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Cutibacterium Species Valvular and Cardiac Device-Related Infective Endocarditis: Contemporary Data From the GAMES
David Alonso-Menchén1, Mercedes Marín-Arriaza1,2,3, Miguel Villamarín4,5
1Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Summary
Cutibacterium infective endocarditis (IE) is rare but serious, especially in men with prosthetic material. New criteria and molecular tests aid diagnosis, while surgery and device removal reduce mortality.
Area of Science:
- Cardiovascular Infectious Diseases
- Microbiology
- Diagnostic Medicine
Background:
- Limited data exists on infective endocarditis (IE) caused by Cutibacterium species.
- The efficacy of new Duke-International Society for Cardiovascular Infectious Diseases (ISCVID) criteria for Cutibacterium IE requires assessment.
Purpose of the Study:
- To examine clinical characteristics and outcomes of Cutibacterium IE.
- To evaluate the performance of diagnostic tests for Cutibacterium valvular IE and cardiac implantable electronic device-related IE (CIED-IE).
Main Methods:
- A prospective national cohort study of 6692 IE episodes from 46 Spanish hospitals (2008-2023).
- Reassessment of possible IE cases using new Duke-ISCVID criteria.
- Evaluation of diagnostic test sensitivity: blood cultures, valve/CIED cultures, and 16S rRNA gene polymerase chain reaction and sequencing (16SPCR).
Main Results:
- Cutibacterium spp. caused 67 (1%) IE episodes, predominantly in men, affecting prosthetic valves (45) and CIEDs (17).
- New criteria identified 8 additional cases and reclassified 15 as definite IE.
- Intracardiac complications occurred in 46% of valvular IE cases, with 18% mortality (up to 40% if surgery was contraindicated). CIED-IE had no mortality after device removal.
- 16SPCR showed the highest diagnostic yield (82%), followed by valve/device cultures (70%) and blood cultures (52%).
Conclusions:
- Cutibacterium IE is rare but life-threatening, particularly in men with endovascular prosthetics.
- The Duke-ISCVID criteria and molecular diagnostics like 16SPCR improve diagnosis.
- Cardiac surgery and CIED removal are crucial for reducing mortality in Cutibacterium IE.
