Natural History of Streptococcus Faecalis Endocarditis

Toh, C. C. S.; Bali, K. P.

doi:10.1136/bmj.2.5199.640

Cited by 13 publications

(5 citation statements)

References 14 publications

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“…It should be emphasized that one should not hesitate to use the potentially toxic aminoglycosides in older patients as here reported, provided serum levels are assayed regularly and renal function monitored (as this is the major route of aminoglycoside excretion), especially as the urinary tract is at particular risk of being compromised providing as it does the most common source of the faecal streptococcal organisms causing endocarditis (Geraci and Martin, 1954;Toh and Ball, 1960).…”

Section: Discussionmentioning

confidence: 95%

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Streptoccocus faecalis endocarditis: an emerging problem?

Welsby

1978

Postgraduate Medical Journal

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Section: Discussionmentioning

confidence: 95%

“…The ability of enterococci to attack normal heart valves is well documented (Geraci and Martin, 1954;Toh and Ball, 1960). It therefore seems sensible that, after a suspicion or clinical diagnosis of bacterial endocarditis in such patients, a faecal streptococcus should be considered a possible, indeed probable causative organism.…”

Section: Discussionmentioning

confidence: 99%

Streptoccocus faecalis endocarditis: an emerging problem?

Welsby

1978

Postgraduate Medical Journal

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“…This is usually accompanied by an endovascular injury. Nevertheless, it is noteworthy that numerous papers in the earlier literature (prior to 1975) reported that enterococcal endocarditis appeared to arise in a substantial proportion of individuals without obvious prior gross endothelial damage or structural cardiac defects [ 28 , 29 ]. As is frequently the case in earlier literature, the exact determination of the particular bacterial strain can be challenging.…”

Section: Historymentioning

confidence: 99%

Current Knowledge of Enterococcal Endocarditis: A Disease Lurking in Plain Sight of Health Providers

Nappi

2024

Pathogens

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Enterococcus faecalis is a bacterial pathogen that can cause opportunistic infections. Studies indicate that initial biofilm formation plays a crucial regulatory role in these infections, as well as in colonising and maintaining the gastrointestinal tract as a commensal member of the microbiome of most land animals. It has long been thought that vegetation of endocarditis resulting from bacterial attachment to the endocardial endothelium requires some pre-existing tissue damage, and in animal models of experimental endocarditis, mechanical valve damage is typically induced by cardiac catheterisation preceding infection. This section reviews historical and contemporary animal model studies that demonstrate the ability of E. faecalis to colonise the undamaged endovascular endothelial surface directly and produce robust microcolony biofilms encapsulated within a bacterially derived extracellular matrix. This report reviews both previous and current animal model studies demonstrating the resilient capacity of E. faecalis to colonise the undamaged endovascular endothelial surface directly and produce robust microcolony biofilms encapsulated in a bacterially derived extracellular matrix. The article also considers the morphological similarities when these biofilms develop on different host sites, such as when E. faecalis colonises the gastrointestinal epithelium as a commensal member of the common vertebrate microbiome, lurking in plain sight and transmitting systemic infection. These phenotypes may enable the organism to survive as an unrecognised infection in asymptomatic subjects, providing an infectious resource for subsequent clinical process of endocarditis.

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“…As noted above, the classical model of bacterial colonization of the heart involves an abiotic accumulation of host factors, typically associated with an endovascular insult. Notably, however, numerous papers in the older (pre-1975) literature reported that enterococcal endocarditis appears to occur in a significant fraction of patients without obvious pre-existing gross endothelial damage or cardiac structural defects (Geraci and Martin, 1954;Toh and Ball, 1960). (As often occurs in older literature, the precise identification of specific bacterial species can be difficult to determine definitively.)…”

Section: Introductionmentioning

confidence: 99%

Enterococcal Endocarditis: Hiding in Plain Sight

Barnes

Frank

Dunny

2021

Front. Cell. Infect. Microbiol.

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Enterococcus faecalis is a major opportunistic bacterial pathogen of increasing clinical relevance. A substantial body of experimental evidence suggests that early biofilm formation plays a critical role in these infections, as well as in colonization and persistence in the GI tract as a commensal member of the microbiome in most terrestrial animals. Animal models of experimental endocarditis generally involve inducing mechanical valve damage by cardiac catheterization prior to infection, and it has long been presumed that endocarditis vegetation formation resulting from bacterial attachment to the endocardial endothelium requires some pre-existing tissue damage. Here we review both historical and contemporary animal model studies demonstrating the robust ability of E. faecalis to directly attach and form stable microcolony biofilms encased within a bacterially-derived extracellular matrix on the undamaged endovascular endothelial surface. We also discuss the morphological similarities when these biofilms form on other host tissues, including when E. faecalis colonizes the GI epithelium as a commensal member of the normal vertebrate microbiome - hiding in plain sight where it can serve as a source for systemic infection via translocation. We propose that these phenotypes may allow the organism to persist as an undetected infection in asymptomatic individuals and thus provide an infectious reservoir for later clinical endocarditis.

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Natural History of Streptococcus Faecalis Endocarditis

Cited by 13 publications

References 14 publications

Streptoccocus faecalis endocarditis: an emerging problem?

Streptoccocus faecalis endocarditis: an emerging problem?

Current Knowledge of Enterococcal Endocarditis: A Disease Lurking in Plain Sight of Health Providers

Enterococcal Endocarditis: Hiding in Plain Sight

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