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Ramos-Martínez A, González-Merino P, Suanzes-Martín E, la Fuente MMD, Escudero-López G, Andrés-Eisenhofer A, Expósito-Palomo E, Gutierrez-Villanueva A, Diego-Yagüe I, Múñez E, Fernandez-Cruz A, Calderón-Parra J. Risk of endocarditis among patients with coagulase-negative Staphylococcus bacteremia. Sci Rep 2023; 13:15613. [PMID: 37730691 PMCID: PMC10511700 DOI: 10.1038/s41598-023-41888-7] [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: 03/01/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023] Open
Abstract
Coagulase-negative staphylococci (CoNS) are currently considered typical microorganisms causing infective endocarditis (IE) in patients with prosthetic valves. The objective was to determine variables associated with IE in patients with CoNS bacteremia. We performed an analysis of the clinical characteristics of patients with CoNS bacteremia admitted to a university hospital in Madrid (Spain) from 2021 to December 2022 according to the occurrence of IE. This study is an evaluation of a bacteremia registry. During the study period, 106 patients with CoNS bacteremia were detected. In 85 patients an echocardiogram was performed during hospital admission to rule out IE. Among them, 12 episodes were detected that met IE criteria (14.2%). Of the 6 patients with heart valve prostheses, 5 patients (83.3%) had IE (p < 0.001). Patients with IE more frequently had positive blood cultures more than 12 h after the first draw (58.3% versus 13.4%; p < 0.001). There was a tendency to associate community-acquired bacteremia and to that all blood culture bottles obtained were positive with an increased risk of IE (p = 0.091 and p = 0,057, respectively). Attributable mortality to infection was higher in patients with IE relative to all other patients (16.7% vs. 0%; p = 0.033). The multivariable analysis included having valve prosthesis and persistent bacteremia for more than 12 h. Both were independently associated with IE: valve prosthesis OR 38.6 (95% CI 5.8-258; p < 0.001) and persistent bacteremia OR 2.6 (95% CI 1.1-6.8; p = 0.046). In conclusion, a high percentage of cases of CoNS bacteremia may be due to IE. Some of the variables related to a higher risk of IE, such as having a valvular prosthesis or presenting positive blood cultures for more than 12 h, should lead to rule out or confirm the presence of IE by performing echocardiography.
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Affiliation(s)
- Antonio Ramos-Martínez
- Internal Medicine Department, Infectious Diseases Unit, Autonomous University of Madrid, Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHSA), Hospital Universitario Puerta de Hierro, C/ Maestro Rodrigo 2, 28222, Majadahonda, Spain.
| | | | - Elena Suanzes-Martín
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - Gabriela Escudero-López
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Ane Andrés-Eisenhofer
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Esther Expósito-Palomo
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - Itziar Diego-Yagüe
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Elena Múñez
- Infectious Diseases Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Ana Fernandez-Cruz
- Internal Medicine Department, Infectious Diseases Unit, Autonomous University of Madrid, Instituto Investigación Sanitaria Puerta de Hierro - Segovia de Arana (IDIPHSA), Hospital Universitario Puerta de Hierro, C/ Maestro Rodrigo 2, 28222, Majadahonda, Spain
| | - Jorge Calderón-Parra
- Infectious Diseases Unit, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
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Haddad SF, Lahr BD, Patarroyo SS, Chesdachai S, Kies KD, O’Horo JC, DeSimone DC, Sendi P, Baddour LM. Bloodstream Infection Due to Coagulase-Negative Staphylococci: Impact of Species on Prevalence of Infective Endocarditis. Antibiotics (Basel) 2023; 12:1453. [PMID: 37760749 PMCID: PMC10525567 DOI: 10.3390/antibiotics12091453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: Coagulase-negative staphylococci (CoNS) are an important group of organisms that can cause bloodstream infection (BSI) and infective endocarditis (IE). The prevalence of IE in patients with BSI due to different CoNS species, however, has received limited attention; (2) Methods: A retrospective study of adults with monomicrobial CoNS BSI who had undergone echocardiography and a risk factor analysis was done to determine the most common CoNS species that cause definite