Treatment of endocarditis due to Proteus species: a literature review

Kalra, Ankur; Cooley, Christine L.; Tsigrelis, Constantine

doi:10.1016/j.ijid.2010.12.002

Cited by 14 publications

(14 citation statements)

References 13 publications

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“…Subsequently, an increasing incidence of IE due to GNB and a changing pattern of risk factors were described among patients with health care contacts (4,5). Most of the knowledge about this clinical entity derived from some case series, single-center experiences, and the ICE study, including 49 patients with IE due to non-HACEK GNB (1,4,(13)(14)(15)(16)(17). Thus, our investigation represents the largest contemporary cohort of patients with IE due to non-HACEK GNB for which data have been collected to date.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

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Durante‐Mangoni

et al. 2018

Antimicrob Agents Chemother

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The objective of this study was to investigate predisposing factors and outcomes of infective endocarditis (IE) caused by non-HACEK Gram-negative bacilli (GNB) in a contemporary multicenter cohort. Patients with IE due to GNB, prospectively observed in 26 Italian centers from 2004 to 2011, were analyzed. Using a case-control design, each case was compared to three age- and sex-matched controls with IE due to other etiologies. Logistic regression was performed to identify risk factors for IE due to GNB. Factors associated with early and late mortality were assessed by Cox regression analysis. The study group comprised 58 patients with IE due to GNB. We found that was the most common pathogen, followed by and The genitourinary tract as a source of infection (odds ratio [OR], 13.59; 95% confidence interval [CI], 4.63 to 39.93; < 0.001), immunosuppression (OR, 5.16; 95% CI, 1.60 to 16.24; = 0.006), and the presence of a cardiac implantable electronic device (CIED) (OR, 3.57; 95% CI, 1.55 to 8.20; = 0.003) were factors independently associated with IE due to GNB. In-hospital mortality was 13.8%, and mortality rose to 30.6% at 1 year. A multidrug-resistant (MDR) etiology was associated with in-hospital mortality (hazard ratio [HR], 21.849; 95% CI, 2.672 to 178.683; = 0.004) and 1-year mortality (HR, 4.408; 95% CI, 1.581 to 12.287; = 0.005). We conclude that the presence of a genitourinary focus, immunosuppressive therapy, and an indwelling CIED are factors associated with IE due to GNB. MDR etiology is the major determinant of in-hospital and long-term mortality.

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Section: Discussionmentioning

confidence: 99%

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

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Tiseo

Durante‐Mangoni

et al. 2018

Antimicrob Agents Chemother

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“…KALRA et al (2011) reviewed endocarditis due to Proteus species and OKIMOTO et al (2010) reported P. mirabilis pneumonia. Brain abscesses during P. vulgaris bacteremia were described by BLOCH et al (2010).…”

Section: Pathogenicitymentioning

confidence: 99%

Proteus sp. – an opportunistic bacterial pathogen – classification, swarming growth, clinical significance and virulence factors

et al. 2012

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The genus Proteus belongs to the Enterobacteriaceae family, where it is placed in the tribe Proteeae, together with the genera Morganella and Providencia. Currently, the genus Proteus consists of five species: P. mirabilis, P. vulgaris, P. penneri, P. hauseri and P. myxofaciens, as well as three unnamed Proteus genomospecies. The most defining characteristic of Proteus bacteria is a swarming phenomenon, a multicellular differentiation process of short rods to elongated swarmer cells. It allows population of bacteria to migrate on solid surface. Proteus bacteria inhabit the environment and are also present in the intestines of humans and animals. These microorganisms under favorable conditions cause a number of infections including urinary tract infections (UTIs), wound infections, meningitis in neonates or infants and rheumatoid arthritis. Therefore, Proteus is known as a bacterial opportunistic pathogen. It causes complicated UTIs with a higher frequency, compared to other uropathogens. Proteus infections are accompanied by a formation of urinary stones, containing struvite and carbonate apatite. The virulence of Proteus rods has been related to several factors including fimbriae, flagella, enzymes (urease - hydrolyzing urea to CO2 and NH3, proteases degrading antibodies, tissue matrix proteins and proteins of the complement system), iron acqusition systems and toxins: hemolysins, Proteus toxin agglutinin (Pta), as well as an endotoxin - lipopolysaccharide (LPS). Proteus rods form biofilm, particularly on the surface of urinary catheters, which can lead to serious consequences for patients. In this review we present factors involved in the regulation of swarming phenomenon, discuss the role of particular pathogenic features of Proteus spp., and characterize biofilm formation by these bacteria.

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“…The first instance of survival without a surgical intervention was reported in 2007 in a patient treated with ceftriaxone for 4 weeks 7. More recently, a successful outcome was reported with ampicillin and gentamicin for an ampicillin-sensitive strain of P. mirabilis 8. In this instance, echocardiography was prompted after a murmur was detected on examination.…”

Section: Discussionmentioning

confidence: 93%

Native valveProteus mirabilisendocarditis: successful treatment of a rare entity formulated by in vitro synergy antibiotic testing

et al. 2016

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SUMMARY Infective endocarditis caused by Proteus mirabilis is a rare and poorly reported disease, with no well-defined effective antibiotic regimen. Here, we present a case of P. mirabilis aortic valve endocarditis. We reviewed prior cases and treatment regimens, and devised effective treatment, which was guided by in vitro sensitivity and synergy testing on the pathogen. Our patient survived without complications or the need for a surgical intervention.

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Treatment of endocarditis due to Proteus species: a literature review

Abstract: Endocarditis due to Proteus species is very rare. We report a case of endocarditis due to Proteus mirabilis that was successfully treated with ampicillin and gentamicin, and review the treatment regimens of previously published cases of Proteus endocarditis.

Cited by 14 publications

References 13 publications

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

Risk Factors and Outcomes of Endocarditis Due to Non-HACEK Gram-Negative Bacilli: Data from the Prospective Multicenter Italian Endocarditis Study Cohort

Proteus sp. – an opportunistic bacterial pathogen – classification, swarming growth, clinical significance and virulence factors

Native valveProteus mirabilisendocarditis: successful treatment of a rare entity formulated by in vitro synergy antibiotic testing

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