Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients undergoing major heart surgery (MHS) may be at increased risk for nosocomial infections. To assess the incidence and type of infections in MHS patients in European intensive care units (ICUs) and their quality of care, a questionnaire was sent to a selection of MHS ICUs in Europe. Seventeen hospitals from seven European countries participated. Overall, 53% of the ICUs received patients only for MHS and the other 47% were mixed. During the study period, 11 915 patients underwent MHS and 1181 (9.9%) developed one or more nosocomial infections. Ventilator-associated pneumonia (VAP) was the most common infection [median 3.8%; interquartile range (IQR) 1.8-4.9], followed by surgical wound infection (median 1.6%; IQR 0.8-2.3), catheter-related bloodstream infection (median 1.3%; IQR 0.8-2.1), mediastinitis (median 1.1%; IQR 0.4-1.6), urinary tract infection (median 0.6; IQR 0.4-1.4) and nosocomial endocarditis (median 0.2%; IQR 0.0-0.9). Median mortality was 4.7% (IQR 2.7-8.4) and median infection-related mortality was 1% (IQR 0.5-2.7). Regarding VAP, 18% of the ICUs did not routinely pursue a diagnosis. Microbiological information was quantitative in 35% of cases and exclusively qualitative in 65% of cases. An infectious disease specialist was regularly involved in VAP management in only 35% of the ICUs, and the therapeutic approach to VAP involved de-escalation in 59% of the ICUs. MHS ICUs in Europe still have a high rate of postoperative infections. Well-recognized routine practices for the diagnosis and treatment of VAP are not implemented regularly in many European institutions.
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PMID:Infections following major heart surgery in European intensive care units: there is room for improvement (ESGNI 007 Study). 1678 Oct 14

In order to evaluate the present state of bacteremia, we investigated the clinical and microbiological characteristics of positive blood culture cases hospitalized in Shin-Kokura Hospital from January 1998 through December 2002. Seventy-five cases showed positive blood cultures during the 5 years, and 48 cases (64%) were 70 years old or more. Most of the cases had underlying diseases, such as malignancy. The diagnoses of the infectious diseases found included pneumonia (9 cases), enteric infection (9 cases), hepatobiliary infection (8 cases), urinary tract infection (8 cases), and endocarditis (6 cases). A total of 102 strains of microorganism were isolated, and Gram-positive bacteria accounted for 64.7% of the cases, with Gram-negative bacteria accounting for 29.4%. Most of the isolated microorganisms showed good susceptibility to antimicrobial agents except for MRSA. Antimicrobial agents were used for 54 cases of bacteremia, and 33 patients improved, but 21 patients died, including 10 whose death was due to infection. In this study, the 54 cases of bacteremia (72% of all cases with a positive blood culture) showed a mortality rate of 18.5% due to infection, in spite of adequate antimicrobial treatment. Our data suggest that physicians should recognize the difficulty of treating bacteremia, and should pay close attention to the physical condition of patients with bacteremia.
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PMID:Clinical and microbiological characteristics in cases of positive blood cultures at Shin-Kokura Hospital during a period of 5 years. 1710 97

Staphylococcus sciuri are important human pathogens responsible for endocarditis, peritonitis, septic shock, urinary tract infection, pelvic inflammatory disease and wound infections. However, little information is known regarding the pathogenicity of S. sciuri to animals. From the pericardial fluid of a diseased piglet with exudative epidermitis (EE), we isolated a strain of Staphylococcus in pure culture. Surprisingly, this isolate was a member of S. sciuri rather than S. hyicus as identified by its biochemical traits and also by analysis of 23S ribosomal DNA using Internal Transcribed Spacer PCR. In addition, inoculation of newborn piglets with 1x10(10) CFU of the isolate by oral feeding or intra-muscular injection successfully reproduced EE in piglets, which suggested that the oral intake of the pathogen by the animals is one of the major routes of exposure. These unexpected findings prioritized S. sciuri as important zoonotic agents, which may have ramifications for human medicine.
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PMID:A highly pathogenic strain of Staphylococcus sciuri caused fatal exudative epidermitis in piglets. 1721 58

