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Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, Caselli S, Doenst T, Ederhy S, Erba PA, Foldager D, Fosbøl EL, Kovac J, Mestres CA, Miller OI, Miro JM, Pazdernik M, Pizzi MN, Quintana E, Rasmussen TB, Ristić AD, Rodés-Cabau J, Sionis A, Zühlke LJ, Borger MA. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J 2023; 44:3948-4042. [PMID: 37622656 DOI: 10.1093/eurheartj/ehad193] [Citation(s) in RCA: 226] [Impact Index Per Article: 226.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
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2
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Rawangkan A, Yosboonruang A, Kiddee A, Siriphap A, Pook-In G, Praphasawat R, Saokaew S, Duangjai A. Restoring Ampicillin Sensitivity in Multidrug-Resistant Escherichia coli Following Treatment in Combination with Coffee Pulp Extracts. J Microbiol Biotechnol 2023; 33:1179-1188. [PMID: 37317587 PMCID: PMC10580893 DOI: 10.4014/jmb.2304.04051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/10/2023] [Accepted: 05/15/2023] [Indexed: 06/16/2023]
Abstract
Escherichia coli, particularly multidrug-resistant (MDR) strains, is a serious cause of healthcare-associated infections. Development of novel antimicrobial agents or restoration of drug efficiency is required to treat MDR bacteria, and the use of natural products to solve this problem is promising. We investigated the antimicrobial activity of dried green coffee (DGC) beans, coffee pulp (CP), and arabica leaf (AL) crude extracts against 28 isolated MDR E. coli strains and restoration of ampicillin (AMP) efficiency with a combination test. DGC, CP, and AL extracts were effective against all 28 strains, with a minimum inhibitory concentration (MIC) of 12.5-50 mg/ml and minimum bactericidal concentration of 25-100 mg/ml. The CP-AMP combination was more effective than CP or AMP alone, with a fractional inhibitory concentration index value of 0.01. In the combination, the MIC of CP was 0.2 mg/ml (compared to 25 mg/ml of CP alone) and that of AMP was 0.1 mg/ml (compared to 50 mg/ml of AMP alone), or a 125-fold and 500-fold reduction, respectively, against 13-drug resistant MDR E. coli strains. Time-kill kinetics showed that the bactericidal effect of the CP-AMP combination occurred within 3 h through disruption of membrane permeability and biofilm eradication, as verified by scanning electron microscopy. This is the first report indicating that CP-AMP combination therapy could be employed to treat MDR E. coli by repurposing AMP.
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Affiliation(s)
- Anchalee Rawangkan
- Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence in Research and Product Development of Coffee, Division of Physiology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Atchariya Yosboonruang
- Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Anong Kiddee
- Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Achiraya Siriphap
- Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Grissana Pook-In
- Division of Microbiology and Parasitology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Ratsada Praphasawat
- Department of Pathology, School of Medicine, University of Phayao, Phayao 56000, Thailand
| | - Surasak Saokaew
- Division of Social and Administrative Pharmacy, Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
- Centre of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
- Unit of Excellence on Clinical Outcomes Research and Integration (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao 56000, Thailand
| | - Acharaporn Duangjai
- Unit of Excellence in Research and Product Development of Coffee, Division of Physiology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
- Division of Physiology, School of Medical Sciences, University of Phayao, Phayao 56000, Thailand
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Martínez-Sellés M, Muñoz P. Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis. J Clin Med 2023; 12:5705. [PMID: 37685770 PMCID: PMC10488693 DOI: 10.3390/jcm12175705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Infective endocarditis (IE) has experienced enormous changes in recent decades [...].
