1
|
Pagotto A, Campanile F, Conti P, Prataviera F, Della Siega P, Flammini S, Giuliano S, Martini L, Pecori D, Sartor A, Screm M, Semenzin T, Tascini C. An Aminoglycoside-Sparing Regimen with Double Beta-Lactam to Successfully Treat Granulicatella adiacens Prosthetic Aortic Valve Endocarditis-Time to Change Paradigm? Infect Dis Rep 2024; 16:249-259. [PMID: 38525767 PMCID: PMC10961776 DOI: 10.3390/idr16020020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/26/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
(1) Background: Granulicatella adiacens is a former nutritionally variant streptococci (NVS). NVS infective endocarditis (IE) is generally characterized by a higher rate of morbidity and mortality, partially due to difficulties in choosing the most adequate microbiological culture method and the most effective treatment strategy, and partially due to higher rates of complications, such as heart failure, peripheral septic embolism, and peri-valvular abscess, as well as a higher rate of valve replacement. Depending on the affected valve (native valve endocarditisNVE, or prosthetic valve endocarditisPVE), the American Heart Association (AHA) 2015 treatment guidelines (GLs) suggest penicillin G, ampicillin, or ceftriaxone plus gentamicin (2 weeks for NVE and up to 6 weeks for PVE), while vancomycin alone may be a reasonable alternative in patients who are intolerant of β-lactam therapy. The European Society of Cardiology (ESC) 2023 GLs recommend treating NVE with penicillin G, ceftriaxone, or vancomycin for 6 weeks, suggesting combined with an aminoglycoside (AG) for at least the first 2 weeks only for PVE; likewise, the same recommendations for IE due to Enterococcus faecalis. (2) Methods: Starting from the case of a 51-year-old man with G. adiacens aortic bio-prosthesis IE who was successfully treated with aortic valve replacement combined with double beta-lactams, an AG-sparing regimen, we performed microbiology tests in order to validate this potential treatment change. (3) Results: As for E. faecalis IE, we found that the combination of ampicillin plus cephalosporines (like ceftriaxone or ceftobiprole) showed a synergistic effect in vitro, probably due to wider binding to penicillin-binding proteins (PBPs), thus contributing to enhanced bacterial killing and good clinical outcome, as well as avoiding the risk of nephrotoxicity due to AG association therapy. (4) Conclusions: Further studies are required to confirm this hypothesis, but double beta-lactams and an adequate sourcecontrol could be a choice in treating G. adiacens IE.
Collapse
Affiliation(s)
- Alberto Pagotto
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, Italy; (F.C.); (P.C.)
| | - Paola Conti
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, Italy; (F.C.); (P.C.)
| | - Francesca Prataviera
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Paola Della Siega
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Sarah Flammini
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Simone Giuliano
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Luca Martini
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Davide Pecori
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Assunta Sartor
- Microbiology Unit, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (A.S.); (M.S.)
| | - Maria Screm
- Microbiology Unit, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy; (A.S.); (M.S.)
| | - Tosca Semenzin
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| | - Carlo Tascini
- Infectious Diseases Division, Department of Medicine (DAME), Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), 33100 Udine, Italy (P.D.S.); (S.F.); (S.G.); (L.M.); (D.P.); (T.S.); (C.T.)
| |
Collapse
|
2
|
Furugaito M, Arai Y, Uzawa Y, Kamisako T, Ogura K, Okamoto S, Kikuchi K. Antimicrobial Susceptibility to 27 Drugs and the Molecular Mechanisms of Macrolide, Tetracycline, and Quinolone Resistance in Gemella sp. Antibiotics (Basel) 2023; 12:1538. [PMID: 37887239 PMCID: PMC10604004 DOI: 10.3390/antibiotics12101538] [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: 09/20/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
Gemella is a catalase-negative, facultative anaerobic, Gram-positive coccus that is commensal in humans but can become opportunistic and cause severe infectious diseases, such as infective endocarditis. Few studies have tested the antimicrobial susceptibility of Gemella. We tested its antimicrobial susceptibility to 27 drugs and defined the resistant genes using PCR in 58 Gemella strains, including 52 clinical isolates and six type strains. The type strains and clinical isolates included 22 G. morbillorum, 18 G. haemolysans (GH) group (genetically indistinguishable from G. haemolysans and G. parahaemolysans), 13 G. taiwanensis, three G. sanguinis, and two G. bergeri. No strain was resistant to beta-lactams and vancomycin. In total, 6/22 (27.3%) G. morbillorum strains were erythromycin- and clindamycin-resistant ermB-positive, whereas 4/18 (22.2%) in the GH group, 7/13 (53.8%) G. taiwanensis, and 1/3 (33.3%) of the G. sanguinis strains were erythromycin-non-susceptible mefE- or mefA-positive and clindamycin-susceptible. The MIC90 of minocycline and the ratios of tetM-positive strains varied across the different species-G. morbillorum: 2 µg/mL and 27.3% (6/22); GH group: 8 µg/mL and 27.8% (5/18); G. taiwanensis: 8 µg/mL and 46.2% (6/13), respectively. Levofloxacin resistance was significantly higher in G. taiwanensis (9/13 69.2%) than in G. morbillorum (2/22 9.1%). Levofloxacin resistance was associated with a substitution at serine 83 for leucine, phenylalanine, or tyrosine in GyrA. The mechanisms of resistance to erythromycin and clindamycin differed across Gemella species. In addition, the rate of susceptibility to levofloxacin differed across Gemella sp., and the quinolone resistance mechanism was caused by mutations in GyrA alone.
