Gram-negative endocarditis: disease presentation, diagnosis and treatment

Bouza, Emilio; Muñóz, Patricia; Burillo, Almudena

doi:10.1097/qco.0000000000000788

Cited by 17 publications

(28 citation statements)

References 81 publications

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“…IE is a rare disease carrying significant mortality and morbidity. It is most commonly caused by Gram-positive bacteria; however, it may be caused by Gram-negative bacteria in some cases, often in the context of previous hospitalization or exposure to the healthcare system [ 54 , 55 , 56 ]. Information regarding the particularities of clinical presentation and specific guidelines on the management of IE by Gram-negative species in the literature is generally inadequate [ 12 , 13 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is most commonly caused by Gram-positive bacteria; however, it may be caused by Gram-negative bacteria in some cases, often in the context of previous hospitalization or exposure to the healthcare system [ 54 , 55 , 56 ]. Information regarding the particularities of clinical presentation and specific guidelines on the management of IE by Gram-negative species in the literature is generally inadequate [ 12 , 13 , 56 ]. For this reason, better understanding of IE caused by different species, especially Gram-negative bacteria, is required in a systematic way to identify any differences in terms of their epidemiology, clinical presentation, treatment and outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Infective Endocarditis by Moraxella Species: A Systematic Review

Ιωάννου

Alexakis

Baliou

et al. 2022

JCM

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Moraxella catarrhalis is the most clinically relevant species among Moraxella spp. For decades, it was considered to be part of the normal human flora in the upper respiratory tract. However, since the late 1970s, considerable evidence has proposed that M. catarrhalis is an important pathogen in the human respiratory tract. Even though Infective Endocarditis (IE) is rarely caused by Moraxella spp., these infections can be problematic due to the lack of experience in their management. The aim of this study was to systematically review all published cases of IE by Moraxella spp. A systematic review of PubMed, Scopus and Cochrane library (through 8 December 2021) for studies providing epidemiological, clinical, microbiological data as well as treatment data and outcomes of IE by Moraxella spp. was performed. A total of 27 studies, containing data for 31 patients, were included. A prosthetic valve was present in 25.8%. Mitral valve was the most commonly infected site. Fever, sepsis and embolic phenomena were the most common clinical presentations. Cephalosporins, aminoglycosides, aminopenicillins and penicillin were the most commonly used antimicrobials. Overall mortality was 12.9%.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infective Endocarditis by Moraxella Species: A Systematic Review

Ιωάννου

Alexakis

Baliou

et al. 2022

JCM

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“…К наиболее «частым» редким грамотрицательным возбудителям ИЭ относятся Escherichia coli, Pseudo monas aeruginosa, Bartonella, Campylobacter, Enterobacter, Klebsiella, Salmonella, Serratia, Acinetobacter и в некоторых регионах Coxiella [26,45,53,[63][64][65]. Большинство случаев ИЭ, вызванного грамотрицательными бактериями не группы НАСЕК, возникают у людей старшего возраста, ассоциированы с медицинской помощью, в том числе являются внутрибольничными инфекциями, и наблюдаются у пациентов, получающих иммуносупрессивную терапию в связи с трансплантацией органов.…”

Section: инфекционный эндокардит вызванный грамотрицательными бактери...unclassified

“…Большинство случаев ИЭ, вызванного грамотрицательными бактериями не группы НАСЕК, возникают у людей старшего возраста, ассоциированы с медицинской помощью, в том числе являются внутрибольничными инфекциями, и наблюдаются у пациентов, получающих иммуносупрессивную терапию в связи с трансплантацией органов. Грамотрицательный ИЭ не является болезнью наркоманов, но в регионах с высокой частотой внутривенной наркомании этот предрасполагающий фактор может иметь значение [65].…”

Section: инфекционный эндокардит вызванный грамотрицательными бактери...unclassified

