Native Mitral Valve Endocarditis Caused by<i>Neisseria elongata</i>subsp.<i>nitroreducens</i>in a Patient with Marfan Syndrome: First Case in Italy and Review of the Literature

Parrinello, Rossella; Carità, Patrizia; Oreste, Triolo Fabio; Trapani, Renato; Grassedonio, Emanuele; Argano, Vincenzo; Novo, Giuseppina; Silvana, Vallone; Fasciana, Teresa; Verdecchia, Massimo; Giammanco, Anna; Midiri, Massimo; Novo, Salvatore

doi:10.1155/2016/4956205

Cited by 5 publications

(7 citation statements)

References 15 publications

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“…The percentage of positive blood culture and TTE pictures suggestive for IE, according to the Duke modified criteria, observed in our study is due to an earlier alert of an infectious disease consultant closely involved with the hospital team for the management of IE patients. In fact, in our patients, both blood culture and TTE were performed within the first days from admission to the emergency unit, confirming the utility of an early TTE [26,[28][29]. Fever was the main symptom of IE, highlighting that this symptom is vital for the suspicion of IE.…”

Section: Discussionsupporting

confidence: 72%

“…According to the diagnostic algorithm proposed by the European Society of Cardiology (ESC) guidelines, all patients with a clinical suspicion of IE underwent a first complete transthoracic echocardiography (TTE) using the Siemens AcusonSC 2000 ultrasound system prime echocardiography machine (Siemens AG, Munich, Germany), equipped with a 2.5-3.5 MHz probe within one week from the admission to the emergency unit of the University Hospital [23]. Transesophageal echocardiography (TEE) using the iE 33 echocardiographic Philips Medical System (Veenpluis, The Netherlands) was always performed in all TTE with low-quality imaging, valve prosthesis implantation, and cardiac implantable electronic devices (CIED) at the cardiosurgical unit of "Paolo Giaccone" University Hospital in Palermo as previously reported [24][25][26]. All echocardiographic investigations were performed according to the criteria stated in the Duke classification and discussed at the MDT meetings [2].…”

Section: Methodsmentioning

confidence: 99%

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Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Serra¹,

Colomba²,

Carlo³

et al. 2020

Cureus

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Background Infective endocarditis (IE) is an uncommon disease with an involved interplay of clinical and surgical team management. We aimed to define diagnosis parameters and delineate in-hospital management in patients with IE admitted in a tertiary hospital of Southern Italian. Materials and methods Fifty-six consecutive patients (42 males, 14 females; age range: 34-85 years) admitted for IE in the Infectious Diseases, Cardiac Surgery, and Cardiology units, between January 2011 and August 2017, were enrolled. Demographic data, mortality, comorbidities, specimen type, microscopy results, special histological staining performed, and antimicrobial therapy were collected and analyzed. Any comments at the multidisciplinary team meetings were recorded in minutes of and approved. Results We found 83.9% of patients with positive blood cultures. The four most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA: 21.3%), methicillin-sensitive Staphylococcus aureus (MSSA: 17%), Streptococci (14.9%), and Enterococci (14.9%). Both in the univariate and multivariate analysis, we observed a significant positive correlation between surgery and complications. Particularly in the univariate analysis only, surgery was positively correlated to males and C-reactive protein (CPR) at baseline. Also, considering the most common bacteria, it resulted in a positive correlation between surgery and MRSA and Streptococci spp. and between complications and MSSA. Finally, the male gender was positively correlated to MSSA and heart complications, major arterial embolism, septic pulmonary emboli, splenic infarction, and cerebral embolism. Conclusions A blood culture test remains a critical factor for the diagnosis of IE and the antibiotic treatment 1 2 2,

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Section: Discussionsupporting

confidence: 72%

Section: Methodsmentioning

confidence: 99%

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Serra¹,

Colomba²,

Carlo³

et al. 2020

Cureus

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“…For example, Capnocytophaga gingivalis and C. leadbetteri , E. corrodens , G. morbillorum and N. elongata increased rapidly after 24 hr. There have been reports that E. corrodens , G. morbillorum and N. elongata were found in patients with abscesses and endocarditis (Rossella et al, 2016; Sharara, Tayyar, Kanafani, & Kanj, 2016; Shinha, 2017). On zirconia, seven species exhibited significant changes over time.…”

