无性菌属。和Granulicatellaspp.是革兰氏阳性球菌,以前称为营养变异或缺乏链球菌。它们作为感染性心内膜炎(IE)的病原体的作用在数字上是不确定的,以及这种感染的诊断和临床管理。我们研究的目的是描述临床,微生物,治疗性的,并对这些微生物惹起的IE患者的预后停止年夜于微生物学部门。
回顾性分析所有的无性体患者。和Granulicatellaspp.IE于2004-2021年在我们中心注册。
在研究期间的822IE中,10例(1.2%)是由嗜碱性菌种引起的。(7)或颗粒菌属。(3).涉及的物种是A.defectiva(7),G.adiacens(2)和G.elegans(1)。八名患者是男性,他们的平均年龄为46岁,4名年龄小于21岁.最常见的合并症是先天性心脏病(4;40%)和心内假体材料的存在(5;50%)。IE发生在5个天然瓣膜和5个人工瓣膜或材料上。8/10患者血培养阳性,在18.07小时的平均潜伏期内。另外两个病人,来自瓣膜或假体材料的阳性16SPCR提供了诊断。在7例患者(70%)中进行了IE手术,在所有情况下,都证明了16SrRNAPCR和瓣膜或假体材料的测序阳性。四名患者的瓣膜和/或假体去除材料培养呈阳性。9例患者接受头孢曲松治疗(单药治疗4例,与其他抗生素联合治疗5例)。平均治疗时间为6周,一年随访时IE相关死亡率为20%。
嗜生物菌属。或颗粒菌属。IE在我们的环境中很少见,但并不例外,特别是影响先天性心脏病或假体材料的患者。血液培养和分子方法允许诊断。他们中的大多数需要手术和相关的死亡率,尽管平均年龄为46岁,很高。
Abiotrophia spp. and Granulicatella spp. are Gram-positive cocci, formerly known as nutritionally variant or deficient Streptococcus. Their role as causative agents of infective endocarditis (IE) is numerically uncertain, as well as diagnostic and clinical management of this infection. The aim of our study is to describe the clinical, microbiological, therapeutic, and prognosis of patients with IE caused by these microorganisms in a large microbiology department.
Retrospective analysis of all the patients with
Abiotrophia spp. and Granulicatella spp. IE registered in our centre in the period 2004-2021.
Of the 822 IE in the study period, 10 (1.2%) were caused by
Abiotrophia spp. (7) or Granulicatella spp. (3). The species involved were A.defectiva (7), G.adiacens (2) and G.elegans (1). Eight patients were male, their mean age was 46 years and four were younger than 21 years. The most frequent comorbidities were congenital heart disease (4; 40%) and the presence of intracardiac prosthetic material (5; 50%). IE occurred on 5 native valves and 5 prosthetic valve or material. Blood cultures were positive in 8/10 patients, within a mean incubation period of 18.07 hours. In the other two patients, a positive 16SPCR from valve or prosthetic material provided the diagnosis. Surgery for IE was performed in seven patients (70%) and in all cases positive 16S rRNA PCR and sequencing from valve or prosthetic material was demonstrated. Valves and/or prosthetic removed material cultures were positive in four patients. Nine patients received ceftriaxone (4 in monotherapy and 5 in combination with other antibiotics). The mean length of treatment was 6 weeks and IE-associated mortality was 20% at one year follow-up.
Abiotrophia spp. or Granulicatella spp. IE were infrequent but not exceptional in our environment and particularly affected patients with congenital heart disease or prosthetic material. Blood cultures and molecular methods allowed the diagnosis. Most of them required surgery and the associated mortality, in spite of a mean age of 46 years, was high.