Infective endocarditis caused by Gemella - a retrospective registry-based study

Area of Science:

• Cardiology
• Infectious Diseases
• Microbiology

Background:

• Infective endocarditis (IE) diagnosis relies on the Duke criteria, updated in 2023.
• The Duke-ISCVID 2023 criteria now recognize Gemella as a typical IE pathogen.
• Understanding Gemella IE's clinical profile is crucial following its updated classification.

Purpose of the Study:

• To evaluate the clinical characteristics of infective endocarditis caused by Gemella species.
• To compare Gemella IE with IE caused by other common pathogens.
• To assess the impact of the Duke-ISCVID 2023 criteria on Gemella IE diagnosis.

Main Methods:

• Retrospective analysis of data from the Swedish Registry of Infective Endocarditis (SRIE).
• Comparison of clinical features of Gemella IE with IE caused by non-beta haemolytic streptococci, Staphylococcus aureus, and enterococci.
• Assessment of diagnostic criteria changes using modified Duke vs. Duke-ISCVID 2023 criteria.

Main Results:

• Gemella IE accounted for 0.4% of all IE cases in the SRIE (29/7677 episodes).
• Gemella morbillorum and Gemella bergerii were the most common species.
• Definite IE diagnosis increased from 45% to 72% with Duke-ISCVID 2023 criteria.
• Patients were older (median 70 years), predominantly had native valve IE (90%), and low mortality (3%).
• Clinical presentation of Gemella IE resembled that of non-beta haemolytic streptococcal IE.

Conclusions:

• Gemella IE is a rare condition with clinical features similar to non-beta haemolytic streptococcal IE.
• The updated Duke-ISCVID 2023 criteria enhance the diagnosis of Gemella IE.
• Gemella IE appears to have a relatively favorable prognosis.