Benefits of a Pre-Treatment Comprehensive Geriatric Assessment in a Rare Case of Gemella Haemolysans Endocarditis in an 86-Year-Old Patient and a Review of the Literature

Sadaune, Lucie; Roca, Frédéric; Bordage, Mathilde; Guillou, Vincent Le; Lesourd, Anaïs; Michel, Anne

doi:10.3390/medicina55060292

Cited by 7 publications

(18 citation statements)

References 28 publications

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“…oralis AsaA as a query. AsaA orthologues were identified in other IE-causing bacterial species including S. mitis, Staphylococcus pasteuri, Granulicatella elegans and G. haemolysans [43][44][45][46][47][48][49][50][51][52][53]. Overall, the protein architecture of these AsaA orthologues is similar to that of S. oralis AsaA.…”

Section: Asaa Is Present In Other Ie-causing Bacterial Speciesmentioning

confidence: 81%

A novel sialic acid-binding adhesin present in multiple species contributes to the pathogenesis of Infective endocarditis

Gaytán

Singh

Woodiga

et al. 2020

Preprint

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Bacterial binding to platelets is a key step in the development of infective endocarditis (IE). Sialic acid, a common terminal carbohydrate on host glycans, is the major receptor for streptococci on platelets. So far, all defined interactions between streptococci and sialic acid on platelets are mediated by serine rich repeat proteins (SRRPs). However, we identified Streptococcus oralis subsp. oralis IE-isolates that bind sialic acid but lack SRRPs. In addition to binding sialic acid, some SRRP-negative isolates also bind the cryptic receptor β-1,4-linked galactose through a yet unknown mechanism. Using comparative genomics, we identified a novel sialic acid-binding adhesin, here named AsaA (associated with sialic acid adhesion A), present in IE-isolates lacking SRRPs. We demonstrated that S. oralis subsp. oralis AsaA is required for binding to platelets in a sialic acid-dependent manner. AsaA comprises a non-repeat region (NRR), consisting of a FIVAR/CBM and two Siglec-like and Unique domains, followed by 31 DUF1542 domains. When recombinantly expressed the NRR competitively inhibited binding of S. oralis subsp. oralis, suggesting that these domains are involved in the direct interaction of AsaA with sialic acid on platelets. We further demonstrated that AsaA impacts the pathogenesis of S. oralis subsp. oralis in a rabbit model of IE. Additionally, we found AsaA orthologues in other IE-causing species and demonstrated that the NRR of AsaA from Gemella haemolysans blocked binding of S. oralis subsp. oralis, suggesting that AsaA contributes to the pathogenesis of multiple IE-causing species. Finally, our findings provide evidence that sialic acid is a key factor for bacterial-platelets interactions in a broader range of species than previously appreciated, highlighting its potential as a therapeutic target.

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Section: Asaa Is Present In Other Ie-causing Bacterial Speciesmentioning

confidence: 81%

A novel sialic acid-binding adhesin present in multiple species contributes to the pathogenesis of Infective endocarditis

Gaytán

Singh

Woodiga

et al. 2020

Preprint

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“…All studies were published between 1989 and 2019. The majority of studies were conducted in Europe and the UK [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 30 , 32 , 34 , 35 , 36 , 37 , 38 , 40 , 46 , 47 , 49 , 52 , 56 , 57 , 58 , 60 , 61 , 66 , 68 , 72 , 73 , 75 , 84 , 92 ] followed by North America [ 15 , 17 , 19 , 21 , 29 , 31 , 33 , 39 , 43 , 45 , 48 , 54 , 55 , 64 , 67 , 69 , 71 , 76 , 77 , 78 , 79 , 83 , 86 , 88 , 89 , 90 ] and Asia. [ 14 , 16 , 18 , 20 , 41 , 44 , 50 , 51 , 53 , 62 , 63 , 65 , 74 ,…”

Section: Resultsmentioning

confidence: 99%

“…in adult patients with infective endocarditis. [ 14 – 20 , 24 , 25 , 29 , 30 , 32 – 34 , 36 , 38 , 39 , 41 – 43 , 46 , 48 , 49 , 52 , 53 , 57 – 60 , 64 – 66 , 68 , 69 , 72 , 73 , 75 – 85 , 87 – 90 ] While the majority of these studies reported the presence of the bacteria in predominantly native-valves, [ 14 – 16 , 18 , 20 , 24 , 25 , 29 , 30 , 32 – 34 , 36 , 38 , 41 , 43 , 46 , 48 , 49 , 52 , 53 , 57 – 59 , 64 , 65 , 68 , 72 , 77 – 81 , 83 – 85 , 87 – 89 ] 12 of those studies highlighted the association of prosthetic valve endocarditis by Gemella spp. [ 17 , 19 , 39 , 42 , 60 , 66 ,…”