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Affiliation(s)
- Manuel Martínez-Sellés
- Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain;
- School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Europea, 28001 Madrid, Spain
| | - Patricia Muñoz
- Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain;
- School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), 28029 Madrid, Spain
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4
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Fernández-Espigares L, Hernández-Chico I, Expósito-Ruiz M, Rosales-Castillo A, Navarro-Marí JM, Gutiérrez-Fernández J. Antibiotic Resistance Changes in Gram-Positive Bacteria from Urine Cultures: Development Analysis in a Health Area of South-East Spain. Antibiotics (Basel) 2023; 12:1133. [PMID: 37508228 PMCID: PMC10376075 DOI: 10.3390/antibiotics12071133] [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: 05/25/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
This study analyzed the epidemiology and antibiotic susceptibility profile of significant bacteriuria and assessed the impact of adopting EUCAST criteria on antibiotic resistances. A systematic review was performed on publications in English or Spanish between 1 January 2010 and 30 June 2021 on the susceptibility of Gram-positive bacteria isolated in urinary samples in Europe. A retrospective descriptive study was also conducted on the results of 21,838 urine cultures with presumptive urinary tract infection (UTI) obtained during the past five years by the Department of Microbiology of the Virgen de las Nieves University Hospital (Granada, Spain). The activity of various antibiotics was determined, differentiated among various populations, and interpretations compared according to the application of EUCAST or CLSI criteria. Among 21,838 cases of significant bacteriuria, 27.69% were by Gram-positive bacteria, which were Enterococcus faecalis in 19.04% and Enterococcus faecium in 3.92%. The susceptibility profile remained stable for most antibiotics except for levofloxacin for E. faecalis and Staphylococcus aureus and nitrofurantoin for E. faecium. The resistance of Enterococcus spp. and Staphylococcus spp. to glycopeptides was exceptionally low in our setting. No significant difference in the prevalence of methicillin-resistant Staphylococcus aureus was observed between hospital (26.67%) and community (28.85%) samples. Resistances in our local setting remain stable and appear to be lower than reported in other studies. The adoption of EUCAST vs. CLSI criteria did not produce a general change in resistance rates. Findings suggest the need to revise certain empirical criteria, such as aminoglycoside synergy for Enterococcus and for community-origin S. aureus.
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Affiliation(s)
- Luis Fernández-Espigares
- Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), 18014 Granada, Spain; (L.F.-E.)
| | - Itahisa Hernández-Chico
- Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), 18014 Granada, Spain; (L.F.-E.)
| | - Manuela Expósito-Ruiz
- Unit of Biostatistics, Department of Statistics, School of Medicine, University of Granada, 18016 Granada, Spain;
| | - Antonio Rosales-Castillo
- Program in Clinical Medicine and Public Health, University of Granada & Ibs.GRANADA, 18016 Granada, Spain
| | - José María Navarro-Marí
- Department of Microbiology, Hospital Universitario Virgen de las Nieves-Ibs, 18014 Granada, Spain;
| | - José Gutiérrez-Fernández
- Department of Microbiology, School of Medicine, University of Granada-Instituto de Investigación Biosanitaria de Granada (Ibs.GRANADA), 18014 Granada, Spain; (L.F.-E.)
- Program in Clinical Medicine and Public Health, University of Granada & Ibs.GRANADA, 18016 Granada, Spain
- Department of Microbiology, Hospital Universitario Virgen de las Nieves-Ibs, 18014 Granada, Spain;
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5
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Danneels P, Hamel JF, Lemaignen A, Cattoir V, Dubée V. Reply to Cuervo et al and Horinouchi et al. Clin Infect Dis 2023; 76:1525-1528. [PMID: 36527727 DOI: 10.1093/cid/ciac956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Adrien Lemaignen
- Infectious Diseases and Tropical Medicine, Tours University Hospital
| | - Vincent Cattoir
- Department of Bacteriology
- National Reference Center for Enterococci, Pontchaillou University Hospital, Rennes, France
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Herrera-Hidalgo L, Fernández-Rubio B, Luque-Márquez R, López-Cortés LE, Gil-Navarro MV, de Alarcón A. Treatment of Enterococcus faecalis Infective Endocarditis: A Continuing Challenge. Antibiotics (Basel) 2023; 12:antibiotics12040704. [PMID: 37107066 PMCID: PMC10135260 DOI: 10.3390/antibiotics12040704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/30/2023] [Accepted: 04/01/2023] [Indexed: 04/07/2023] Open
