Actinobacillus actinomycetemcomitans Prosthetic Valve Endocarditis

Grace, Christopher; Levitz, Robert E.; Katz-Pollak, Harry; Brettman, Lee R.

doi:10.1093/clinids/10.5.922

Cited by 41 publications

(27 citation statements)

References 46 publications

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“…With 93 reported cases, Actinobacillus actinomycetemcomitans is the most frequent agent of endocarditis in the HACEK group (11,20,41,100,106,107,139,206,249). This bacterium was frequently found associated with Actinomyces infections, as suggested by its name, and is commonly found in human periodontal cultures (139).…”

Section: Gram-negative Bacillimentioning

confidence: 99%

“…Prior dental disease was found in 46% of patients with A. actinomycetemcomitans endocarditis, which occurs in young middle-aged patients. Underlying heart disease was noted in 70% of infected patients including those with previous cardiac valve damage (33%) and prosthetic valves (28%) (11,106). The case fatality rate is between 9 and 15%, depending on the series.…”

Section: Gram-negative Bacillimentioning

confidence: 99%

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Endocarditis Due to Rare and Fastidious Bacteria

2001

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The etiologic diagnosis of infective endocarditis is easily made in the presence of continuous bacteremia with gram-positive cocci. However, the blood culture may contain a bacterium rarely associated with endocarditis, such as Lactobacillus spp., Klebsiella spp., or nontoxigenic Corynebacterium, Salmonella, Gemella, Campylobacter, Aeromonas, Yersinia, Nocardia, Pasteurella, Listeria, or Erysipelothrix spp., that requires further investigation to establish the relationship with endocarditis, or the blood culture may be uninformative despite a supportive clinical evaluation. In the latter case, the etiologic agents are either fastidious extracellular or intracellular bacteria. Fastidious extracellular bacteria such as Abiotrophia, HACEK group bacteria, Clostridium, Brucella, Legionella, Mycobacterium, and Bartonella spp. need supplemented media, prolonged incubation time, and special culture conditions. Intracellular bacteria such as Coxiella burnetii cannot be isolated routinely. The two most prevalent etiologic agents of culture-negative endocarditis are C. burnetti and Bartonella spp. Their diagnosis is usually carried out serologically. A systemic pathologic examination of excised heart valves including periodic acid-Schiff (PAS) staining and molecular methods has allowed the identification of Whipple's bacillus endocarditis. Pathologic examination of the valve using special staining, such as Warthin-Starry, Gimenez, and PAS, and broad-spectrum PCR should be performed systematically when no etiologic diagnosis is evident through routine laboratory evaluation

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Section: Gram-negative Bacillimentioning

confidence: 99%

Section: Gram-negative Bacillimentioning

confidence: 99%

Endocarditis Due to Rare and Fastidious Bacteria

2001

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“…on May 11, 2018 by guest http://iai.asm.org/ vascular diseases, including infective endocarditis (4,10,26), atherosclerosis (20), and aneurysm (24). These findings are not surprising, since periodontal pathogens can enter the bloodstream through daily activities, including tooth brushing and chewing food, especially in individuals with poor oral hygiene (12,37).…”

Section: Vol 76 2008mentioning

confidence: 99%

“…The HACEK organisms represent a group of gram-negative, fastidious, slow-growing oropharyngeal bacilli, which contribute to 3% of infective endocarditis in humans. The infection mainly involves children and young adults, including both native and prosthetic valves, with a preference for the left-side valves (4,10,26). A. actinomycetemcomitans is the prevailing agent causing infective endocarditis within the HACEK group (4).…”

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confidence: 99%

EmaA, a Potential Virulence Determinant of Aggregatibacter actinomycetemcomitans in Infective Endocarditis

Tang¹,

Kitten

Munro

et al. 2008

Infect Immun

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The gram-negative fastidious human oropharyngeal Aggregatibacter actinomycetemcomitans is implicated in the etiology of infective endocarditis. EmaA, an oligomeric coiled-coil adhesin homologous to YadA of Yersinia enterocolitica, was hypothesized to mediate the interaction of A. actinomycetemcomitans with collagen. Collagen, the most abundant protein in human bodies and the main component of extracellular matrix (ECM), predominates in the supporting tissue of cardiac valves. To extend our earlier studies using purified collagen to determine bacterial binding activities, we developed a tissue model using rabbit cardiac valves to investigate the interaction of A. actinomycetemcomitans with native collagen. The resected mitral valves, with or without removal of the endothelium, were incubated with equivalent numbers of the wild type and the isogenic emaA mutant defective in collagen binding. There was no difference in binding between the wild-type and the mutant strains when the endothelium remained intact. However, the emaA mutant was fivefold less effective than the wild-type strain in colonizing the exposed ECM. A 10-fold increase in the binding of the wild-type strain to ECM was observed compared with the intact endothelium. Similar observations were replicated in an in vivo endocarditis rabbit model; the emaA mutant was 10-fold less effective in the initial infection of the traumatized aortic valve. Colocalization studies indicated that A. actinomycetemcomitans bound to type I collagen. A. actinomycetemcomitans preferentially colonized the ECM and, together with the evidence that EmaA interacts with the native collagen, suggested that the adhesin is likely a potential virulence determinant of the bacterium in the initiation of infective endocarditis.

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“…A. actinomycetemcomitans is also a member of the clinically important HACEK group of bacteria (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus, A. actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae) (4). These fastidious, gram-negative organisms are considered normal flora of the human oral cavity but can infrequently enter the submucosa and cause extraoral infections including endocarditis, bacteremias, and abscesses (16,23,29,33,55).…”

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confidence: 99%

Structural and Genetic Analyses of O Polysaccharide from Actinobacillus actinomycetemcomitans Serotype f

et al. 2001

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The oral bacterium Actinobacillus actinomycetemcomitans is implicated as a causative agent of localized juvenile periodontitis (LJP). A. actinomycetemcomitans is classified into five serotypes (a to e) corresponding to five structurally and antigenically distinct O polysaccharide (O-PS) components of their respective lipopolysaccharide molecules. Serotype b has been reported to be the dominant serotype isolated from LJP patients. We determined the lipopolysaccharide O-PS structure from A. actinomycetemcomitans CU1000, a strain isolated from a 13-year-old African-American female with LJP which had previously been classified as serotype b. The O-PS of strain CU1000 consisted of a trisaccharide repeating unit composed of L-rhamnose and 2-acetamido-2-deoxy-D-galactose (molar ratio, 2:1) with the structure 32)-

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Actinobacillus actinomycetemcomitans Prosthetic Valve Endocarditis

Cited by 41 publications

References 46 publications

Endocarditis Due to Rare and Fastidious Bacteria

Endocarditis Due to Rare and Fastidious Bacteria

EmaA, a Potential Virulence Determinant of Aggregatibacter actinomycetemcomitans in Infective Endocarditis

Structural and Genetic Analyses of O Polysaccharide from Actinobacillus actinomycetemcomitans Serotype f

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