Collapse
Affiliation(s)
- Michiko Furugaito
- Department of Clinical Laboratory and Biomedical Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan; (M.F.); (S.O.)
- Department of Clinical Laboratory, Kindai University Hospital, Osakasayama, Osaka 589-8511, Japan
| | - Yuko Arai
- Department of Infectious Diseases, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo 162-8666, Japan; (Y.A.); (Y.U.)
| | - Yutaka Uzawa
- Department of Infectious Diseases, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo 162-8666, Japan; (Y.A.); (Y.U.)
| | - Toshinori Kamisako
- Department of Clinical Laboratory Medicine, Faculty of Medicine, Kindai University, Osakasayama, Osaka 589-8511, Japan;
| | - Kohei Ogura
- Division of Food Science and Biotechnology, Graduate School of Agriculture, Kyoto University, Uji, Kyoto 611-0011, Japan;
| | - Shigefumi Okamoto
- Department of Clinical Laboratory and Biomedical Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka 565-0871, Japan; (M.F.); (S.O.)
| | - Ken Kikuchi
- Department of Infectious Diseases, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo 162-8666, Japan; (Y.A.); (Y.U.)
| |
Collapse
|
3
|
Li X, Yu C, Zhang B, Shan X, Mao W, Zhang Z, Wang C, Jin X, Wang J, Zhao H. The recovery of the microbial community after plaque removal depends on periodontal health status. NPJ Biofilms Microbiomes 2023; 9:75. [PMID: 37805507 PMCID: PMC10560279 DOI: 10.1038/s41522-023-00441-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023] Open
Abstract
Plaque accumulation and microbial community changes are important causes of periodontal disease. Cleaned plaque microorganisms will reattach to form biofilms, but the recovery and outcome of plaque microbial communities in different periodontal health states remain unknown. In this study, we tracked the biofilm remodeling process in 206 dental plaque samples from 40 healthy periodontal, gingivitis and periodontitis volunteers at 6 time points before and after supragingival scaling. We found that microbial communities of different periodontal states changed asynchronously during the process, and the more severe the periodontal disease condition, the more lagged the recovery of plaque microorganisms to their original state after cleaning; this reflected a higher degree of plaque development in periodontitis samples. The plaque index and bleeding index were significantly correlated with plaque recovery, especially the recovery of bacteria such as Abiotrophia and Capnocytophaga. Meanwhile, we found that the microbial community structure of different periodontal health states was most similar at the Day 3 after plaque cleaning, and the communities gradually differentiated and developed in different directions. Abiotrophia and other bacteria might play an important role in determining the development trend of plaque biofilms. The discovery of specific time points and bacteria was of great value in clarifying the pathogenesis of periodontal disease and in seeking targets for prevention and treatment.