IE; (3) Results: 247 patients with CoNS BSI were included in the investigation; 49 (19.8%) had definite IE, 124 (50.2%) possible IE, and 74 (30.0%) BSI only. The latter two entities were grouped in one category for further analysis. The most common species in CoNS BSI was Staphylococcus epidermidis (79.4%) and most patients (83.2%) had possible IE/BSI only. 59.1% of patients with BSI due to S. lugdunensis had definite IE. The majority of CoNS were healthcare-associated/nosocomial bacteremia. Multivariable analysis demonstrated that valve disease (p = 0.002) and a foreign cardiovascular material (p < 0.001) were risk factors associated with definite IE. Patients with S. lugdunensis BSI had an 8-fold higher risk of definite IE than did those with S. epidermidis BSI and nearly a 13-fold higher risk than did patients with BSI due to other species of CoNS (p = 0.002); (4) Conclusions: The prevalence of definite IE in patients with BSI due to different CoNS species was significant. CoNS bacteremia, particularly with S. lugdunensis, confers a significant risk of IE, particularly in patients with a valve disease or intravascular foreign body material and should not be immediately dismissed as a contaminant.
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Affiliation(s)
- Sara F. Haddad
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (S.S.P.)
| | - Brian D. Lahr
- Division of Clinical Trials and Biostatistics, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Sebastian Santos Patarroyo
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (S.S.P.)
| | - Supavit Chesdachai
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (S.S.P.)
| | - Kami D. Kies
- Clinical Microbiology Core Laboratory, Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA;
| | - John C. O’Horo
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (S.S.P.)
- Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Daniel C. DeSimone
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (S.S.P.)
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Parham Sendi
- Institute for Infectious Diseases, University of Bern, 3001 Bern, Switzerland
| | - Larry M. Baddour
- Division of Public Health, Infectious Diseases and Occupational Medicine, Department of Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA; (S.S.P.)
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN 55905, USA
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Choukrani H, Maaroufi A, Ould Mohamed Sidi B, Bennouna MG, Drighil A, Habbal R. Infective endocarditis secondary to coagulase-negative staphylococcus revealed by endogenous endophthalmitis: Case report. Ann Med Surg (Lond) 2021; 70:102788. [PMID: 34557297 PMCID: PMC8445831 DOI: 10.1016/j.amsu.2021.102788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Endogenous endophthalmitis is a rare disease which remains a diagnostic and therapeutic emergency. Infective endocarditis is the first etiology, and coagulase-negative staphylococcus is most often incriminated in endocarditis on prosthesis and rarely on native valve. CASE REPORT We report the case of a 70 year old female patient, who has a chronic renal failure on haemodialysis, admitted to the ophthalmology department in endogenous endophthalmitis. Blood cultures, intravitreal sampling and culture of the haemodialysis catheter were positive for a multi-sensitive coagulase-negative staphylococcus. On transthoracic and transoesophageal ultrasound, vegetation was found in the right atrium along the path of the haemodialysis catheter and in the aortic and mitral valves. The patient received intravenous antibiotic and intravitreal injections of antibiotics. The evolution was marked by a systemic improvement but the ocular prognosis was poor and the evisceration decision was taken. DISCUSSION Endogenous endophthalmitis is related to a metastatic infectious process secondary to haematogenous microbial dissemination. The germs involved are Gram-positive bacteria and occurs very frequently in predisposed conditions. A primary infectious site is found in 90% of cases and this is most frequently endocarditis. Coagulase-negative staphylococci are responsible for 20-45% of endocarditis in prosthetic valves and the prevalence in native valve endocarditis is considered low. CONCLUSION Endogenous endophthalmitis remains an emergency. The search for a source of infection, primarily endocarditis, is systematic. The improvement of the prognosis depends essentially on the eviction and early treatment of infectious foci in people at risk.