Abstract
Today, Enterococcus faecalis is one of the main causes of infective endocarditis in the world, generally affecting an elderly and fragile population, with a high mortality rate. Enterococci are partially resistant to many commonly used antimicrobial agents such as penicillin and ampicillin, as well as high-level resistance to most cephalosporins and sometimes carbapenems, because of low-affinity penicillin-binding proteins, that lead to an unacceptable number of therapeutic failures with monotherapy. For many years, the synergistic combination of penicillins and aminoglycosides has been the cornerstone of treatment, but the emergence of strains with high resistance to aminoglycosides led to the search for new alternatives, like dual beta-lactam therapy. The development of multi-drug resistant strains of Enterococcus faecium is a matter of considerable concern due to its probable spread to E. faecalis and have necessitated the search of new guidelines with the combination of daptomycin, fosfomycin or tigecycline. Some of them have scarce clinical experience and others are still under investigation and will be analyzed in this review. In addition, the need for prolonged treatment (6–8 weeks) to avoid relapses has forced to the consideration of other viable options as outpatient parenteral strategies, long-acting administrations with the new lipoglycopeptides (dalbavancin or oritavancin), and sequential oral treatments, which will also be discussed.
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Affiliation(s)
- Laura Herrera-Hidalgo
- Unidad de Gestión Clínica de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología (UCEIMP) Grupo de Resistencias Bacterianas y Antimicrobianos (CIBERINFEC), Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
| | - Beatriz Fernández-Rubio
- Unidad de Gestión Clínica de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
| | - Rafael Luque-Márquez
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología (UCEIMP) Grupo de Resistencias Bacterianas y Antimicrobianos (CIBERINFEC), Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
| | - Luis E. López-Cortés
- Unidad Clínica de Enfermedades Infecciosas y Microbiología, Grupo de Resistencias Bacterianas y Antimicrobianos (CIBERINFEC), Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena/SCIC/Universidad de Sevilla, 41009 Seville, Spain
| | - Maria V. Gil-Navarro
- Unidad de Gestión Clínica de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
| | - Arístides de Alarcón
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología (UCEIMP) Grupo de Resistencias Bacterianas y Antimicrobianos (CIBERINFEC), Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, 41013 Seville, Spain
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Fernández-Rubio B, Herrera-Hidalgo L, Luque-Márquez R, de Alarcón A, López-Cortés LE, Luque-Pardos S, Gutiérrez-Urbón JM, Fernández-Polo A, Gil-Navarro MV, Gutiérrez-Valencia A. Stability of Ampicillin plus Ceftriaxone Combined in Elastomeric Infusion Devices for Outpatient Parenteral Antimicrobial Therapy. Antibiotics (Basel) 2023; 12:antibiotics12030432. [PMID: 36978299 PMCID: PMC10044682 DOI: 10.3390/antibiotics12030432] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/24/2023] Open
Abstract
Currently, ampicillin plus ceftriaxone (AC) is one of the preferred treatments for Enterococcus faecalis infective endocarditis. However, there is a lack of stability data for the combination of both drugs in elastomeric devices, so the inclusion of AC in Outpatient Parenteral Antimicrobial Therapy (OPAT) programs is challenging. The objective of the study was to determine the stability of AC in elastomeric pumps when stored at 8 ± 2 °C, 25 ± 2 °C, 30 ± 2 °C and 37 ± 2 °C using LC-MS/MS. The combination was diluted in 0.9% sodium chloride and the final concentrations were ampicillin 24 g/L plus ceftriaxone 8 g/L. Physical and chemical stability were evaluated at 12, 20, 24, 36 and 48 h after preparation. Stability was met at each time point if the percentage of intact drug was ≥90% of its respective baseline concentration and color and clearness remained unchanged. The drug combination was stable for 48 h when it was kept at 8 ± 2 °C. At 25 ± 2 °C and 30 ± 2 °C, they were stable for 24 h of storage. At 37 ± 2 °C, the stability criterion was not met at any time point. These results prove that AC could be included in OPAT programs using elastomeric infusion devices for the treatment of E. faecalis infections.
