[Enterococcal infective endocarditis: description of 12 cases]

We have performed a retrospective study of patients diagnosed with infective endocarditis due to Enterococcus in our hospital for a period of 12 years (1994-2005). We review clinical and microbiological aspects, therapy, and outcome. We found 12 cases that were 6 % of total endocarditis, and 7% of enterococcal bacteremia. Eight cases were male, and 4 were female, aged between 37 and 94 years. The causative organism of endocarditis was E. faecalis in 10 patients and E. faecium in 2. Two E. faecalis were resistant to aminoglycosides. Aortic valve was the most frequently affected with 9 cases, followed by mitral valve (2 cases), and tricuspid valve (1 case). In 10 cases endocarditis affected a native valve, and only in 2 cases a prosthetic valve. Only 5 patients had underlying valve disease. The most frequently used antimicrobial therapy was the combination of ampicillin plus gentamicin (8 patients). Four cases were treated with monotherapy, 2 with ampicillin, and 2 with vancomycin. Seven patients suffered heart failure, and five of them required surgical therapy with aortic valve replacement. All the patients treated with monotherapy had severe complications, that led to death in 2 of them.