Section: Discussionmentioning

confidence: 99%

Biofilm formation on zirconia and titanium over time—An in vivo model study

Desch

Maltzahn

Stumpp

et al. 2020

Clinical Oral Implants Res

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Objectives The aim of this study was to evaluate volume, vitality and diversity of biofilms on the abutment materials zirconia and titanium as a function of time using an in vivo model for the biofilm formation. Materials and methods The development of biofilms on zirconia and titanium grade 4 test specimens in the human oral cavity over time was analysed. After pretreatment, a total of 96 titanium and 96 zirconia discs were fixed on 12 composite splints, which were worn by 12 volunteers. After 6 hr, 24 hr, 3 days and 5 days, biofilms on 48 specimens of each material were analysed with confocal laser scanning microscopy (CLSM). The microbiota composition on the other 48 test specimens was examined using full‐length 16S sequence analysis. Statistical analysis was performed by SPSS and R, and level of significance was set at 0.05. Results Confocal laser scanning microscopy analysis of the biofilms revealed significant changes in volume over time on zirconia and titanium. The material did not significantly influence the volume or live/dead ratio at the individual time points. The composition of the microbiome was influenced by the age of the biofilm, but not by the material of the test specimen. The most frequently found bacteria were Streptococcus spp., followed by Neisseria spp., Rothia spp., Haemophilus spp., Gemella spp. and Abiotrophia spp. Conclusions On both materials, the quantity and diversity of the microbiome increased over time. Apart from a slight difference in Veillonella abundance at one time point, there were no significant differences between zirconia and titanium.

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“…The most common pathogen among Neisseria species causing IE remain Neisseria gonorrhoeae , with 71 cases reported since 1939, involving predominantly left-sided native valves in young males (21, 22), and Neisseria elongata with 18–24 cases (23, 24) described in literature. N .…”

Section: Resultsmentioning

confidence: 99%

Rare Case of Community-Acquired Endocarditis Caused by Neisseria meningitidis Assessed by Clinical Metagenomics

Choutko¹,

Lazarević²,

Gaïa³

et al. 2019

Front. Cardiovasc. Med.

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The most common causes of infective endocarditis (IE) are Staphylococcus, Streptococcus, Enterococcus , and HACEK-related organisms. In 15–30% of the IE cases, standard blood cultures remain sterile. We aimed at identifying the causative agent of a blood-culture-negative IE by whole metagenome shotgun sequencing (WMGS). A 54-year old woman diagnosed with community-onset pneumonia by a general practitioner, was admitted with dyspnea, cough and fever. The patient's blood cultures were repeatedly negative. The transesophageal echocardiography and transthoracic echocardiography showed an echo density on the left coronary leaflet of the aortic valve and signs suggestive of a ruptured abscess of the mitro-aortic junction. The patient underwent a semi-urgent aortic valve replacement by a mechanical prosthetic valve. We extracted DNA from the surgically-removed fresh valve tissue. The extraction procedure included bacterial/fungal DNA enrichment procedure. Nextera XT library prepared from the valve DNA extract was sequenced (2 × 250) on an Illumina MiSeq instrument. Sequence reads were mapped against bacterial genomic sequences, 16S rRNA genes and clade-specific taxonomic markers. Most of the 103,136 sequencing reads classified as bacterial were assigned to Neisseria meningitidis . In line with these data, mapping of reads against clade-specific and 16S rRNA gene markers revealed N . meningitidis as the most represented species. Assembled metagenomic fragments had the best average nucleotide identity (ANI) with N . meningitidis . Comparison of assembled contigs to reference alleles showed that this strain belongs to the ST-41/44 complex. N. meningitidis is commonly associated with meningitis and/or septicemia but should not be neglected as a causative agent of IE, which became exceedingly rare with the introduction of antibiotics. Our data show that WMGS may be used as a diagnostic procedure to strengthen the diagnosis of IE and to obtain draft genomic sequence of the pathogen and typing information.

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Native Mitral Valve Endocarditis Caused byNeisseria elongatasubsp.nitroreducensin a Patient with Marfan Syndrome: First Case in Italy and Review of the Literature

Cited by 5 publications

References 15 publications

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Infective Endocarditis: Preliminary Results of a Cohort Study in the Southern Italian Population

Biofilm formation on zirconia and titanium over time—An in vivo model study

Rare Case of Community-Acquired Endocarditis Caused by Neisseria meningitidis Assessed by Clinical Metagenomics

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