A case report and literature overview: Abiotrophia defectiva aortic valve endocarditis in developing countries

Ramos, Juliana Nunes; Santos, Louisy Sanches dos; Vidal, Leonardo; Pereira, Paula Marcele Afonso; Salgado, Angelo Antunes; Fortes, Cláudio Querido; Vieira, Verônica Viana; Mattos‐Guaraldi, Ana Luíza; Júnior, Raphael Hirata; Damasco, Paulo Vieira

doi:10.1007/s15010-014-0595-3

Cited by 14 publications

(17 citation statements)

References 17 publications

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“…A recent retrospective case review of eight patients in Taiwan documented successful outcomes for all the patients, although for 2 patients, antimicrobial regimens were adjusted to include vancomycin, teicoplanin, or cefotaxime due to poor initial responses (i.e., continued fever) (16). In addition, several case reports describe outcomes varying from clinical cure to death following treatment of NVS IE with benzylpenicillin plus gentamicin (20)(21)(22). Few data exist regarding the in vitro susceptibility of NVS to antimicrobials typically used for treatment.…”

Section: T He Nutritionally Variant Streptococci (Nvs) Are Fastidiousmentioning

confidence: 99%

Antimicrobial Susceptibilities of Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans

Alberti

Hindler

Humphries

2016

Antimicrob Agents Chemother

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Nutritionally variant streptococci (NVS) are fastidious Gram-positive cocci comprised of the species Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans. NVS are an important cause of bacteremia and infective endocarditis (IE) associated with significant morbidity and mortality. Antimicrobial susceptibility testing (AST) was performed for 14 antimicrobials using the broth microdilution MIC method described in the Clinical and Laboratory Standards Institute (CLSI) M45 guideline. A total of 132 clinical NVS blood isolates collected from 2008 to 2014 were tested. Species level identification of NVS isolates was achieved by 16S rRNA gene sequencing and/or matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Ninety isolates were identified as G. adiacens, 37 as A. defectiva, and 5 as G. elegans. All isolates were susceptible to vancomycin (MIC 90 ‫؍‬ 1 g/ml), and none displayed high-level resistance to aminoglycosides. G. adiacens was considerably more susceptible to penicillin than A. defectiva (38.9% versus 10.8% of isolates susceptible) but was less susceptible to cephalosporins than was A. defectiva (43.3% versus 100% of isolates susceptible to ceftriaxone). Several isolates were resistant to levofloxacin (6%), erythromycin (51%), and clindamycin (10%). The MIC 90 for daptomycin was >4 g/ml for G. adiacens and A. defectiva. G. elegans isolates were 100% susceptible to all antimicrobials tested, with the exception of erythromycin, to which only 20% were susceptible. This study provides antimicrobial susceptibility data for a recent collection of NVS and demonstrates important NVS species-related differences with respect to susceptibility to penicillin, cephalosporins, carbapenems, and daptomycin. Species-level identification of NVS organisms when susceptibility testing is not readily available may aid in treatment decisions.

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Section: T He Nutritionally Variant Streptococci (Nvs) Are Fastidiousmentioning

confidence: 99%

Antimicrobial Susceptibilities of Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans

Alberti

Hindler

Humphries

2016

Antimicrob Agents Chemother

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“…[9] Abiotrophia defectiva rarely causes IE leading to high mortality and morbidity rates. [9] Recently, A. defectiva has been identified as a causative agent in Park et al [3] 62/K Mitral Yes Valve replacement Medical+surgery Carleo et al [9] 74/E Aorta No Immunosuppressive treatment Medical+surgery Pinkey et al [14] 27/E Mitral No None Medical+surgery Ramos et al [4] 60/E Aorta No DM, HT Medical+surgery Kalegeropolus et al [17] 19/E Aorta Yes None Medical+surgery Botta et al [18] 39/K Mitral No None Medical+surgery Bajaj et al [19] 40/E Aorta Yes Aortic valve replacement Medical+surgery Akkoyunlu et al [10] 23/K Mitral No Rheumatoid arthritis Medical+surgery Bozkurt et al [15] 42/K Mitral, aorta Yes None Medical+surgery Yemişen et al [2] 66/K Mitral No Mitral valve replacement Medical+surgery DM: Diabetes mellitus; HT: Hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…This causes doubts about the reliability of antibiotic susceptibility testing results. [4,9,10,12,14] Studies suggest that early surgical intervention provides more favorable outcomes in patients with severe valve disease and widespread vegetations. [15] In the literature review, we determined three case reports from Turkey, listed with other cases from other countries in Table 1.…”

Section: Discussionmentioning

confidence: 99%

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Mitral and aortic valve endocarditis due to a rare microorganism: Abiotrophia defectiva and literature review

Aydemir¹

2017

Turk Gogus Kalp Dama

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ÖZAbiotrophia defectiva besinsel olarak varyant streptokoklar grubuna aittir ve orofarengeal, gastrointestinal ve genitoüriner sistemlerde kolonileşebilir. Abiotrophia defectiva nadiren infektif endokardite yol açarken Abiotrophia defectiva'nın yol açtığı enfeksiyonlar yüksek morbidite ve mortalite oranlarına sahiptir. Bu olgu sunumunda, Abiotrophia defectiva'nın yol açtığı infektif mitral ve aort kapak endokarditi olgusu sunuldu.Anah tar söz cük ler: Abiotrophia defectiva; infektif endokardit; varyant streptokoklar ABSTRACTAbiotrophia defectiva belongs to the nutritionally variant streptococci group and can colonize in oropharyngeal, gastrointestinal and genitourinary systems. Abiotrophia defectiva rarely causes infective endocarditis while infections caused by Abiotrophia defectiva have high morbidity and mortality rates. In this case report, we present a case of infective mitral and aortic valve endocarditis caused by Abiotrophia defectiva.

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“…Collins and Lawson9 have reclassified the genus Abiotrophia with A. defectiva as the only species in this genus. Classically, A. defectiva has been described as non-motile, Gram-positive cocci in chains that are catalase negative, pyridoxine dependent and exhibit satellitism 10 11…”

Section: Introductionmentioning

confidence: 99%

Abiotrophia defectiva endocarditis

Pinkney

Nagassar²,

Roye-Green

et al. 2014

BMJ Case Reports

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SUMMARYA previously healthy 27-year-old Jamaican man presented to the University Hospital of the West Indies with recurrent joint pain, remitting and relapsing fever, and shortness of breath. He was subsequently found to have Abiotrophia defectiva endocarditis. This was the first time this organism had been isolated at our institution. Despite culture directed antibiotics, his clinical course was quite severe with mitral regurgitation and congestive cardiac failure requiring mitral valve replacement. He recovered well postoperatively and is currently being followed at our outpatient cardiology clinic. This report highlights the severe presentation and often poor outcome associated with A. defectiva endocarditis and stresses that the outcome may be improved by early and appropriate surgical intervention. BACKGROUND

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A case report and literature overview: Abiotrophia defectiva aortic valve endocarditis in developing countries

Abstract: A fatal case of aortic valve endocarditis due to Abiotrophia defectiva was reported in Brazil. An overview of cases of endocarditis and other human infections related to A. defectiva in developing countries was also accomplished.

Cited by 14 publications

References 17 publications

Antimicrobial Susceptibilities of Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans

Antimicrobial Susceptibilities of Abiotrophia defectiva, Granulicatella adiacens, and Granulicatella elegans

Mitral and aortic valve endocarditis due to a rare microorganism: Abiotrophia defectiva and literature review

Abiotrophia defectiva endocarditis

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