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Endocarditis and pericarditis complicating pneumococcal bacteraemia, with special reference to the adhesive abilities

B Kan1, J Ries, B Henriques Normark

  • 1Unit of Infectious Diseases, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden.

Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases
|March 10, 2006
PubMed

Insights

Pneumococcal cardiac infections like endocarditis and pericarditis are rare but serious. This study found non-encapsulated Streptococcus pneumoniae strains exhibit increased adherence, potentially explaining their role in these rare infections.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • The incidence and pathogenicity of pneumococcal cardiac infections remain poorly understood.
  • Streptococcus pneumoniae bacteraemia can lead to severe complications, including endocarditis and pericarditis.

Purpose of the Study:

  • To determine the incidence of pneumococcal cardiac infections.
  • To compare clinical and microbiological characteristics of patients with and without these complications.
  • To investigate the adherence properties of Streptococcus pneumoniae strains.

Main Methods:

  • Prospective, international, observational study of 844 patients with Streptococcus pneumoniae bacteraemia.
  • Comparison of clinical data and microbiological characteristics between patients with cardiac complications and controls.
  • In vitro adherence assays using encapsulated and non-encapsulated S. pneumoniae strains.

Main Results:

  • Eight patients (n=5 endocarditis, n=3 pericarditis) developed cardiac complications.
  • Estimated incidence of pneumococcal endocarditis is 1-3 per million inhabitants per year.
  • Non-encapsulated S. pneumoniae demonstrated higher hydrophobicity and increased adherence to human epithelial cells compared to encapsulated strains.

Conclusions:

  • Pneumococcal cardiac infections are rare but occur in patients with S. pneumoniae bacteraemia.
  • No specific medical history pattern identified for patients with infectious cardiac complications.
  • Non-encapsulated S. pneumoniae's adherence properties may contribute to cardiac infections.

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