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Updated: Aug 13, 2025
Experimental Endocarditis Model of Methicillin Resistant Staphylococcus aureus MRSA in Rat
Published on: June 4, 2012
A Fatal Case of Native Valve Endocarditis with Multiple Embolic Phenomena and Invasive Methicillin-Resistant
Ali Shafeeq1, Hisham Ahmed Imad2,3,4, Ahmed Azhad1
1National Cardiac Center, Indira Gandhi Memorial Hospital, Malé 20002, Maldives.
Abstract:
Infective endocarditis (IE) is a life-threatening condition caused by infection within the endocardium of the heart and commonly involves the valves. The subsequent cascading inflammation leads to the appearance of a highly friable thrombus that is large enough to become lodged within the heart chambers. As a result, fever, fatigue, heart murmurs, and embolization phenomena may be seen in patients with IE. Embolization results in the seeding of bacteria and obstruction of circulation, causing cell ischemia. Of concern, bacteria with the potential to gain pan-drug resistance, such as methicillin-resistant Staphylococcus aureus (MRSA), are increasingly being identified as the causative agent of IE in hospitals and among intravenous drug abusers. We retrospectively reviewed de-identified clinical data to summarize the clinical course of a patient with MRSA isolated using an automated blood culture system. At the time of presentation, the patient showed a poor consciousness level, and the calculated Glasgow scale was 10/15. A high-grade fever with circulatory shock indicated an occult infection, and a systolic murmur was observed with peripheral signs of embolization. This case demonstrated the emerging threat of antimicrobial resistance in the community and revealed clinical findings of IE that may be helpful to clinicians for the early recognition of the disease. The management of such cases requires a multi-specialty approach, which is not widely available in small-island developing states such as the Maldives.
Insights
Infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA) presents a growing threat. Early recognition of IE symptoms is crucial for timely intervention, especially in community-acquired infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Infective endocarditis (IE) is a severe cardiac infection, often involving heart valves.
- Increasing prevalence of pan-drug resistant bacteria, like MRSA, complicates IE treatment.
- IE can lead to serious complications including embolization and organ ischemia.
Observation:
- A case of IE caused by MRSA in a patient presenting with altered consciousness (Glasgow Coma Scale 10/15).
- Clinical signs included high-grade fever, circulatory shock, a systolic murmur, and peripheral embolization.
- The causative agent, MRSA, was identified using an automated blood culture system.
Findings:
- This case highlights the emergence of community-acquired antimicrobial resistance.
- Clinical presentation of IE can be diverse, necessitating vigilance for early diagnosis.
- MRSA-related IE poses a significant challenge due to limited treatment options.
Implications:
- Early recognition of IE symptoms is vital for effective patient management.
- Multi-specialty care is essential for managing complex IE cases.
- The findings underscore the need for robust antimicrobial stewardship programs globally.
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