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Affiliation(s)
- Hanane Choukrani
- Service de Cardiologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | - Anass Maaroufi
- Service de Cardiologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
| | - Boutar Ould Mohamed Sidi
- Service de Cardiologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
- Faculté de Médecine et de Pharmacie, Université Hassan II, B.P5696, Casablanca, Morocco
| | - Mohamed Ghali Bennouna
- Service de Cardiologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
- Faculté de Médecine et de Pharmacie, Université Hassan II, B.P5696, Casablanca, Morocco
| | - Abdennasser Drighil
- Service de Cardiologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
- Faculté de Médecine et de Pharmacie, Université Hassan II, B.P5696, Casablanca, Morocco
| | - Rachida Habbal
- Service de Cardiologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco
- Faculté de Médecine et de Pharmacie, Université Hassan II, B.P5696, Casablanca, Morocco
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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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García-Granja PE, López J, Vilacosta I, Ortiz-Bautista C, Sevilla T, Olmos C, Sarriá C, Ferrera C, Gómez I, Román JAS. Polymicrobial Infective Endocarditis: Clinical Features and Prognosis. Medicine (Baltimore) 2015; 94:e2000. [PMID: 26656328 PMCID: PMC5008473 DOI: 10.1097/md.0000000000002000] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 12/17/2022] Open
Abstract
To describe the profile of left-sided polymicrobial endocarditis (PE) and to compare it with monomicrobial endocarditis (ME).Among 1011 episodes of left-sided endocarditis consecutively diagnosed in 3 tertiary centers, between January 1, 1996 and December 31, 2014, 60 were polymicrobial (5.9%), 821 monomicrobial (81.7%), and in 123 no microorganism was detected (12.2%). Seven patients (0.7%) were excluded from the analysis because contamination of biologic tissue could not be discarded. The authors described the clinical, microbiologic, echocardiographic, and outcome of patients with PE and compared it with ME.Mean age was 64 years SD 16 years, 67% were men and 30% nosocomial. Diabetes mellitus (35%) were the most frequent comorbidities, fever (67%) and heart failure (43%) the most common symptoms at admission. Prosthetic valves (50%) were the most frequent infection location and coagulase-negative Staphylococci (48%) and enterococci (37%) the leading etiologies. The most repeated combination was coagulase-negative Staphylococci with enterococci (n = 9). Polymicrobial endocarditis appeared more frequently in patients with underlying disease (70% versus 56%, P = 0.036), mostly diabetics (35% versus 24%, P = 0.044) with previous cardiac surgery (15% versus 8% P = 0.049) and prosthetic valves (50% versus 37%, P = 0.038). Coagulase-negative Staphylococci, enterococci, Gram-negative bacilli, anaerobes, and fungi were more frequent in PE. No differences on age, sex, symptoms, need of surgery, and in-hospital mortality were detected.Polymicrobial endocarditis represents 5.9% of episodes of left-sided endocarditis in our series. Despite relevant demographic and microbiologic differences between PE and ME, short-term outcome is similar.