Section: Resultsmentioning

confidence: 99%

“…The most common species was Gemella morbillorum (44.6%) [ 14 , 16 – 19 , 23 , 24 , 27 , 28 , 30 , 31 , 35 , 37 , 38 , 42 , 43 , 47 , 49 – 53 , 56 , 58 , 63 , 64 , 70 , 74 – 76 , 80 , 81 , 84 , 90 , 91 ] followed by Gemella haemolysans (26.5%). [ 15 , 21 , 22 , 25 , 26 , 32 , 36 , 40 , 46 , 48 , 52 , 54 , 59 – 61 , 68 , 69 , 72 , 73 , 88 , 92 ] The predominant strains in studies published in Europe and North America were Gemella morbillorum [ 17 , 19 , 23 , 24 , 27 , 28 , 30 , 31 , 35 , 37 , 38 , 43 , 47 , 49 , 52 , 56 , 57 , 64 , …”

Section: Resultsmentioning

confidence: 99%

“…[ 15 , 21 , 22 , 25 , 26 , 32 , 36 , 40 , 46 , 48 , 52 , 54 , 59 – 61 , 68 , 69 , 72 , 73 , 88 , 92 ] The predominant strains in studies published in Europe and North America were Gemella morbillorum [ 17 , 19 , 23 , 24 , 27 , 28 , 30 , 31 , 35 , 37 , 38 , 43 , 47 , 49 , 52 , 56 , 57 , 64 , 75 , 76 , 84 , 90 ] and Gemella haemolysans, [ 15 , 21 , 22 , 25 , 26 , 32 , 36 , 40 , 46 , 48 , 52 , 54 , 60 , 61 , 68 , 69 , 72 , 73 , 88 , 91 ] whereas articles from Asia involved mainly Gemella morbillorum. [ 14 , 16 , 18 , 50 , 51 , ...…”

Section: Resultsmentioning

confidence: 99%

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Risk Factors and Patient Profile of Infective Endocarditis due to <i>Gemella spp.</i>

Kariyanna

Sutarjono²,

Ellanti

et al. 2020

AJMCR

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Background. The diagnosis of infective endocarditis is difficult, especially when it involves atypical organisms. Therefore, our study identified risk factors of infective endocarditis caused by rare pathogen, Gemella spp . Methods. A systematic review was conducted to investigate characteristics of endocarditis patients infected with Gemella spp. using the search term “ Gemella ” and “endocarditis.” Case reports were gathered by searching Medline/Pubmed, Google Scholar, CINAHL, Cochrane CENTRAL, and Web of Science databases. 83 articles were selected for review. Results. Five species of Gemella were identified. Typical patients were males between 31 and 45 years of age. On admission, patients had fever, tachycardia, and normal blood pressure. Common clinical manifestation other than fever included fatigue and weakness, chills and sweating, and nausea, vomiting, diarrhea, and weight changes. One in four reported a history of congenital heart disease, and a recent oral cavity infection. Laboratory tests reveal anemia, leukocytosis, and elevated erythrocyte sedimentation in all age groups, elevated C-reactive protein is observed among adult and geriatric populations only. Mitral and aortic valves were most commonly infected by Gemella spp. . The most common Gemella spp. -susceptible antibiotics were penicillin, vancomycin, cephalosporin, macrolide, and aminoglycosides. However, antibiotic resistance was observed against penicillin, aminoglycoside, and fluoroquinolone. Antibiotic course of at least six weeks resulted in superior clinical improvements than durations under six weeks. Finally, one in two patients underwent valve replacement or repair, with common complications affecting the cardiovascular, neurological, and renal systems. Finally, death occurred in 1 in 8 patients, half of which occurred post-surgical procedure, and the majority occurring equal to or greater than 1 week from admission. Conclusion. Our systematic review highlights the importance of considering rare pathogens, particularly in the presence of predisposing risk factors.

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Gemella haemolysans as an emerging pathogen for bacteremia among the elderly

Kodaka

Uchida

Gomi

2021

J of Gen and Family Med

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Gemella species are facultatively anaerobic, Gram-variable cocci.They can take various forms, such as pairs, clusters, and short chains. Wide-zone alpha-hemolysis can be observed, especially with Gemella haemolysans. 1 G. haemolysans, G. morbillorum, G. bergeri, G. sanguinis, G. assacharolytica, G. taiwanensis, G. parahaemolysans, G. palaticanis, and G. cuniculi are the currently recognized species within the genus. 2 Gemella haemolysans is part of the normal flora in the human oral cavity, upper respiratory tract, gastrointestinal tract, and genitourinary tract. 3 Although infections with Gemella

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Benefits of a Pre-Treatment Comprehensive Geriatric Assessment in a Rare Case of Gemella Haemolysans Endocarditis in an 86-Year-Old Patient and a Review of the Literature

Cited by 7 publications

References 28 publications

A novel sialic acid-binding adhesin present in multiple species contributes to the pathogenesis of Infective endocarditis

A novel sialic acid-binding adhesin present in multiple species contributes to the pathogenesis of Infective endocarditis

Risk Factors and Patient Profile of Infective Endocarditis due to <i>Gemella spp.</i>

Gemella haemolysans as an emerging pathogen for bacteremia among the elderly

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