Aerococcus urinae is a rarely reported pathogen that often causes mild urinary tract infection (UTI), although serious complications such as endocarditis and septicemia have also been described. The organism may easily be missed or misidentified when using commercial detection systems. A. urinae is resistant to sulfonamides and, therefore, a typical treatment for UTI may be inappropriate. To date, 14 cases of A. urinae infective endocarditis (IE) have been reported, most of which were elderly males with predisposing conditions to UTI. Of these patients, eight died and 50% of survivors had severe neurological problems. The case is reported of blood culture-negative IE in a 69-year-old male. The patient recovered fully after undergoing aortic valve replacement and receiving a nine-day course of intravenous ceftriaxone, followed by peroral cefuroxime for the next 11 weeks. The causative agent was identified from the excised valve by bacterial broad-range PCR and direct sequencing of the 16S rRNA gene.
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PMID:Culture-negative infective endocarditis caused by Aerococcus urinae. 1748 72

Deletion mutants of the two sortase genes of Enterococcus faecalis OG1RF were constructed. srtC (renamed here bps for biofilm and pilus-associated sortase) was previously shown to be necessary for the production of Ebp pili and important for biofilm formation and endocarditis. Here, we report that a srtA deletion mutant showed a small (5%) yet significant (P = 0.037) reduction in biofilm relative to OG1RF, while a DeltasrtA Deltabps double mutant showed a much greater reduction (74% versus OG1RF and 44% versus the Deltabps mutant). In a murine urinary tract infection (UTI), the 50% infective doses of both the DeltasrtA Deltabps and Deltabps mutants were approximately 2 log10 greater than that of OG1RF or the DeltasrtA mutant. Similarly, approximately 2 log10 fewer bacteria were recovered from the kidneys after infection with the Deltabps mutant (P = 0.017) and the DeltasrtA Deltabps double mutant (P = 0.022) compared to wild-type strain OG1RF. In a competition UTI, the Deltabps mutant was slightly, but not significantly, less attenuated than the DeltasrtA Deltabps double mutant. Fluorescence-activated cell sorter analysis with Ebp-specific antibodies confirmed that a minority of OG1RF cells express Ebp pili on their surface in vitro and that Bps has a major role in Ebp pilus biogenesis but also indicated a function for SrtA in surface localization of the pilus subunit protein EbpA. In conclusion, deletion of bps had a major effect on virulence in murine UTIs, as well as biofilm; deletion of srtA from OG1RF had little effect on these phenotypes, but its deletion from a bps mutant had a pronounced effect on biofilm, suggesting that Bps and/or the proteins it anchors may compensate for the loss of some SrtA function(s).
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PMID:Relative contributions of Enterococcus faecalis OG1RF sortase-encoding genes, srtA and bps (srtC), to biofilm formation and a murine model of urinary tract infection. 1778 77

A 60-year-old woman returned from visiting a cousin in Texas. For the past 6 weeks, she had not been feeling well and had lost almost 30 lb. She had frequent night sweats, although she did not recall having taken her temperature. Upon evaluation in the emergency department, results of physical examination were notable for cachexia and poor dentition. She was noted to have pyuria, and therapy was initiated for a urinary tract infection. Results of blood cultures performed the same day were positive for gram-positive cocci, and vancomycin therapy was initiated. She developed difficulty in seeing to her, left and a computed tomographic scan of the brain was performed; results were interpreted as negative. A transesophageal echocardiogram showed a 3-cm mass attached the posterior leaflet of the mitral valve. Initial interpretation was of an atrial myxoma. One of the authors was asked to consult on the case and noted bilateral conjunctival hemorrhages (Figure 1). Subsequently, the blood culture isolate was identified as Streptococcus mitis. Magnetic resonance imaging confirmed multiple cerebral infarcts consistent with embolic origin. The patient underwent emergent cardiac surgery, and her mitral valve was replaced with a bioprosthetic valve. She successfully completed a 4-week course of antibiotic therapy for her endocarditis.
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PMID:Getting to the heart of the matter. 1797 47