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Affiliation(s)
- Pablo Elpidio García-Granja
- From the Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid (PEG-G, JL, CO-B, T S, IG, JASR); Hospital Clínico Universitario San Carlos (IV, CO, CF); and Hospital Clínico Universitario la Princesa, Madrid, España (CS)
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6
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Coagulase-negative staphylococcal bacteremia: risk factors for mortality and impact of initial appropriate antimicrobial therapy on outcome. Eur J Clin Microbiol Infect Dis 2015; 34:1395-401. [PMID: 25828065 DOI: 10.1007/s10096-015-2364-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/12/2015] [Indexed: 01/23/2023]
Abstract
It is uncertain whether an initial inappropriate empirical antibiotic treatment of coagulase-negative staphylococci (CoNS) bacteremia adversely affects the outcome. A retrospective cohort study of CoNS bacteremia was performed at the Dongguk University Ilsan Hospital during a 3-year period. During the study period, 109 patients with CoNS bacteremia were enrolled. The median age of the patients was 72 years and most (96%, 105/109) had one or more comorbid diseases. Among the participants, 29% (32/109) received an appropriate empirical antimicrobial therapy. The 30-day mortality was 24% (26/109) and CoNS bacteremia-related mortality was 14% (15/109). There was no difference in the CoNS bacteremia-related mortality between the group with an inappropriate empirical treatment (13%, 10/77) and that with an appropriate treatment (16%, 5/32) (p = 0.46). In the multivariate analysis using the Cox regression analysis method, Pitt bacteremia scores [hazard ratio (HR) 1.48; 95% confidence interval (CI) 1.09-2.01; p = 0.01] and retention of eradicable focus (HR 5.0; 95% CI 1.39-17.9; p = 0.01) were found to be associated with CoNS bacteremia-related mortality. The results suggest that inappropriate empirical therapy might not necessarily be associated with the 30-day mortality or CoNS bacteremia-related mortality. Conversely, Pitt bacteremia scores and retention of eradicable focus were associated with poor outcomes.
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7
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Abstract
The definition of the heterogeneous group of coagulase-negative staphylococci (CoNS) is still based on diagnostic procedures that fulfill the clinical need to differentiate between Staphylococcus aureus and those staphylococci classified historically as being less or nonpathogenic. Due to patient- and procedure-related changes, CoNS now represent one of the major nosocomial pathogens, with S. epidermidis and S. haemolyticus being the most significant species. They account substantially for foreign body-related infections and infections in preterm newborns. While S. saprophyticus has been associated with acute urethritis, S. lugdunensis has a unique status, in some aspects resembling S. aureus in causing infectious endocarditis. In addition to CoNS found as food-associated saprophytes, many other CoNS species colonize the skin and mucous membranes of humans and animals and are less frequently involved in clinically manifested infections. This blurred gradation in terms of pathogenicity is reflected by species- and strain-specific virulence factors and the development of different host-defending strategies. Clearly, CoNS possess fewer virulence properties than S. aureus, with a respectively different disease spectrum. In this regard, host susceptibility is much more important. Therapeutically, CoNS are challenging due to the large proportion of methicillin-resistant strains and increasing numbers of isolates with less susceptibility to glycopeptides.
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Affiliation(s)
- Karsten Becker
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Christine Heilmann
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
| | - Georg Peters
- Institute of Medical Microbiology, University Hospital Münster, Münster, Germany
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8
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Duah M. Daptomycin for methicillin-resistant Staphylococcus epidermidis native-valve endocarditis: a case report. Ann Clin Microbiol Antimicrob 2010; 9:9. [PMID: 20167084 PMCID: PMC2836277 DOI: 10.1186/1476-0711-9-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 02/18/2010] [Indexed: 11/10/2022] Open
Abstract
Coagulase-negative staphylococci (CoNS) have been increasing in importance as a cause of native valve endocarditis (NVE). Most cases of NVE caused by CoNS are attributable to Staphylococcus epidermidis. NVE caused by CoNS acquired in a nosocomial setting may differ from cases acquired in the community in several ways. It may be associated with hemodialysis, the presence of a long-term indwelling central catheter or pacemaker, or a recent invasive procedure; nosocomial cases may have a higher rate of methicillin resistance among CoNS isolates, and so be more likely to be treated with vancomycin. Unfortunately, NVE caused by methicillin-resistant CoNS has been associated with significantly higher rates of persistent bacteremia and in-hospital mortality than methicillin-susceptible isolates. The poor outcomes in these cases point to the need for alternative therapies with potent activity against methicillin-resistant CoNS. In our medical center, a 76-year-old man presented with native-valve endocarditis and positive blood cultures for methicillin-resistant Staphylococcus epidermidis (MRSE). During each of three 6-week courses of treatment with vancomycin, blood cultures were negative, but they once again became positive for MRSE when vancomycin was discontinued. The minimum inhibitory concentration of the MRSE isolates for vancomycin remained stable at 2 microg/mL. Eventually, treatment with daptomycin was initiated (500 mg [7 mg/kg]) 3 times/week for 6 weeks. Over the following year, no positive cultures for MRSE were detected.