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Affiliation(s)
- Beatriz Fernández-Rubio
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
| | - Laura Herrera-Hidalgo
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
- Unidad de Gestión Clinica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
- Correspondence:
| | - Rafael Luque-Márquez
- Unidad de Gestión Clinica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
| | - Arístides de Alarcón
- Unidad de Gestión Clinica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
| | - Luis E. López-Cortés
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena, Departament of Medicine, School of Medicine, University of Sevilla, Biomedicine Institute of Sevilla (IBiS)/CSIC, 41009 Seville, Spain
- Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sonia Luque-Pardos
- Unidad de Gestión Clínica de Farmacia, Hospital del Mar, 08003 Barcelona, Spain
| | - José María Gutiérrez-Urbón
- Unidad de Gestión Clínica de Farmacia, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain
| | - Aurora Fernández-Polo
- Unidad de Gestión Clínica de Farmacia, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
| | - María V. Gil-Navarro
- Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
- Unidad de Gestión Clinica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
- Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Alicia Gutiérrez-Valencia
- Unidad de Gestión Clinica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
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Danneels P, Hamel JF, Picard L, Rezig S, Martinet P, Lorleac’h A, Talarmin JP, Buzelé R, Guimard T, Le Moal G, Brochard-Libois J, Beaudron A, Letheulle J, Codde C, Chenouard R, Boutoille D, Lemaignen A, Bernard L, Cattoir V, Dubée V. Impact of Enterococcus faecalis Endocarditis Treatment on Risk of Relapse. Clin Infect Dis 2022; 76:281-290. [PMID: 36124844 PMCID: PMC9839190 DOI: 10.1093/cid/ciac777] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/12/2022] [Accepted: 09/16/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Enterococcus faecalis infective endocarditis (EFIE) is characterized by a higher frequency of relapses than other infective endocarditis. The role of the treatment on its occurrence remains poorly understood. The aim of this study was to investigate whether the antibiotic regimen could impact the risk of relapse in EFIE. MATERIALS This was a multicenter retrospective study of patients diagnosed with definite EFIE between 2015 and 2019 in 14 French hospitals. The primary endpoint was the occurrence of relapses within the year following endocarditis diagnosis. As death was a competing risk for relapse, Fine and Gray models were used for studying risk factors and impact of treatment. RESULTS Of the 279 patients included, 83 (29.7%) received the amoxicillin-gentamicin (A-G) combination, 114 (40.9%) amoxicillin-ceftriaxone (A-C), 63 (22.6%) A-G and A-C (A-G/A-C) sequentially, 9 (3.2%) amoxicillin (A), and 10 received other treatments. One-year-relapse rate was 9.3% (26 patients). Relapse occurred after a median delay of 107 days from EFIE diagnosis; 6 occurred after 6 months, and 6 were diagnosed by blood cultures in asymptomatic patients. In multivariate analysis, surgery during treatment was a protective factor against one-year relapse and death.The cumulative incidence of relapse 1 year after endocarditis was 46.2% for patients treated with amoxicillin, 13.4% with A-G, 14.7% with A-C, and 4.3% with A-G/A-C (P≥.05 in multivariate analysis). CONCLUSIONS Relapses after treatment of EFIE are frequent, frequently asymptomatic, and may occur more than 6 months after the initial episode.
