Treatment of Brucella Endocarditis: 15 Years of Clinical and Surgical Experience

Şaşmazel, Ahmet; Baysal, Ayşe; Fedakar, Ali; Bugra, Onursal; Ozkokeli, Mehmet; Büyükbayrak, Fuat; Keleş, Cüneyt; Göçer, Sinan; Sunar, Hasan; Zeybek, Rahmi

doi:10.1016/j.athoracsur.2010.01.048

Cited by 39 publications

(30 citation statements)

References 24 publications

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“…Brusellozis genellikle Akdeniz bölgesi ve Ortadoğu ülkelerinde görülür. Pastörize edilmemiş süt ve süt ürünlerini kullanan veya enfekte hayvanlarla temas öyküsü olanlar mutlaka sorgulanmalıdır (26)(27)(28). Bizim hastalarımızın pastörize edilmemiş süt ve süt ürünleri kullanma öyküsü vardı.…”

Section: Discussionunclassified

Antimicrobial Susceptibility and Microorganisms Isolated from Blood Cultures of Hospitalized Patients in Intensive Care Units

Küçükateş¹,

Gültekin²

2016

Haseki

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ÖzAmaç: Çalışmamızda, yoğun bakım ünitelerimizde yatan hastaların kan kültürlerinde üreyen mikroorganizmaların değerlendirilmesi ve tedavi için uygun antimikrobiyal ajanların saptanması amaçlandı. Aim:The aim of this study was to evaluate microorganism growth in blood cultures of hospitalized patients in our intensive care units and to determine appropriate antimicrobial agents for treatment. Yöntemler Methods:We retrospectively investigated the blood cultures obtained from the patients hospitalized in the Coronary and Surgical Intensive Care Units at the Institute of Cardiology, İstanbul University, between July 2013 and December 2014. All microorganisms were identified using the conventional methods.Results: A total of 1034 blood cultures were obtained from 324 patients. Microbial growth was detected in 174 (16.8%) blood cultures of 68 patients. Among all microbial growth, 113 (58.55%) were gram-positive bacteria, 69 (35.75%) were gram-negative rods and 11 (5.7%) were fungi. Staphylococcus aureus was the most frequent microorganism (48; 24.87%), followed by coagulasenegative Staphylococci (35;18,13%), Enterococcus spp. (30;15,54%), Stenotrophomonas maltophilia, Escherichia coli, and Pseudomonas spp. 60.4% of Staphylococcus aureus were methicillin-resistant and 65.7% of coagulase-negative Staphylococci were also methicillinresistant. All Staphylococci and Enterococci were not resistant to vancomycin, teicoplanin and tigecycline. All the gram-negative rods were susceptible to colistin and tigecycline, followed by imipenem (71.6%) and meropenem (70.7%). Conclusions:We assume that infection control measures must be increased due to high antibiotic resistance and besides, antibiotic policies should be improved.Keywords: Blood cultures, intensive care unit, antimicrobial resistance Abs tractYa z›fl maAd re si/Ad dressforCor res pon den ce:Emine Küçükateş

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Section: Discussionunclassified

Antimicrobial Susceptibility and Microorganisms Isolated from Blood Cultures of Hospitalized Patients in Intensive Care Units

Küçükateş¹,

Gültekin²

2016

Haseki

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“…Brucella endocarditis predominantly involves left-sided valves with a distinct predilection for the aortic valve 4. Left untreated, Brucella endocarditis can progress to aortic root and sinus of Valsalva abscess formation, aortic dissection and cardiac failure 4 5. Moreover, the typically bulky vegetations of brucellosis frequently embolise resulting in infection and infarction of downstream organs 4 6…”

Section: Discussionmentioning

confidence: 99%

Successful management of native-valveBrucellaendocarditis with medical therapy alone

et al. 2013

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A 71-year-old Asian-Indian male agriculturist presented with fever since 3 months. Clinical examination revealed hepatosplenomegaly and an early diastolic murmur in the aortic area. Echocardiography confirmed aortic regurgitation with large vegetations on the aortic valve leaflets, and also showed mild left ventricular dilatation with systolic dysfunction. Although blood cultures were persistently sterile, serology for Brucella was strongly positive. On retrospective questioning, the patient confirmed frequent occupational exposure to cattle. Surgical intervention was offered, but refused by the patient on financial grounds. Medical therapy for brucellosis with rifampicin, doxycycline and streptomycin resulted in complete and durable recovery.

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“…Endocarditis was found in 80% of fatal brucellosis cases (5). Sasmazel et al evaluated 186 patients with a diagnosis of endocarditis; Brucella endocarditis was found in 13 (7%) of them (6). Different from endocarditis related to other bacteria, the Brucella endocarditis has tendency of fibrosis, hyalinization and calcification.…”

Section: Discussionmentioning

confidence: 99%

Presentation of Two Cases Diagnosed with Brucella Endocarditis

Senger

Ersan

et al. 2012

Intern. Med.

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Brucellosis is an important disease in developing countries. Endocarditis is a complication of brucellosis with the highest mortality. Although the most generally accepted therapy is the combination of medication and surgery, it has been reported that antibiotic treatment only might also be adequate. We present two cases for whom antibiotic treatments were initiated, and a follow-up surgery was planned for one of them. The surgery could not be done due to death of the patient, but the other patient fully recovered with antibiotic treatment only. Optimum treatment and prognostic criteria are not well defined for brucella endocarditis, but medical therapy alone can be considered for some chosen patients.

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Treatment of Brucella Endocarditis: 15 Years of Clinical and Surgical Experience

Cited by 39 publications

References 24 publications

Antimicrobial Susceptibility and Microorganisms Isolated from Blood Cultures of Hospitalized Patients in Intensive Care Units

Antimicrobial Susceptibility and Microorganisms Isolated from Blood Cultures of Hospitalized Patients in Intensive Care Units

Successful management of native-valveBrucellaendocarditis with medical therapy alone

Presentation of Two Cases Diagnosed with Brucella Endocarditis

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