Collapse
Affiliation(s)
- Xiaoqing Li
- The Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital/The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China
| | - Cheng Yu
- The Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital/The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China
- Jiangyin Stomatological Hospital/Jiangyin Oral Disease Preventive Treatment, Jiangyin, Jiangsu, China
| | - Bing Zhang
- University of Chinese Academy of Sciences, Beijing, China
- Beijing Institutes of Life Science, Chinese Academy of Sciences, Beijing, China
| | - Xiaogang Shan
- The Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital/The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China
| | - Wenjun Mao
- The Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital/The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China
| | - Zicheng Zhang
- School of Biomedical Engineering, Hainan University, Haikou, Hainan, China
| | - Chunyan Wang
- Henan Key Laboratory of Industrial Microbial Resources and Fermentation Technology, Nanyang Institute of Technology, Nanyang, Henan, China
| | - Xiaoxia Jin
- The Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital/The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China
| | - Jinfeng Wang
- College of Food Science & Nutritional Engineering, China Agricultural University, Beijing, China.
| | - Hui Zhao
- The Third Clinical Institute Affiliated to Wenzhou Medical University/Wenzhou People's Hospital/Wenzhou Maternal and Child Health Care Hospital/The Third Affiliated Hospital of Shanghai University, Wenzhou, Zhejiang, China.
| |
Collapse
|
4
|
Skin microbiota analysis in patients with anorexia nervosa and healthy-weight controls reveals microbial indicators of healthy weight and associations with the antimicrobial peptide psoriasin. Sci Rep 2022; 12:15515. [PMID: 36109548 PMCID: PMC9477808 DOI: 10.1038/s41598-022-19676-6] [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: 05/20/2022] [Accepted: 09/01/2022] [Indexed: 12/29/2022] Open
Abstract
Anorexia nervosa (AN), a psychiatric condition defined by low body weight for age and height, is associated with numerous dermatological conditions. Yet, clinical observations report that patients with AN do not suffer from infectious skin diseases like those associated with primary malnutrition. Cell-mediated immunity appears to be amplified in AN; however, this proinflammatory state does not sufficiently explain the lower incidence of infections. Antimicrobial peptides (AMPs) are important components of the innate immune system protecting from pathogens and shaping the microbiota. In Drosophila melanogaster starvation precedes increased AMP gene expression. Here, we analyzed skin microbiota in patients with AN and age-matched, healthy-weight controls and investigated the influence of weight gain on microbial community structure. We then correlated features of the skin microbial community with psoriasin and RNase 7, two highly abundant AMPs in human skin, to clarify whether an association between AMPs and skin microbiota exists and whether such a relationship might contribute to the resistance to cutaneous infections observed in AN. We find significant statistical correlations between Shannon diversity and the highly abundant skin AMP psoriasin and bacterial load, respectively. Moreover, we reveal psoriasin significantly associates with Abiotrophia, an indicator for the healthy-weight control group. Additionally, we observe a significant correlation between an individual's body mass index and Lactobacillus, a microbial indicator of health. Future investigation may help clarify physiological mechanisms that link nutritional intake with skin physiology.
Collapse
|
5
|
Development of high level daptomycin resistance (HLDR) in Abiotrophia and Granulicatella spp isolates from patients with infective endocarditis (IE). Antimicrob Agents Chemother 2021; 65:e0252220. [PMID: 34252304 DOI: 10.1128/aac.02522-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abiotrophia and Granulicatella species are fastidious organisms, representing around 1%-3% of infective endocarditis (IE). Little is known about the optimal antibiotic treatment of these species, and daptomycin has been suggested as a therapeutic option. We describe the antimicrobial profile in Abiotrophia and Granulicatella IE isolates, investigate high-level daptomycin resistance (HLDR) development and evaluate daptomycin activity in combination therapy. In vitro studies with 16 IE strains (6 A. defectiva, 9 G. adiacens and 1 G. elegans) were performed using microdilution to determine minimal inhibitory concentration (MIC) and time-kill methodology to evaluate combination therapy. Daptomycin non-susceptibility (DNS; MIC≥ 2 mg/L) and HLDR (MIC≥256 mg/L) were based on existing Clinical and Laboratory Standards (CLSI) breakpoints for viridans streptococci. All isolates were susceptible to vancomycin: G. adiacens was more susceptible to penicillin and ampicillin than A. defectiva (22% vs. 0%, and 67% vs. 33%) but less susceptible to ceftriaxone and daptomycin (56% vs. 83%, and 11% vs. 50%). HLDR developed in both A. defectiva (33%) and G. adiacens (78%) after 24h exposure to daptomycin. Combination therapy did not prevent the development of daptomycin resistance with ampicillin (2/3 strains), gentamicin (2/3 strains), ceftriaxone (2/3 strains) or ceftaroline (2/3 strains). Once developed, HLDR was stable for a prolonged time (>3 weeks) in G. adiacens, whereas in A. defectiva the HLDR it reversed to baseline MIC at day 10. This study is first to demonstrate rapid HLDR development in Abiotrophia and Granulicatella species in vitro. Resistance was stable, and most combination therapies did not prevent it.
