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Infective endocarditis due to Streptococci and Enterococci: A 3-year retrospective study
Kavita Raja1, Molly Antony1, S Harikrishnan2
1Department of Microbiology, Sree Chithra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Indian Journal of Pathology & Microbiology
|October 11, 2018
Summary
Infective endocarditis (IE) caused by alpha-hemolytic streptococci and enterococci is challenging to diagnose. Microbiological hurdles include slow-growing organisms and antibiotic resistance, complicating treatment and patient outcomes.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Cardiology
Background:
- Infective endocarditis (IE) involves bacterial infection of heart valves, forming vegetations.
- Alpha-hemolytic streptococci and enterococci are significant causative agents of IE.
Purpose of the Study:
- To retrospectively analyze cases of infective endocarditis (IE) caused by alpha-hemolytic streptococci and enterococci.
- To identify challenges in the microbiological diagnosis and management of IE.
Main Methods:
- Retrospective review of IE cases from January 2010 to December 2012.
- Blood cultures used for organism isolation and identification.
- Clinical and serological data collected via proforma.
Main Results:
- 63 out of 89 suspected IE cases (70.78%) were culture-positive.
- Alpha-hemolytic streptococci and enterococci accounted for 66.66% of positive cultures.
- Rare organisms and high-level aminoglycoside resistance (HLAR) were observed.
Conclusions:
- Accurate aseptic sample collection and multiple blood cultures are crucial for IE diagnosis.
- Antimicrobial susceptibility reporting is challenging for slow-growing organisms like Nutritionally Variant Streptococci (NVS) and HLAR strains.
- Complications such as congestive heart failure and embolization can occur despite successful antibiotic therapy.
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