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Affiliation(s)
- Pierre Danneels
- Infectious Diseases and Tropical Medicine, Angers University Hospital, Angers, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | | | - Léa Picard
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Schéhérazade Rezig
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Pauline Martinet
- Infectious Diseases and Tropical Medicine, La Cavale Blanche University Hospital, Brest, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Aurélien Lorleac’h
- Infectious Diseases and Tropical Medicine, Groupe Hospitalier Bretagne Sud, Lorient, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Jean-Philippe Talarmin
- Infectious Diseases and Tropical Medicine, Cornouaille Hospital, Quimper, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Rodolphe Buzelé
- Infectious Diseases and Tropical Medicine, Saint-Brieuc General Hospital, Saint-Brieuc, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Thomas Guimard
- Infectious Diseases and Tropical Medicine, Vendée Departmental Hospital, La Roche Sur Yon, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Gwenaël Le Moal
- Infectious Diseases and Tropical Medicine, Poitiers University Hospital, Poitiers, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Julia Brochard-Libois
- Infectious Diseases and Tropical Medicine, Saint Nazaire General Hospital, St-Nazaire, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Aurélie Beaudron
- Department of Bacteriology, Le Mans General Hospital, Le Mans, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Julien Letheulle
- Service de médecine polyvalente, Centre Hospitalier de Laval, Laval, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Cyrielle Codde
- Infectious Diseases and Tropical Medicine, Limoges University Hospital, Limoges, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Rachel Chenouard
- Department of Bacteriology, Angers University Hospital, Angers, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - David Boutoille
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire, CIC-UIC 1413 INSERM, Centre Hospitalier Universitaire de Nantes, Nantes, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Adrien Lemaignen
- Infectious Diseases and Tropical Medicine, Tours University Hospital, Tours, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Louis Bernard
- Infectious Diseases and Tropical Medicine, Tours University Hospital, Tours, France,Groupe d’Epidémiologie et Recherche en Infectiologie Clinique du Centre et de l’Ouest (GERICCO), France
| | - Vincent Cattoir
- Department of Bacteriology, Pontchaillou University Hospital, Rennes, France,National Reference Center for Enterococci, Pontchaillou University Hospital, Rennes, France,INSERM unit U1230, University of Rennes 1, Rennes, France
| | - Vincent Dubée
- Correspondence: V. Dubée, Infectious Diseases and Tropical Medicine, University Hospital. 4, Rue Larrey, 49100 Angers, France ()
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Vigneswaran N, McKew G. A retrospective study of Enterococcus faecalis infective endocarditis: comparison of clinical characteristics and outcomes associated with treatment. JAC Antimicrob Resist 2022; 4:dlac096. [PMID: 36196445 PMCID: PMC9524564 DOI: 10.1093/jacamr/dlac096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/19/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
A synergistic antibiotic combination of a penicillin and gentamicin (AG) or ceftriaxone (AC) is used in the management of Enterococcus faecalis infective endocarditis (EFIE). We compare the treatment outcomes between AG and AC, including low and high dose ceftriaxone (1 and 2 g 12 hourly).
Methods
A retrospective cohort study of patients treated for EFIE at single tertiary centre (2012–2019). Outcome measures examined were 90- and 180-day mortality, treatment associated adverse events and relapse of bacteraemia (within 1 year).
Results
39 patients were enrolled [61.6% given (AC) (n = 24), 24% received ACL (n = 10) and 34% received ACN (n = 14)], 38.4% received AG (n = 15). We noted a difference in the mortality outcomes at 90 and 180 days between those treated with AG and AC overall (6.7% and 33.3%, respectively) although this did not reach statistical significance (P = 0.114, P = 0.061). No significant difference was noted between these groups in incidence of relapsed bacteraemia with two cases noted in the AC cohort (8.3%, 2/24) and none observed (0/15) in the AG cohort (P = 0.662, P = 0.414). A greater number of adverse events was observed in the AG group (11/15, 73.3%) compared to the overall AC group (6/24, 25.0%) (P = 0.009), with no difference between the high and low dose ceftriaxone groups (P = 0.05).
Conclusion
Combination treatment of EFIE with AC is associated with a reduced number of adverse events in comparison to AG groups. Although increased mortality was observed in the AC group, this did not reach statistical significance, and reflects the greater comorbidities and reduced capacity for surgical source control in this cohort.
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Affiliation(s)
- N Vigneswaran
- Department of Infectious Diseases and Microbiology, Concord Repatriation General Hospital , Sydney , Australia
| | - G McKew
- Department of Infectious Diseases and Microbiology, Concord Repatriation General Hospital , Sydney , Australia
- University of Sydney , Sydney , Australia
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