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Endocarditis due to high-level gentamicin-resistant Enterococcus faecalis

P Y Lee1, S S Das

  • 1Public Health Laboratory, St George's Hospital, London, UK.

Postgraduate Medical Journal
|February 1, 1995
PubMed
Summary
This summary is machine-generated.

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A challenging case of Enterococcus faecalis endocarditis resistant to gentamicin highlights the need for extensive antimicrobial testing. Despite treatment and surgery, the patient succumbed to infective endocarditis complications.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Antimicrobial Resistance

Background:

  • Infective endocarditis (IE) is a serious infection of the heart valves.
  • Enterococcus faecalis is a common cause of IE, often requiring combination antibiotic therapy.
  • Gentamicin resistance in Enterococcus faecalis poses a significant therapeutic challenge.

Observation:

  • This case involved aortic valve endocarditis caused by Enterococcus faecalis with high-level gentamicin resistance.
  • Conventional antibiotic combination therapy proved ineffective in treating the patient.
  • Extensive in vitro antimicrobial susceptibility testing was necessary to guide treatment.

Findings:

  • A tailored antimicrobial regimen was identified through comprehensive laboratory testing.

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  • Despite achieving bacteriological resolution and undergoing cardiac surgery, the patient did not survive.
  • The patient died from complications attributed to infective endocarditis.

    • Implications:

    • This case underscores the critical need for thorough antimicrobial susceptibility testing in complex IE cases.
    • High-level gentamicin resistance in Enterococcus faecalis necessitates alternative therapeutic strategies.
    • Even with appropriate treatment and surgical intervention, IE can have a fatal outcome due to its complications.