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9
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Rasmussen RV, Snygg-Martin U, Olaison L, Andersson R, Buchholtz K, Larsen CT, Hansen TF, Køber L, Hassager C, Bruun NE. One-year mortality in coagulase-negative Staphylococcus and Staphylococcus aureus infective endocarditis. ACTA ACUST UNITED AC 2009; 41:456-61. [DOI: 10.1080/00365540902896061] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Eiland EH, Edwards JD. Coagulase-negative staphylococci–associated native valve endocarditis: Comparative findings within a large cohort study and a community hospital. J Am Pharm Assoc (2003) 2008; 48:438. [DOI: 10.1331/japha.2008.08022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Choi G, van den Borne MPJ, Visser CE, Kersten MJ, Kater AP. Invasive infections with a coagulase-negative staphylococcus in an immunocompromised patient: case report and review of the literature. Ann Hematol 2008; 87:771-2. [PMID: 18386007 PMCID: PMC2490724 DOI: 10.1007/s00277-008-0476-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 02/25/2008] [Indexed: 11/29/2022]
Affiliation(s)
- Goda Choi
- Department of Internal Medicine, Academic Medical Center, University of Amsterdam, F4-222, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Maaike P. J. van den Borne
- Department of Orthopedics, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
- Present Address: Rijnstate Hospital, Arnhem, the Netherlands
| | - Caroline E. Visser
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Marie José Kersten
- Department of Hematology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
| | - Arnon P. Kater
- Department of Hematology, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, the Netherlands
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Chu VH, Woods CW, Miro JM, Hoen B, Cabell CH, Pappas PA, Federspiel J, Athan E, Stryjewski ME, Nacinovich F, Marco F, Levine DP, Elliott TS, Fortes CQ, Tornos P, Gordon DL, Utili R, Delahaye F, Corey GR, Fowler VG. Emergence of Coagulase-Negative Staphylococci as a Cause of Native Valve Endocarditis. Clin Infect Dis 2008; 46:232-42. [PMID: 18171255 DOI: 10.1086/524666] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Vivian H Chu
- Duke University Medical Center, Durham, North Carolina 27710, USA.
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13
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Cunha BA, Esrick MD, Larusso M. Staphylococcus hominis native mitral valve bacterial endocarditis (SBE) in a patient with hypertrophic obstructive cardiomyopathy. Heart Lung 2007; 36:380-2. [PMID: 17845885 DOI: 10.1016/j.hrtlng.2006.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2006] [Accepted: 11/06/2006] [Indexed: 11/15/2022]
Abstract
There are several species of coagulase-negative Staphylococci (CoNS) that are part of the normal skin flora and are relatively noninvasive/low virulence organisms. CoNS are important pathogens in patients with prosthetic devices and are the most common pathogen associated with prosthetic valve endocarditis. CoNS native valve infective endocarditis (IE) is rare. Patients with hypertrophic obstructive cardiomyopathy and an outflow pressure gradient greater than 30 mm Hg are predisposed to IE. There has been only one reported case of non-mitral valve IE due to CoNS in a patient with hypertrophic obstructive cardiomyopathy. To the best of our knowledge, we report the first case of Staphylococcal hominis mitral valve endocarditis in a patient with hypertrophic obstructive cardiomyopathy.
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Affiliation(s)
- Burke A Cunha
- Winthrop-University Hospital, Mineola, New York; State University of New York School of Medicine, Stony Brook, New York, USA
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Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME, Ferrieri P, Gerber MA, Tani LY, Gewitz MH, Tong DC, Steckelberg JM, Baltimore RS, Shulman ST, Burns JC, Falace DA, Newburger JW, Pallasch TJ, Takahashi M, Taubert KA. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation 2006; 111:e394-434. [PMID: 15956145 DOI: 10.1161/circulationaha.105.165564] [Citation(s) in RCA: 912] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. METHODS AND RESULTS This work represents the third iteration of an infective endocarditis "treatment" document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. CONCLUSIONS The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management.
