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Endocarditis caused by penicillin-resistant viridans streptococci: 2 cases and controversies in therapy

C S Levy1, P Kogulan, V J Gill

  • 1Infectious Disease and Microbiology Services, Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010, USA. csl3@mhg.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 20, 2001
PubMed

Insights

Penicillin-resistant viridans streptococci are emerging in various infections. This study reports on rare cases of penicillin-resistant viridans streptococcal endocarditis, challenging long-held assumptions about antibiotic sensitivity.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Cardiology

Background:

  • Viridans streptococci are typically penicillin-sensitive, commonly causing endocarditis.
  • Increasing isolation of penicillin-resistant strains from various body sites is noted.
  • Endocarditis cases caused by penicillin-resistant viridans streptococci have been exceptionally rare historically.

Observation:

  • Two new cases of penicillin-resistant viridans streptococcal endocarditis are presented.
  • A literature review identified six additional cases.
  • Animal models of this specific infection were also summarized.

Findings:

  • Penicillin-resistant viridans streptococci can cause infective endocarditis.
  • This resistance poses a clinical challenge, necessitating alternative treatment strategies.
  • The incidence of such cases, though low, warrants attention.

Implications:

  • Clinical vigilance for penicillin resistance in viridans streptococci endocarditis is crucial.
  • Treatment guidelines may need re-evaluation for these resistant strains.
  • Further research into resistance mechanisms and therapeutic options is indicated.

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