“…Дополнительные микробиологические исследования, направленные на диагностику грамотрицательных бактерий, наиболее оправданны в случаях негативной гемокультуры при ИЭ протезированных клапанов и кардиостимуляторов, на фоне гемодиализа и иммунодефицитных состояний, а также у людей, имеющих риск инфицирования Bar tonella, Brucella или Chlamydia при контакте с животными [22,51]. Помимо трудности бактериологической диагностики многих грамотрицательных возбудителей и, соответственно, вынужденной эмпирической терапии ИЭ в случаях с негативной гемокультурой, при лечении грамотрицательного не НАСЕК ИЭ врач сталкивается с резистентностью многих возбудителей к антибиотикам и отсутствием общепризнанных рекомендаций по терапии ИЭ с этими редкими возбудителями [65,66]. Такие грамотрицательные бактерии, как Klebsiella, Acinetobacter, Pseudomonas aeruginosa, Entero bacter, входят в группу 6 высоковирулентных и мультирезистентных к антибиотикам бактерий ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pne u moniae, Acinetobacter baumannii, Pseudomonas aeru ginosa, Enterobacter), являющихся главной причиной тяжелых нозокомиальных, или внутрибольничных, инфекций [67].…”

Section: лечение инфекционного эндокардита вызванного грамотрицательн...unclassified

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Infective endocarditis caused by gram-negative bacteria

Чипигина¹,

Karpova²,

Kashentseva³

et al. 2022

Klinicist

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Infective endocarditis (IE) caused by Gram-negative bacteria is a rare and insufficiently characterized form of endocarditis. The literature review presents data on the frequency, course, risk factors, diagnosis and treatment of both IE caused by the HACEK microorganisms (Haemophilus spр., Aggregatibacter spp., Cardiobacterium hominis, Eikenella corrodens, Kingella) and other Gram-negative bacteria. Gram-negative bacteria are the cause of 3.6–13.6 % IE cases (HACEK microorganisms in 0.8–3 % of IE cases in adults, non-HACEK in 1.8–3.9 %). Patients with IE caused by the HACEK microorganisms are younger, their disease is not associated with previous in-hospital treatment and is subacute with favorable prognosis (intrahospital mortality is 2–3 %). HACEK microorganisms mostly retain sensitivity to many antibiotics. Risk factors of IE caused by HACEK microorganisms are dental interventions, heart disorders, valve prostheses and other implanted cardiac devices. IE caused by non-HACEK Gram-negative bacteria is more common in elderly with concomitant disorders and usually is acute; intrahospital mortality is 13–36.5 %. Risk factors of IE caused by non-HACEK microorganisms are valve prostheses, electrical pacemakers, venous and central catheters, recent in-hospital treatment, Gram-negative bacteremia, decreased immunity, drug abuse, urinary infection, alcoholism, cirrhosis of the liver, removed spleen, consequences of dog and cat bites, working with the soil. Among Gram-negative non-HACEK bacteria causing IE, 28 % have multi-drug resistance (MDR / XDR) against antibiotics. Therefore, Gram-negative bacteria rarely cause IE but during selection of empiric therapy in patients with IE with corresponding risk factors, probability of Gram-negative causative microorganisms in IE etiology should be taken into account.

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An enigmatic presentation of Escherichia coli endocarditis: Emphasizing the role of brain magnetic resonance imaging

Benjanuwattra,

Bell,

Yang

et al. 2023

Clinical Case Reports

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Key Clinical MessageInfective endocarditis should be considered in any febrile individual with acute onset neurological symptoms. If suspicion is high, a negative brain computed tomography does not virtually exclude embolism, and magnetic resonance imaging is warranted.AbstractA diagnosis of infective endocarditis (IE) is often delayed, particularly in those infected with unusual organisms. Hereby, we report a case of a female patient presented with dysarthria, confusion, and altered mental status after being treated for Escherichia coli bacteremia. Computed tomography of the brain was unrevealing; however, scattered embolic phenomena were visualized on magnetic resonance imaging (MRI). The case underscores the importance of clinical awareness, particularly in the setting of unusual microorganisms, and the role of brain MRI in the diagnosis of IE.

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Gram-negative endocarditis: disease presentation, diagnosis and treatment

Cited by 17 publications

References 81 publications

Infective Endocarditis by Moraxella Species: A Systematic Review

Infective Endocarditis by Moraxella Species: A Systematic Review

Infective endocarditis caused by gram-negative bacteria

An enigmatic presentation of Escherichia coli endocarditis: Emphasizing the role of brain magnetic resonance imaging

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