregatibacter actinomycetemcomitans (A.a) and to determine the influence of different culture media, specifically brain heart infusion and blood agar, on bacterial survival fraction. An LED emitting at 403 ± 15 nm, with a radiant power of 1W, irradiance of 588.2 mW/cm2, and an irradiation time of 0 min, 1 min, 5 min, 10 min, 30 min, and 60 min, was used. The plates were incubated in microaerophilic conditions at 37 °C for 48 h, and the colony-forming units were counted. The photosensitizers were investigated using spectroscopy and fluorescence microscopy. There was no significant difference between the culture media (p > 0.05). However, a statistical reduction in both media was observed at 30 min (1058 J/cm2) (p < 0.05). The findings of this study suggest that aBL has the potential to kill bacteria regardless of the culture media used. Light therapy could be a promising and cost-effective strategy for preventing periodontal disease when used in combination with mechanical plaque control.
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Affiliation(s)
| | - Renato Araujo Prates
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
| | - Christiane Pavani
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
| | - Sandra Kalil Bussadori
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
| | - Alessandro Melo Deana
- Biophotonics Applied to Health Science Postgraduate program, Nove de Julho UniversityUNINOVE, São Paulo, Brazil
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3
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Devoy C, Flores Bueso Y, Tangney M. Understanding and harnessing triple-negative breast cancer-related microbiota in oncology. Front Oncol 2022; 12:1020121. [PMID: 36505861 PMCID: PMC9730816 DOI: 10.3389/fonc.2022.1020121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/31/2022] [Indexed: 11/27/2022] Open
Abstract
Bacterial inhabitants of the body have the potential to play a role in various stages of cancer initiation, progression, and treatment. These bacteria may be distal to the primary tumour, such as gut microbiota, or local to the tissue, before or after tumour growth. Breast cancer is well studied in this context. Amongst breast cancer types, Triple Negative Breast Cancer (TNBC) is more aggressive, has fewer treatment options than receptor-positive breast cancers, has an overall worse prognosis and higher rates of reoccurrence. Thus, an in-depth understanding of the bacterial influence on TNBC progression and treatment is of high value. In this regard, the Gut Microbiota (GM) can be involved in various stages of tumour progression. It may suppress or promote carcinogenesis through the release of carcinogenic metabolites, sustenance of proinflammatory environments and/or the promotion of epigenetic changes in our genome. It can also mediate metastasis and reoccurrence through interactions with the immune system and has been recently shown to influence chemo-, radio-, and immune-therapies. Furthermore, bacteria have also been found to reside in normal and malignant breast tissue. Several studies have now described the breast and breast tumour microbiome, with the tumour microbiota of TNBC having the least taxonomic diversity among all breast cancer types. Here, specific conditions of the tumour microenvironment (TME) - low O2, leaky vasculature and immune suppression - are supportive of tumour selective bacterial growth. This innate bacterial ability could enable their use as delivery agents for various therapeutics or as diagnostics. This review aims to examine the current knowledge on bacterial relevance to TNBC and potential uses while examining some of the remaining unanswered questions regarding mechanisms underpinning observed effects.
