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Query: UMLS:C0014118 (endocarditis)
 15,629 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three patients, two women aged 54 and 84 years, and a man aged 76 years, had serious complications during a stay in an internal medicine ward. The complications were discussed at monthly multidisciplinary complication meetings, which we organise from 2007 and which are aimed at improving care processes. The first patient developed urinary tract infection, fever and delirium and an arm fracture as a result of a fall after she had been given a routine urinary catheter in order to monitor her fluid balance. The complication discussion indicated that a urinary catheter should not be routinely installed. The second patient developed phlebitis and endocarditis after a venous infusion had been present for several days. As a result of the complication discussion it was decided that venous access was to be renewed after 96 h. The third patient, who was treated for atrial fibrillation, had fatal intracerebral bleeding due to INR > 5. A result of the complication discussion was that active antagonism of anticoagulants is warranted in these cases, not just discontinuation of the anticoagulants. The monthly multidisciplinary complication discussions in our department have led to a change in culture, facilitating the expression of doubts and criticisms, and a readiness to change policies.
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PMID:[Regular discussion of serious complications during admission to an internal medicine department]. 2045 71

We recently identified 15 genes encoding putative surface proteins with features of MSCRAMMs and/or pili in the Enterococcus faecium TX0016 (DO) genome, including four predicted pilus-encoding gene clusters; we also demonstrated that one of these, ebpABC(fm), is transcribed as an operon, that its putative major pilus subunit, EbpC(fm) (also called pilB), is polymerized into high molecular weight complexes, and that it is enriched among clinical E. faecium isolates. Here, we created a deletion of the ebpABC(fm) operon in an endocarditis-derived E. faecium strain (TX82) and showed, by a combination of whole-cell ELISA, flow cytometry, immunoblot and immunogold electron microscopy, that this deletion abolished EbpC(fm) expression and eliminated EbpC(fm)-containing pili from the cell surface. However, transcription of the downstream sortase, bps(fm), was not affected. Importantly, the ebpABC(fm) deletion resulted in significantly reduced biofilm formation (p < 0.0001) and initial adherence (p < 0.0001) versus the wild-type; both were restored by complementing ebpABC(fm) in trans, which also restored cell surface expression of EbpC(fm) and pilus production. Furthermore, the deletion mutant was significantly attenuated in two independent mixed infection mouse urinary tract experiments, i.e., outnumbered by the wild-type in kidneys (p = 0.0003 and < 0.0001, respectively) and urinary bladders (p = 0.0003 and = 0.002). In conclusion, we have shown that the ebpABC(fm) locus encodes pili on the E. faecium TX82 cell surface and provide the first evidence that pili of this emerging pathogen are important for its ability to form biofilm and to cause infection in an ascending UTI model.
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PMID:Characterization of the ebp(fm) pilus-encoding operon of Enterococcus faecium and its role in biofilm formation and virulence in a murine model of urinary tract infection. 2117 46

Corynebacterium species are normal flora of skin and mucous membrane. In recent years, coryneforms have emerged as important opportunistic pathogens in immunocompromised patients. Majority of the Corynebacterium macginleyi isolates are from conjunctiva and cornea. The only reported non ocular isolates are from urinary tract infection, intra-venous catheter related infection, valvular endocarditis and septicaemia. We report herein a rare case of C. macginleyi isolated from tracheostomy site secretions in a patient with carcinoma larynx which was treated successfully with Cefoperazone-sulbactum for seven days and replacing tracheostomy tube. This is the first case of C. macginleyi reported from India.
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PMID:Corynebacterium macginleyi` a rare bacteria causing infection in an immunocompromised patient. 2111 82

The genus Myroides comprises aerobic, yellow-pigmented, non-motile, non-fermenting gram-negative rods formerly classified as Flavobacterium odoratum. Members of the genus are widely distributed in the environment, especially in water, and usually behave as low-grade opportunistic pathogens, having been found to cause urinary tract infection, endocarditis, ventriculitis, and cutaneous infections in severely immunocompromised patients. We report a case of soft tissue infection, septic shock, and pneumonia due to M. odoratimimus in an immunocompetent male. To our knowledge, this is the first description of life-threatening infection caused by this organism in an immunocompetent host. We have also reviewed the medical literature on the genus Myroides.
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PMID:Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus: report of a case and review of Myroides infections. 2124 47

PURPOSE. The efficacy of limited cefuroxime prophylaxis in pediatric patients after cardiovascular surgery was evaluated. METHODS. All patients age 18 years or younger who underwent cardiovascular surgery and received postoperative care from the cardiovascular surgery team between February and July 2006 (preintervention group) and between August 2006 and January 2007 (postintervention group) were eligible for study inclusion. Patients were excluded if they did not receive cefuroxime as postoperative prophylaxis, had a preexisting infection, underwent cardiac transplantation or extracorporeal membrane oxygenation, or underwent delayed sternal closure. The preintervention group received prolonged cefuroxime prophylaxis, and the postintervention group received 24 hours of cefuroxime prophylaxis. Data collected included patient demographics and clinical and laboratory markers of infection, as well as microbiological evidence of and treatment courses for documented or presumed infections. RESULTS. A total of 210 patients were enrolled in the study. The number of patients who required additional antibiotics for suspicion of clinical infection did not significantly differ between the preintervention and postintervention groups (18.6% versus 26.9%, respectively), nor did the rate of documented infection (bacteremia, urinary tract infection, endocarditis, sepsis) (42.1% versus 48.3%, respectively). Moreover, indications for the antibiotics initiated were similar between the preintervention and postintervention groups. Clinical and laboratory signs of postoperative infection were similar between groups. There were no differences in postoperative white blood cell counts, peak serum glucose levels, and platelet nadir between groups. CONCLUSION. Limiting postoperative cefuroxime prophylaxis to 24 hours did not increase infectious outcomes in pediatric patients.
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PMID:Efficacy of limited cefuroxime prophylaxis in pediatric patients after cardiovascular surgery. 2154 42