Staphylococcus lugdunensis has gained recognition as an atypically virulent pathogen with a unique microbiological and clinical profile. S. lugdunensis is coagulase negative due to the lack of production of secreted coagulase, but a membrane-bound form of the enzyme present in some isolates can result in misidentification of the organism as Staphylococcus aureus in the clinical microbiology laboratory. S. lugdunensis is a skin commensal and an infrequent pathogen compared to S. aureus and S. epidermidis, but clinically, infections caused by this organism resemble those caused by S. aureus rather than those caused by other coagulase-negative staphylococci. S. lugdunensis can cause acute and highly destructive cases of native valve endocarditis that often require surgical treatment in addition to antimicrobial therapy. Other types of S. lugdunensis infections include abscess and wound infection, urinary tract infection, and infection of intravascular catheters and other implanted medical devices. S. lugdunensis is generally susceptible to antimicrobial agents and shares CLSI antimicrobial susceptibility breakpoints with S. aureus. Virulence factors contributing to this organism's heightened pathogenicity remain largely unknown. Those characterized to date suggest that the organism has the ability to bind to and interact with host cells and to form biofilms on host tissues or prosthetic surfaces.
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PMID:From clinical microbiology to infection pathogenesis: how daring to be different works for Staphylococcus lugdunensis. 1820 39

A 68- year-old male was referred with fever and urinary tract infection. Abdominal computed tomography showed a right renal infarction with abscess and abscesses in the liver and spleen. Cardiac ultrasonic examination showed a vegitation in the aortic valve. Based on these findings, the patient was diagnosed with infective endocarditis and multiple abdominal organ abscesses. The renal infarctions and multiple abscesses probably developed due to dissemination of warts associated with infective endocarditis. We performed emergency valve replacement at the cardiovascular surgery unit at our hospital. Improvements were made in the multiple abscesses after subsequent treatment with an antibiotic agent. The renal diseases associated with infective endocarditis were found to be diverse and we concluded that it is important to understand the conditions of the disease correctly for appropriate treatment.
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PMID:[Renal infarction with renal abscess onset due to infective endocarditis: a case report]. 1841 79

Acinetobacter baumannii strains are isolated in up to 1% of nosocomial infections mostly from intensive care units immunocompromised patients and are associated with high mortality rates. A baumannii infections include pneumonia, urinary tract infection, endocarditis, skin and soft-tissue infections, surgical-site infection, meningitis, osteomyelitis, and septicemia. We report an extremely rare case of deep neck abscess due to multidrug-resistant A baumannii infection. The isolate strain was analyzed by a repetitive sequence-based polymerase chain reaction typing method: the isolate profile was compared with other strains obtained from isolates recovered in the hospital in that period. Our patient underwent 2 neck explorations and antibiotic treatment (tigecycline 50 mg, twice per day). Five weeks after admission, the patient was discharged in good general conditions. Considering the other obtained strains, 4 different profiles were identified, one as prominent (profile A, 18 isolates), the index case (B), and 2 others (C, D) as divergent.
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PMID:Deep neck abscess due to Acinetobacter baumannii infection. 2001 65

Enterococcus faecalis has emerged as a prominent healthcare-associated pathogen frequently encountered in bacteremia, endocarditis, urinary tract infection, and as a leading cause of antibiotic-resistant infections. We recently demonstrated a capacity for high-level biofilm formation by a clinical E. faecalis isolate, E99. This high biofilm-forming phenotype was attributable to a novel locus, designated bee, specifying a pilus at the bacterial cell surface and localized to a large approximately 80 kb conjugative plasmid. To better understand the origin of the bee locus, as well as to potentially identify additional factors important to the biology and pathogenesis of strain E99, we sequenced the entire plasmid. The nucleotide sequence of the plasmid, designated pBEE99, revealed large regions of identity to the previously characterized conjugative plasmid pCF10. In addition to the bee locus, pBEE99 possesses an open reading frame potentially encoding aggregation substance, as well as open reading frames putatively encoding polypeptides with 60% to 99% identity at the amino acid level to proteins involved in regulation of the pheromone response and conjugal transfer of pCF10. However, strain E99 did not respond to the cCF10 pheromone in clumping assays. While pBEE99 was found to be devoid of any readily recognizable antibiotic resistance determinants, it carries two non-identical impB/mucB/samB-type genes, as well as genes potentially encoding a two-component bacteriocin similar to that encoded on pYI14. Although no bacteriocin activity was detected from an OG1RF transconjugant carrying pBEE99 against strain FA2-2, it was approximately an order of magnitude more resistant to ultraviolet radiation. Moreover, curing strain E99 of this plasmid significantly reduced its ability to survive UV exposure. Therefore, pBEE99 represents a novel conjugative plasmid that confers biofilm-forming and enhanced UV resistance traits that might potentially impact the virulence and/or fitness of E. faecalis.
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PMID:A novel conjugative plasmid from Enterococcus faecalis E99 enhances resistance to ultraviolet radiation. 2030 69


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