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Affiliation(s)
- Ciaran Devoy
- Cancer Research@UCC, College of Medicine and Health, University College Cork, Cork, Ireland,SynBio Center, University College Cork, Cork, Ireland,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Yensi Flores Bueso
- Cancer Research@UCC, College of Medicine and Health, University College Cork, Cork, Ireland,SynBio Center, University College Cork, Cork, Ireland,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Mark Tangney
- Cancer Research@UCC, College of Medicine and Health, University College Cork, Cork, Ireland,SynBio Center, University College Cork, Cork, Ireland,APC Microbiome Ireland, University College Cork, Cork, Ireland,School of Pharmacy, College of Medicine and Health, University College Cork, Cork, Ireland,*Correspondence: Mark Tangney,
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Radovanovic M, Marthaler BR, Nordstrom CW, Petrovic M, Dumic I, Barsoum MK. Cardiobacterium hominis endocarditis incidentally diagnosed following an aortic valve replacement surgery. IDCases 2022; 29:e01529. [PMID: 35693329 PMCID: PMC9184553 DOI: 10.1016/j.idcr.2022.e01529] [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] [Received: 04/19/2022] [Accepted: 06/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Cardiobacterum hominis (C. hominis) is the part of the HACEK group (Haemophilus spp, Actinobacillus spp, C. hominis, Eikenella, and Kingella spp) that accounts for the majority of the Gram-negative infective endocarditis cases. Historically, the fastidious characteristics of these microorganisms proved challenging to many clinicians. Advances in microbiological identification of culture-negative endocarditis; however, may be the reason for the rising incidence of these infections. Here, we report an incidentally diagnosed C. hominis endocarditis following an aortic valve replacement. Case report A healthy 54-year-old gentleman presented after several months of generalized weakness and exertional intolerance. He was found to have a bicuspid aortic valve with regurgitation and underwent aortic valve replacement surgery. Intraoperatively, the patient was found to have a large perforation of the fused leaflet associated with abnormal pink tissue in the aortic valve area. The aortic valve tissue was cultured. Gram-negative rods were isolated 48 h later and were ultimately identified as C. hominis. He was successfully treated with 6 weeks of intravenous ceftriaxone with sterile blood cultures throughout the hospital stay. In retrospect, the patient’s valve failure was likely secondary to subacute endocarditis from C. hominis complicated by leaflet perforation. Conclusion C. hominis is a rare cause of infective endocarditis with an excellent prognosis when timely diagnosed and managed. By reporting this case, we wish to raise awareness of potential asymptomatic infection, particularly amongst patients with underlying native valve abnormalities, new leaflet perforation, and valve insufficiency.
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Bläckberg A, Morenius C, Olaison L, Berge A, Rasmussen M. Infective endocarditis caused by HACEK group bacteria-a registry-based comparative study. Eur J Clin Microbiol Infect Dis 2021; 40:1919-1924. [PMID: 33852103 PMCID: PMC8346386 DOI: 10.1007/s10096-021-04240-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/29/2021] [Indexed: 12/28/2022]
Abstract
Infective 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.
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Affiliation(s)
- Anna Bläckberg
- Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden. .,Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden.
| | - Christian Morenius
- Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden
| | - Lars Olaison
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden.,Swedish Society of Infectious Diseases, Uppsala, Sweden
| | - Andreas Berge
- Unit of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.,Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Rasmussen
- Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden.,Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden
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6
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Daoud H, Abugroun A, Olanipekun O, Garrison D. Infective endocarditis and brain abscess secondary to Aggregatibacter aphrophilus. IDCases 2019; 17:e00561. [PMID: 31193507 PMCID: PMC6535683 DOI: 10.1016/j.idcr.2019.e00561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/09/2019] [Accepted: 05/09/2019] [Indexed: 11/17/2022] Open
Abstract
Aggregatibacter aphrophilus is a rare cause of infective endocarditis that was first described in 1940 by Khairat et al. and is now classified under the HACEK group of bacteria (Haemophilus spp., Aggregatibacter spp., Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae). There is limited literature describing the extracardiac complications of infective endocarditis caused by this organism. We report a case of a 53-year-old male with no significant past medical history who developed acute infective endocarditis complicated by a brain abscess caused by A. aphrophilus. The patient underwent aspiration of the abscess and treated with a long course of intravenous antimicrobials. This case represents a rare complication of infective endocarditis caused by A. aphrophilus and to the best of our knowledge, is the second reported case in the literature describing such a complication in a previously healthy patient. Although neurological sequela is associated with higher mortality and may be the presenting symptom of infective endocarditis, it may also be clinically silent - only detected upon imaging.
