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Infective endocarditis by Serratia species: a systematic review
Petros Ioannou1, Konstantinos Alexakis1, Despoina Spentzouri1
1Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, Heraklion, Greece.
Journal of Chemotherapy (Florence, Italy)
|February 25, 2022
Summary
Infective endocarditis (IE) caused by Serratia species is rare but serious, with high mortality. Surgical intervention combined with antibiotics significantly improves survival rates for this challenging infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Serratia species are Gram-negative bacteria causing various infections.
- Infective endocarditis (IE) is a severe condition with high morbidity and mortality.
- IE caused by Serratia species is infrequent and poorly understood, posing management challenges.
Purpose of the Study:
- To systematically review and analyze all published cases of IE caused by Serratia species.
- To elucidate the epidemiological, clinical, microbiological, treatment, and outcome characteristics of Serratia IE.
Main Methods:
- A comprehensive systematic review of PubMed, Scopus, and Cochrane Library databases was conducted.
- Data from 50 studies involving 72 patients with Serratia IE were analyzed.
- Epidemiological, clinical, microbiological, treatment, and outcome data were extracted and synthesized.
Main Results:
- The mitral valve was the most frequently affected site, with prosthetic valves present in 18.1% of cases.
- Common presentations included fever, sepsis, embolic phenomena, and heart failure.
- Clinical cure rates were low (53.5%), with an overall mortality of 47.2%.
- Surgical treatment alongside antimicrobial therapy was independently associated with reduced mortality.
- Serratia IE showed higher rates of heart failure, embolic phenomena, and mortality compared to other non-HACEK Gram-negative IE.
Conclusions:
- IE caused by Serratia species represents a significant clinical challenge with high mortality.
- Multidisciplinary management involving both surgical intervention and appropriate antimicrobial therapy is crucial for improving outcomes.
- Further research is needed to optimize treatment strategies for this rare but severe infection.
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