Aerococcus urinae is a endocarditis rare causative organism with low virulene. We report an A. urinae endocarditis case treated by aortic valve replacement. An 80-year-old woman hospitalized for urinary tract infection and hydronephrosis due to three-week renal calculi. Blood culture on admission isolated Streptococcus acidominimus. During the course, she was transferred to our care for surgical intervention after developing congestive heart failure due to severe aortic regurgitation. Echocardiographic findings indicated infective endocarditis. She underwent aortic valve replacement, and gram staining of the resected valve tissue showed gram-positive cocci, although valve culture was negative. PCR amplification and DNA sequencing using the valve material matched an A. urinae sequence. The woman recovered and was discharged six weeks after antibiotic treatment.
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PMID:[A case of infective Aerococcus urinae endocarditis successfully treated by aortic valve replacement]. 2225 Apr 61

A 63-year-old female, who had undergone aortic and mitral valve replacement 16 years ago, was admitted because of urinary tract infection. The patient developed cerebral hemorrhage. Methicillinresistant Staphylococcus aureus was isolated from her blood culture. Transesophageal echocardiography revealed paravalvular aortic and mitral abscesses, and the diagnosis of prosthetic valve endocarditis was established. A redo double valve replacement was performed. Both paravalvular abscess cavities were debrided and closed with fresh autologous pericardial patches, and mechanical valves were implanted. The patient's postoperative course was uneventful, and she had no sign of recurrent infection 3 years postoperatively.
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PMID:[Prosthetic valve endocarditis associated with paravalvular aortic and mitral abscesses]. 2237 98

Enterococcus spp. as pathogens have increased, but the sources of infection often remain unclear. To investigate whether poultry might be a reservoir for E. faecalis-associated urinary tract infections (UTIs) in humans, we characterized E. faecalis isolates from patients in Vietnam with UTIs during January 2008-January 2010 and poultry living in close contact with them by multilocus sequence typing (MLST), pulsed-field gel electrophoresis, analysis of antimicrobial drug susceptibility patterns, and sequencing of virulence genes. In 7 (23%) of 31 UTI cases, we detected identical MLST, indistinguishable or closely related pulsed-field gel electrophoresis patterns, and similar antimicrobial drug susceptibility patterns. Isolates from urine and poultry showed identical virulence gene profiles, except for 1 variation, and individual genes showed identical sequences. The homology of isolates from urine and poultry further indicates the zoonotic potential and global spread of E. faecalis sequence type 16, which recently was reported in humans with endocarditis and in pigs in Denmark.
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PMID:Enterococcus faecalis clones in poultry and in humans with urinary tract infections, Vietnam. 2270 4

Staphylococcus aureus bacteriuria is a common condition with still largely undetermined clinical relevance. Although S. aureus bacteriuria can be secondary to bacteremia and systemic infection in some patients, it may predispose to bacteremia and invasive disease in others. Whereas most patients with S. aureus bacteriuria do not have symptomatic urinary tract infection, it is reportedly associated with endocarditis and other types of invasive diseases, thereby resulting in major morbidity and occasional mortality. This review summarizes and analyzes the results of previous reports of S. aureus bacteriuria and assesses the clinical relevance and management of this increasingly recognized entity.
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PMID:Staphylococcus aureus Bacteriuria: Source, Clinical Relevance, and Management. 2294 79

Aerococcus is a genus that comprises seven species, of which Aerococcus urinae, and Aerococcus sanguinicola are emerging human pathogens. Aerococci are gram positive cocci that are easily misidentified as streptococci or staphylococci, and thus the incidence of aerococcal infections has been underestimated. With the introduction of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) clinical microbiologists now have access to a rapid and accurate method to identify aerococci. A. urinae and A. sanguinicola are isolated in a small proportion of urinary specimens in many laboratories and many patients with bacteriuria with aerococci have symptoms of urinary tract infection (UTI). A. urinae, and also A. sanguinicola, cause invasive infections including infective endocarditis (IE) with many reported fatalities. Especially older men with urinary tract abnormalities are at risk for bacteraemia with A. urinae but the prognosis of bacteraemia without IE is favourable. Penicillin is appropriate for treatment of invasive infections and in IE, addition of an aminoglycoside should be considered. Treatment of UTI with aerococci is complicated by uncertainty about the effect of trimethoprim-sulphametoxazole and fluoroquinolones on aerococci. This review will discuss identification of Aerococcus spp., antibiotic resistance, the clinical presentation and management of aerococcal infections as well as the virulence mechanisms of these bacteria.
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PMID:Aerococci and aerococcal infections. 2327 6


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