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Asai N, Sakanashi D, Suematsu H, Nishiyama N, Watanabe H, Kato H, Shiota A, Hagihara M, Koizumi Y, Yamagishi Y, Mikamo H. Infective endocarditis caused by Cardiobacterium hominis endocarditis: A case report and review of the literature. J Infect Chemother 2019; 25:626-629. [PMID: 31043327 DOI: 10.1016/j.jiac.2019.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/16/2019] [Accepted: 02/01/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND While it has been increasing cases of C. hominis endocarditis in the past decades due to advances of diagnostic methods, the epidemiology and clinical manifestations of IE caused by C. hominis is still unknown. CASE PRESENTATION A 62-year old man was admitted to our institute with fever, anorexia and general fatigue for the preceding one month. He had a past medical history of both aortic and mitral valves replacement due to cardiac diseases. He was diagnosed as IE caused by C. hominis according to the modified duke criteria. The patient received 2 weeks of combination therapy of intravenous ceftriaxone (CTRX) 2g and gentamycin 180mg daily followed by 4 weeks CTRX 2g daily alone. Oral moxifloxacin 400mg once daily was given for an additional 4 weeks. After the antibiotic therapy was discontinued, disease recurrence was not observed. We reviewed previously reported C. hominis IE cases in 60 publications including ours. Of 73 patients enrolled, 53 were male, the mean age was 52 years. The most common risk factor of IE was past history of cardiac diseases in 44/73 (60%). As for antibiotics initially prescribed, third-generation cephalosporins was most frequently used in 28/69 (41%). While the cure rate was 67/73 (93%), 31/73 patients (43%) received a surgical intervention. Embolic lesions to the central nervous system and vertebrae were seen in 16/72 (22%) and 5/72 (7%). CONCLUSION IE caused by C. hominis has a favorable prognosis, showing the cure rate of 93%. Physicians should recognize the possible occurrence of emboli among IE patients.
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Affiliation(s)
- Nobuhiro Asai
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Daisuke Sakanashi
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroyuki Suematsu
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Naoya Nishiyama
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroki Watanabe
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hideo Kato
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Arufumi Shiota
- Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Mao Hagihara
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan
| | - Yusuke Koizumi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Yuka Yamagishi
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan; Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan.
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8
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Ambrosioni J, Martinez-Garcia C, Llopis J, Garcia-de-la-Maria C, Hernández-Meneses M, Tellez A, Falces C, Almela M, Vidal B, Sandoval E, Fuster D, Quintana E, Tolosana JM, Marco F, Moreno A, Miró JM. HACEK infective endocarditis: Epidemiology, clinical features, and outcome: A case-control study. Int J Infect Dis 2018; 76:120-125. [PMID: 30153485 DOI: 10.1016/j.ijid.2018.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/18/2018] [Accepted: 08/21/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES The study aimed to describe the epidemiological, microbiological, and clinical features of a population sample of 17 patients with HACEK infective endocarditis (HACEK-IE) and to compare them with matched control patients with IE caused by viridans group streptococci (VGS-IE). METHODS Cases of definite (n=14, 82.2%) and possible (n=3, 17.6%) HACEK-IE included in the Infective Endocarditis Hospital Clinic of Barcelona (IE-HCB) database between 1979 and 2016 were identified and described. Furthermore, a retrospective case-control analysis was performed, matching each case to three control subjects with VGS-IE registered in the same database during the same time period. RESULTS Seventeen out of 1209 IE cases (1.3%, 95% confidence interval 0.69-1.91%) were due to HACEK group organisms. The most frequently isolated HACEK species were Aggregatibacter spp (n=11, 64.7%). Intracardiac vegetations were present in 70.6% of cases. Left heart failure (LHF) was present in 29.4% of cases. Ten patients (58.8%) required in-hospital surgery and none died during hospitalization. In the case-control analysis, there was a trend towards larger vegetations in the HACEK-IE group (median (interquartile range) size 11.5 (10.0-20.0) mm vs. 9.0 (7.0-13.0) mm; p=0.068). Clinical manifestations, echocardiographic findings, LHF rate, systemic emboli, and other complications were all comparable (p>0.05). In-hospital surgery and mortality were similar in the two groups. One-year mortality was lower for HACEK-IE (1/17 vs. to 6/48; p=0.006). CONCLUSIONS HACEK-IE represented 1.3% of all IE cases. Clinical features and outcomes were comparable to those of the VGS-IE control group. Despite the trend towards a larger vegetation size, the embolic event rate was not higher and the 1-year mortality was significantly lower for HACEK-IE.
