التفاصيل البيبلوغرافية
| العنوان: |
Infective endocarditis caused by penicillin-resistant viridans group streptococci: a series of nine cases from a Spanish cohort. |
| المؤلفون: |
Escrihuela-Vidal, Francesc1 (AUTHOR), Fernández-Hidalgo, Núria2,3 (AUTHOR), Muñoz, Patricia4 (AUTHOR), Villamarín, Miguel2 (AUTHOR), García, Nicolás Jiménez5 (AUTHOR), Escudero, Encarnación Moral6 (AUTHOR), Marcos, Francisco Javier Martínez7 (AUTHOR), Cuervo, Guillermo8 (AUTHOR) glcuervo@clinic.cat, Boix-Palop, Lucía9 (AUTHOR), Berbel, Dámaris10 (AUTHOR), Carratalà, Jordi1,3 (AUTHOR), Miró, Jose M3,8 (AUTHOR) |
| المصدر: |
Journal of Antimicrobial Chemotherapy (JAC). Dec2024, Vol. 79 Issue 12, p3230-3235. 6p. |
| مصطلحات موضوعية: |
*THIRD generation cephalosporins, *INFECTIVE endocarditis, *GENTAMICIN, *SURGICAL indications, *CARDIAC surgery, *BETA lactam antibiotics, *CEFTRIAXONE |
| مستخلص: |
Background Infective endocarditis (IE) caused by viridans and gallolyticus group streptococci (VGS-GGS) resistant to penicillin (PEN-R; minimum inhibitory concentration ≥4 mg/L) is rare but poses therapeutic challenges. Objectives To describe the characteristics of patients with IE caused by PEN-R VGS-GGS, focusing on antimicrobial management. Methods Retrospective analysis of a prospective cohort of definite IE caused by PEN-R VGS-GGS between 2008 and 2023 in 40 Spanish hospitals. We describe clinical characteristics, management and outcome of the cases, and compare them to IE caused by VGS-GGS with susceptibility or susceptibility with increased exposure to penicillin (PEN-I). Results We identified nine cases of PEN-R VGS-GGS IE in a cohort of 1563 streptococcal IE (0.58%). All isolates belonged to S. mitis group. Three cases died during hospitalization and no relapse occurred at 3 months of follow-up. Compared to cases with susceptibility or PEN-I, PEN-R showed a higher rate of mitral location (78% versus 51%), surgical indication (67% versus 51%), and in-hospital mortality (33% versus 12%). Most cases (86%) showed resistance to third-generation cephalosporins. The preferred antibiotic regimen was beta-lactam-based: ceftriaxone plus gentamicin, penicillin plus gentamicin, ceftriaxone plus levofloxacin, and ceftaroline plus daptomycin. Two cases received a combination of vancomycin plus gentamicin. Levofloxacin was used in two cases in combination with ceftriaxone or daptomycin. All patients that received cardiac surgery were cured at the end of follow-up. Conclusions IE caused by PEN-R VGS-GGS was rare and only affected mitis group streptococci. Antibiotic combination including a beta-lactam seems to be effective in its management. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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