Academic Journal
Infective endocarditis caused by penicillin-resistant viridans group streptococci: a series of nine cases from a Spanish cohort.
| العنوان: | Infective endocarditis caused by penicillin-resistant viridans group streptococci: a series of nine cases from a Spanish cohort. |
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| المؤلفون: | Escrihuela-Vidal, Francesc, Fernández-Hidalgo, Núria, Muñoz, Patricia, Villamarín, Miguel, García, Nicolás Jiménez, Escudero, Encarnación Moral, Marcos, Francisco Javier Martínez, Cuervo, Guillermo, Boix-Palop, Lucía, Berbel, Dámaris, Carratalà, Jordi, Miró, Jose M |
| 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] |
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| قاعدة البيانات: | Complementary Index |
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