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Affiliation(s)
- Juan Ambrosioni
- Infectious Diseases Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | | | - Jaume Llopis
- Biostatistics Department, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Cristina Garcia-de-la-Maria
- Infectious Diseases Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Marta Hernández-Meneses
- Infectious Diseases Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Adrián Tellez
- Infectious Diseases Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Carles Falces
- Cardiology Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Manel Almela
- Microbiology Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Bàrbara Vidal
- Cardiology Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Elena Sandoval
- Cardiac Surgery Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - David Fuster
- Nuclear Medicine Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Eduard Quintana
- Cardiac Surgery Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - José M Tolosana
- Cardiology Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Francesc Marco
- Microbiology Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Asunción Moreno
- Infectious Diseases Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - José M Miró
- Infectious Diseases Service, Hospital Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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9
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Avery LM, Felberbaum CB, Hasan M. Ciprofloxacin for the treatment of Cardiobacterium hominis prosthetic valve endocarditis. IDCases 2018; 11:77-79. [PMID: 29619328 PMCID: PMC5881436 DOI: 10.1016/j.idcr.2018.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 01/30/2018] [Accepted: 01/31/2018] [Indexed: 01/06/2023] Open
Abstract
Prosthetic valve endocarditis due to Cardiobacterium hominis is rare and recommended therapy includes a third generation cephalosporin. We report a case of Cardiobacterium hominis endocarditis post transcatheter aortic valve replacement in a patient with significant beta-lactam antimicrobial sensitivities who was successfully treated with ciprofloxacin monotherapy in conjunction with surgery.
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Affiliation(s)
- Lisa M Avery
- Department of Pharmacy, St. Joseph's Health, Syracuse, NY, USA.,Department of Pharmacy Practice, St. John Fisher College, Wegmans School of Pharmacy, Rochester, NY, USA
| | | | - Muhammad Hasan
- Department of Infectious Diseases, St. Joseph's Health, Syracuse, NY, USA
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10
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Lützen L, Olesen B, Voldstedlund M, Christensen JJ, Moser C, Knudsen JD, Fuursted K, Hartmeyer GN, Chen M, Søndergaard TS, Rosenvinge FS, Dzajic E, Schønheyder HC, Nørskov-Lauritsen N. Incidence of HACEK bacteraemia in Denmark: A 6-year population-based study. Int J Infect Dis 2018; 68:83-87. [PMID: 29408674 DOI: 10.1016/j.ijid.2018.01.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/22/2018] [Accepted: 01/24/2018] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES Bacteria with common microbiological and clinical characteristics are often recognized as a particular group. The acronym HACEK stands for five fastidious genera associated with infective endocarditis (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella). Data on the epidemiology of HACEK are sparse. This article reports a 6-year nationwide study of HACEK bacteraemia in Denmark. METHODS Cases of HACEK bacteraemia occurring during the years 2010-2015 were retrieved from the national Danish microbiology database, covering an average surveillance population of 5.6 million per year. RESULTS A total of 147 cases of HACEK bacteraemia were identified, corresponding to an annual incidence of 0.44 per 100000 population. The annual incidence for males was 0.56 per 100000 and for females was 0.31 per 100000. The median age was 56 years (range 0-97 years), with variation among the genera. One hundred and forty-three isolates were identified to the species level and six to the genus level: Haemophilus spp, n=55; Aggregatibacter spp, n=37; Cardiobacterium spp, n=9; Eikenella corrodens n=21; and Kingella spp, n=27. CONCLUSIONS This is the first study on the incidence of HACEK bacteraemia in a large surveillance population and may inspire further studies on the HACEK group. Haemophilus spp other than Haemophilus influenzae accounted for most cases of HACEK bacteraemia in Denmark, with Aggregatibacter spp in second place.
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Affiliation(s)
- Lisbeth Lützen
- Department of Clinical Microbiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Department of Clinical Microbiology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark; Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark.
| | - Bente Olesen
- Department of Clinical Microbiology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark.
| | - Marianne Voldstedlund
- Infectious Disease Preparedness, Statens Serum Institut, Artillerivej 5, 2300 København S, Denmark.
| | - Jens J Christensen
- Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200 Slagelse, Denmark.
| | - Claus Moser
- Department of Clinical Microbiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark.
| | - Jenny D Knudsen
- Department of Clinical Microbiology, Copenhagen University Hospital, Hvidovre Hospital, Kettegård Alle 30, 2650 Hvidovre, Denmark.
| | - Kurt Fuursted
- Department of Clinical Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, 2300 København S, Denmark.
| | - Gitte N Hartmeyer
- Department of Clinical Microbiology, Odense University Hospital, Søndre Boulevard 29, 5000 Odense, Denmark.
| | - Ming Chen
- Department of Clinical Microbiology, Hospital of Southern Jutland, Sydvang 1, 6400 Sønderborg, Denmark.