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Frutos-López M, de Alarcón A, Romero-Rodríguez N. [Endocarditis in a patient with an autograft by the Ross procedure]. Enferm Infecc Microbiol Clin 2005; 23:511-2. [PMID: 16185573 DOI: 10.1157/13078836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Revilla A, San Román JA, López J, Vilacosta I, Luaces M, Fernández-Avilés F. Perfil actual de la endocarditis por estafilococo coagulasa negativo en válvulas nativas izquierdas. Rev Esp Cardiol 2005. [DOI: 10.1157/13076424] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chu VH, Cabell CH, Corey GR, Miro JM, Stryjewski ME, Pappas P, Habib G, Fowler VG. Reply to Shah. Clin Infect Dis 2005. [DOI: 10.1086/430182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Chu VH, Cabell CH, Abrutyn E, Corey GR, Hoen B, Miro JM, Olaison L, Stryjewski ME, Pappas P, Anstrom KJ, Eykyn S, Habib G, Benito N, Fowler VG. Native valve endocarditis due to coagulase-negative staphylococci: report of 99 episodes from the International Collaboration on Endocarditis Merged Database. Clin Infect Dis 2004; 39:1527-30. [PMID: 15546091 DOI: 10.1086/424878] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2004] [Accepted: 06/11/2004] [Indexed: 02/05/2023] Open
Abstract
Using a large cohort of patients from the International Collaboration on Endocarditis Merged Database, we compared coagulase-negative staphylococcal (CoNS) native-valve endocarditis (NVE) to NVE caused by more common pathogens. Rates of heart failure and mortality were similar between patients with CoNS NVE and patients with Staphylococcus aureus NVE, but rates for both groups were significantly higher than rates for patients with NVE due to viridans streptococci. These results emphasize the importance of CoNS as a cause of NVE and the potential for serious complications with this infection.
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Affiliation(s)
- Vivian H Chu
- Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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von Eiff C, Peters G, Heilmann C. Pathogenesis of infections due to coagulase-negative staphylococci. THE LANCET. INFECTIOUS DISEASES 2002; 2:677-85. [PMID: 12409048 DOI: 10.1016/s1473-3099(02)00438-3] [Citation(s) in RCA: 531] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
As a group, the coagulase-negative staphylococci (CoNS) are among the most frequently isolated bacteria in the clinical microbiology laboratory and are becoming increasingly important, especially as causes of hospital-acquired infections. These bacteria are normal inhabitants of human skin and mucous membranes and, therefore, one of the major challenges of daily diagnostic work is to distinguish clinically significant CoNS from contaminant strains. This overview addresses current knowledge of the pathogenesis of infections due to CoNS and particularly focuses on virulence factors of the species Staphylococcus epidermidis. S epidermidis has been identified as a major cause of nosocomial infections, especially in patients with predisposing factors such as indwelling or implanted foreign polymer bodies. Most important in the pathogenesis of foreign-body-associated infections is the ability of these bacteria to colonise the polymer surface by the formation of a thick, multilayered biofilm. Biofilm formation takes place in two phases. The first phase involves the attachment of the bacteria to polymer surfaces that may be either unmodified or coated with host extracellular matrix proteins. In the second phase, the bacteria proliferate and accumulate into multilayered cell clusters that are embedded in an extracellular material. The bacterial factors involved in both phases of biofilm formation are discussed in this review. In addition, the most important aspects of the pathogenic potential of S saprophyticus, S lugdunensis, and S schleiferi are described, although, compared with S epidermidis, much less is known in these species concerning their virulence factors.
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Affiliation(s)
- Christof von Eiff
- Institute of Medical Microbiology, University of Münster Hospital and Clinics, Münster, Germany.
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