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Streptococcus bovis clone causing two episodes of endocarditis 8 years apart
K Mühlemann1, S Graf, M G Täuber
1Institute for Medical Microbiology, University of Bern, Bern, Switzerland. muehlemann@imm.unibe.ch
Journal of Clinical Microbiology
|February 13, 1999
Summary
Recurrent endocarditis caused by Streptococcus bovis can result from a single, persistent clone. Pulsed-field gel electrophoresis confirmed identical isolates from two separate infections eight years apart, demonstrating long-term bacterial persistence.
Area of Science:
- Microbiology
- Infectious Diseases
- Genetics
Background:
- Endocarditis is a serious infection of the heart lining.
- Streptococcus bovis is a known cause of endocarditis, often associated with underlying gastrointestinal issues.
- Recurrent infections pose significant treatment challenges.
Observation:
- A patient experienced two distinct episodes of Streptococcus bovis endocarditis, separated by an eight-year interval.
- Pulsed-field gel electrophoresis (PFGE) was used to analyze the genetic relatedness of the bacterial isolates.
- Seven other unrelated blood isolates of Streptococcus bovis were analyzed for comparison.
Findings:
- The Streptococcus bovis isolates from the patient's two endocarditis episodes were genetically identical according to PFGE analysis.
- In contrast, seven unrelated blood isolates of Streptococcus bovis exhibited unique PFGE patterns, highlighting genetic diversity within the species.
- This suggests that the same bacterial clone persisted in the patient for at least eight years.
Implications:
- The findings demonstrate the potential for long-term persistence of a single Streptococcus bovis clone within a host, leading to recurrent endocarditis.
- Understanding clonal persistence is crucial for developing targeted treatment strategies and preventing relapse in patients with recurrent bacterial infections.
- This case underscores the importance of considering persistent reservoirs of infection in managing recurrent endocarditis.