| | - Turid S Søndergaard
- Department of Clinical Microbiology, Hospital of Southern Jutland, Sydvang 1, 6400 Sønderborg, Denmark; Department of Microbiology, Hospitalsenheden Midt-Vest, Viborg/Herning, Heibergs Alle 4, 8800 Viborg, Denmark.
| | - Flemming S Rosenvinge
- Department of Clinical Microbiology, Odense University Hospital, Søndre Boulevard 29, 5000 Odense, Denmark; Department of Clinical Microbiology, Sygehus Lillebælt Vejle Sygehus, Beriderbakken 4, 7100 Vejle, Denmark.
| | - Esad Dzajic
- Department of Clinical Microbiology, Sydvestjysk Sygehus Esbjerg, Finsensgade 35, 6700 Esbjerg, Denmark.
| | - Henrik C Schønheyder
- Department of Clinical Microbiology, Aalborg University Hospital, Hobrovej 18-22, 9100 Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark.
| | - Niels Nørskov-Lauritsen
- Department of Clinical Microbiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
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Litmathe J, Fussen R, Heinzel A, Müller M, Sucker C, Tewarie L, Dafotakis M. An unusual agent for an unusual localization of infective endocarditis. Perfusion 2017; 32:691-694. [PMID: 28578609 DOI: 10.1177/0267659117712406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We report on a 32-year-old male patient with acute left-hemispheric stroke caused by embolism due to infective endocarditis affected from the HACEK group. Additionally, atypical findings from the transesophageal echocardiography (TEE) which showed fluttering structures belonging to the papillary muscle could be proven as infectious agents with the help of a glucose positron emission tomography (PET) scan. TEE controls showed increasing vegetation involving the mitral valve so that surgery became necessary. The current work reflects, in detail, the emergent clinical course of this young patient, suffering from both an unusual localization and an infrequent cause of endocarditis and focuses on an actual view to the literature.
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Affiliation(s)
- Jens Litmathe
- 1 Department of Neurology, RWTH Aachen University, Aachen, Germany
| | - Rene Fussen
- 2 Department of Infection Control and Infectious Diseases, RWTH Aachen University, Aachen, Germany
| | - Alexander Heinzel
- 3 Department of Nuclear Medicine, RWTH Aachen University, Aachen, Germany
| | - Marguerite Müller
- 4 Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany
| | | | - Lachmandath Tewarie
- 6 Department of Thoracic and Cardiovascular Surgery, RWTH Aachen University, Aachen, Germany
| | - Manuel Dafotakis
- 1 Department of Neurology, RWTH Aachen University, Aachen, Germany
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Abstract
INTRODUCTION The HACEK group, referring to Haemophilus spp., Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae, is a rare cause of infective endocarditis (IE). It causes the majority of Gram-negative endocarditis cases and has an excellent prognosis and simple management if properly identified. However, delay in diagnosis and associated complications can render the infection fatal. AREAS COVERED Over the past few decades, there have been tremendous advancements in understanding the manifestations and progression of HACEK endocarditis (HE). This review tackles the epidemiology of HE, the microbiological characteristics of each organism in the HACEK group, the methods used to diagnose HE, the clinical manifestations, complications, and mortality of patients with HE, as well as the recommended treatment and preventive methods. Expert Commentary: The lack of robust randomized controlled trials in diagnosis and treatment of HE makes it difficult to determine the optimal management of such infections. Nevertheless, advancements in culturing methods have shown progress in isolating and identifying these fastidious organisms. Positive blood cultures for any of the HACEK organisms in the setting of no definite focus of infection is highly suggestive of HE. In such cases, treatment with ceftriaxone or a fluoroquinolone, even without obtaining antibiotic susceptibilities, should be initiated. Moreover, the decision to proceed with surgical intervention should be individualized. As is the case for other IE, HE requires the collaboration of a multidisciplinary team consisting of the infectious disease specialist, cardiologist, cardiothoracic surgeon, and the microbiologist.