Collapse
|
6
|
Yang S, Wu L, Xu L, Huang X, Sun X, Yang L, Xu L. Lung abscess secondary to lung cancer with a coinfection of Granulicatellaadiacens and other bacteria: a case report. BMC Infect Dis 2021; 21:662. [PMID: 34238251 PMCID: PMC8265077 DOI: 10.1186/s12879-021-06191-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/17/2021] [Indexed: 01/02/2023] Open
Abstract
Background Granulicatella adiacens is facultative anaerobic Gram-positive bacteria, which mainly involve bacterial endocarditis and bacteremia, but there are few reports of local suppurative infection. A case of lung abscess with a coinfection of Granulicatella adiacens and other bacteria in a lung cancer patient will be reported in this paper. To our knowledge, this is the first case report describing lung abscess due to G.adiacens. Case presentation A 52-year-old Chinese woman was admitted to the hospital, She complained of coughing and expectoration for 1 month, shortness of breath for half a month, and dyspnea for 1 day. After a series of examinations, she was diagnosed with lung abscess, pleural effusion, and bronchogenic carcinoma. Draining pus culture demonstrated Granulicatella adiacens. After more than 5 weeks of antibiotic therapies in total, she gradually recovered to fight against lung cancer. Conclusion This is the first reported lung abscess caused by G.adiacens. In immunosuppressed hosts, G.adiacens is a virulent pathogen associated with a spectrum of intrathoracic suppurative. Earlier diagnosis and proper drainage surgery with effective antibiotics treatment are very important, and antimicrobial treatment should be more than 5 weeks. When complex pulmonary infection interferes with the CT diagnosis, clinical suspicion of lung cancer should be increased if G.adiacens or Eikenella corrodens is detected from a pulmonary infection.
Collapse
Affiliation(s)
- Shuo Yang
- The first Clinical College of Xinjiang Medical University, Urumqi city, China
| | - Liangliang Wu
- The first Clinical College of Xinjiang Medical University, Urumqi city, China
| | - Lili Xu
- Gansu University of traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Xiang Huang
- The first Clinical College of Xinjiang Medical University, Urumqi city, China
| | - Xiaofeng Sun
- Infection center, the First Affiliated Hospital of Xinjiang Medical University, Urumqi city, China.
| | - Lan Yang
- The first Clinical College of Xinjiang Medical University, Urumqi city, China
| | - Ling Xu
- The first Clinical College of Xinjiang Medical University, Urumqi city, China
| |
Collapse
|
7
|
Abstract
Objectives Tamoxifen (TAM), which is used for treating breast cancer, has exhibited another important function as an antimicrobial agent. The objective of this study is to investigate the antibacterial action of TAM against the bacteria present in the human oral cavity. Materials and Methods The bacteria present in the human oral cavity were isolated from healthy individuals. Different concentrations of TAM were tested against the isolated bacteria. Additionally, bactericidal and bacteriostatic effects of TAM were also determined. Results Out of 23 isolated bacteria, a greater number of Gram-positive bacteria were highly susceptible to the low concentrations of TAM than Gram-negative bacteria. Kytococcus sedentarius, which is Gram-positive bacterium, and Pseudomonas stutzeri, which is Gram-negative bacterium, needed a high minimum inhibitory concentration value of TAM (2.5 mg/mL) to be inhibited by TAM's bacteriostatic action. Resistance to TAM was also observed in three strains of Gram-positive and four strains of Gram-negative bacteria. Conclusion TAM has shown a potential antibacterial effect against the bacteria present in the oral cavity, especially against Gram-positive bacteria. This effect is mostly bacteriostatic. This study also found bacterial resistance toward TAM.
Collapse
|
8
|
Perna A, Ricciardi L, Sturiale CL, Fantoni M, Tamburrelli FC, Bonfiglio N, Proietti L. Skipped vertebral spontaneous spondylodiscitis caused by Granulicatella adiacens: Case report and a systematic literature review. J Clin Orthop Trauma 2020; 11:937-941. [PMID: 32879584 PMCID: PMC7452249 DOI: 10.1016/j.jcot.2019.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/23/2019] [Accepted: 07/11/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Granulicatella adiacens is a nutritional variant of streptococcus (NVS), which has been rarely reported as an etiologic agent in spondylodiscitis (SD). MATERIAL AND METHODS We report a case of a 51-year-old male with from chronic low-back pain associated with right sciatica and ipsilateral monoparesis. Spinal MRI showed radiological signs on L1-L2 and L5-S1 discs consistent with SD. We also performed a systematic review of the pertinent literature in order to retrieve all the key information regarding microbiological and clinical features. RESULTS Including our patients, seven cases with a mean age 56 ± 10.2 years were reported in English literature. Six patients were conservatively managed with antibiotic therapy (66%), whereas three with surgery in combination with antibiotics (33%). An endocarditis was associated in three cases, and a pacemaker infection in one. All patients received targeted antibiotic therapy resulting in a quick improvement of clinical symptoms with favorable outcome. Our case is the only with a skip spontaneous SD, which needed a surgical decompression due to the associated neurological symptoms. CONCLUSIONS This incidence of SD sustained by Granulicatella adiances could be underestimated due to their particular microbiological conditions requested for their cultures. However, this infection should be suspected in cases of culture-negative SD, especially when associated with endocarditis.
Collapse
Affiliation(s)
- Andrea Perna
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Ricciardi
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore, Rome, Italy
- Corresponding author. Department of Neurosurgery, Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy, Largo A. Gemelli 1, 00168, Rome, Italy.
| | | | - Massimo Fantoni
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di Malattie infettive, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ciro Tamburrelli
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nadia Bonfiglio
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Proietti
- Fondazione Policlinico Universitario Agostino Gemelli – IRCCS, Rome, Italy
- Istituto di ortopedia e traumatologia, unità di chirurgia vertebrale, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
9
|
Patil SM, Arora N, Nilsson P, Yasar SJ, Dandachi D, Salzer WL. Native Valve Infective Endocarditis with Osteomyelitis and Brain Abscess Caused by Granulicatella adiacens with Literature Review. Case Rep Infect Dis 2019; 2019:4962392. [PMID: 31467742 PMCID: PMC6701334 DOI: 10.1155/2019/4962392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/22/2019] [Accepted: 07/07/2019] [Indexed: 12/11/2022] Open
Abstract
Granulicatella adiacens is a type of NVS (nutritionally variant streptococci) rarely causing infective endocarditis (IE). NVS are fastidious and unable to sustain growth on routine culture media due to lack of specific nutrients. Endocarditis caused by NVS due to their virulence is associated with higher treatment failures and mortality rates. New antimicrobial susceptibility patterns are indicative of a significant rise in penicillin resistance and susceptibility differences between NVS subspecies. Initial empirical therapy is essential as a delay in using the appropriate agent leads to poor results. We present a case of an immunocompetent young female with recent intravenous drug abuse resulting in native mitral valve endocarditis with ruptured chordae tendineae and septic embolization, causing brain abscess and lumbar spine osteomyelitis. She was transferred to a tertiary center where she underwent mitral valve replacement successfully and treated with six weeks of intravenous vancomycin and ertapenem. To our knowledge, ours is the first case report of G. adiacens endocarditis in an adult with brain abscess and osteomyelitis with an excellent response to antibiotic therapy. Based on our case report, literature review, and new antimicrobial susceptibility patterns, updates to treatment guidelines are suggested to improve the therapeutic outcomes.
Collapse
Affiliation(s)
- Sachin M. Patil
- Infectious Disease Department, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Niraj Arora
- Neurology Department, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Peter Nilsson
- Internal Medicine Department, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - S. J. Yasar
- Cardiology Department, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Dima Dandachi
- Infectious Disease Department, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| | - W. L. Salzer
- Infectious Disease Department, University of Missouri Hospital and Clinic, 1 Hospital Dr, Columbia, MO 65212, USA
| |
Collapse
|
10
|
Sakagami H. Introduction to the Special Issue "Biological Efficacy of Natural and Chemically Modified Products against Oral Inflammatory Lesions". MEDICINES 2019; 6:medicines6020052. [PMID: 31035315 PMCID: PMC6630427 DOI: 10.3390/medicines6020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/16/2022]
Abstract
This editorial is a brief introduction to the Special Issue of “Biological Efficacy of Natural and Chemically Modified Products against Oral Inflammatory Lesions”. From the natural resources and chemical modifications of the backbone structures of natural products, various attractive substances with new biological functions were excavated. Best fit combination of these materials may contribute in the treatment of oral diseases.
Collapse
Affiliation(s)
- Hiroshi Sakagami
- Meikai University Research Institute of Odontology (M-RIO), 1-1 Keyakidai, Sakado, Saitama 350-0283, Japan.
| |
Collapse
|