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Affiliation(s)
- Sima L Sharara
- a School of Medicine, American University of Beirut , Beirut , Lebanon
| | - Ralph Tayyar
- b Division of Infectious Diseases, Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon
| | - Zeina A Kanafani
- b Division of Infectious Diseases, Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon
| | - Souha S Kanj
- b Division of Infectious Diseases, Department of Internal Medicine , American University of Beirut Medical Center , Beirut , Lebanon
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13
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Kingella kingae Prosthetic Valve Endocarditis. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2014. [DOI: 10.1097/ipc.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Application of matrix-assisted laser desorption ionization-time of flight mass spectrometry for identification of the fastidious pediatric pathogens Aggregatibacter, Eikenella, Haemophilus, and Kingella. J Clin Microbiol 2013; 51:3862-4. [PMID: 23966506 DOI: 10.1128/jcm.02233-13] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The accuracy of matrix-assisted laser desorption-ionization time of flight mass spectrometry (MALDI-TOF MS) in the identification of Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella (HACEK) species was compared to that of phenotypic methods (Remel RapID and Vitek 2). Overall, Vitek MS correctly identified more isolates, incorrectly identified fewer isolates, and failed to identify fewer isolates than both phenotypic methods.
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Tien YC, Chang CC, Liu YM. Haemophilus aphrophilus associated spleen abscess: an unusual presentation of subacute endocarditis. J Clin Med Res 2012; 4:209-11. [PMID: 22719808 PMCID: PMC3376880 DOI: 10.4021/jocmr803w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2011] [Indexed: 11/10/2022] Open
Abstract
The HACEK group of bacteria (Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella spp.), is uncommon pathogens of infective endocarditis, but can cause life-threatening events such as heart failure or formation of lethal emboli. Here we report a 58-year-old Asian man with a past history of congenital valvular heart disease who presented with sudden onset of left flank pain followed by fever with chills for 2 weeks. Abdominal computed tomography (CT) indicated a 1.6 cm abscess in the spleen. Culturing indicated the presence of Haemophilus aphrophilus. We diagnosed the patient with subacute endocarditis complicated with spleen abscess. The patient recovered fully after two weeks antibiotic (Ceftriaxone) treatment. Clinicians should give further attention to infective endocarditis caused by bacteria in the HACEK group in patients with metastatic infection such as spleen abscess with suspected valvular heart disease.
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Affiliation(s)
- Ya-Chih Tien
- Department of Internal Medicine, Changhua Christian Hospital, Changhua City, Taiwan
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Clock SA, Planet PJ, Perez BA, Figurski DH. Outer membrane components of the Tad (tight adherence) secreton of Aggregatibacter actinomycetemcomitans. J Bacteriol 2008; 190:980-90. [PMID: 18055598 PMCID: PMC2223556 DOI: 10.1128/jb.01347-07] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Accepted: 11/20/2007] [Indexed: 12/15/2022] Open
Abstract
Prokaryotic secretion relies on proteins that are widely conserved, including NTPases and secretins, and on proteins that are system specific. The Tad secretion system in Aggregatibacter actinomycetemcomitans is dedicated to the assembly and export of Flp pili, which are needed for tight adherence. Consistent with predictions that RcpA forms the multimeric outer membrane secretion channel (secretin) of the Flp pilus biogenesis apparatus, we observed the RcpA protein in multimers that were stable in the presence of detergent and found that rcpA and its closely related homologs form a novel and distinct subfamily within a well-supported gene phylogeny of the entire secretin gene superfamily. We also found that rcpA-like genes were always linked to Aggregatibacter rcpB- or Caulobacter cpaD-like genes. Using antisera, we determined the localization and gross abundances of conserved (RcpA and TadC) and unique (RcpB, RcpC, and TadD) Tad proteins. The three Rcp proteins (RcpA, RcpB, and RcpC) and TadD, a putative lipoprotein, localized to the bacterial outer membrane. RcpA, RcpC, and TadD were also found in the inner membrane, while TadC localized exclusively to the inner membrane. The RcpA secretin was necessary for wild-type abundances of RcpB and RcpC, and TadC was required for normal levels of all three Rcp proteins. TadC abundance defects were observed in rcpA and rcpC mutants. TadD production was essential for wild-type RcpA and RcpB abundances, and RcpA did not multimerize or localize to the outer membrane without the expression of TadD. These data indicate that membrane proteins TadC and TadD may influence the assembly, transport, and/or function of individual outer membrane Rcp proteins.
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Affiliation(s)
- Sarah A Clock
- Department of Microbiology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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