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)

Strains of coagulase-negative staphylococci were tested for in vivo resistance in a rabbit model of prophylaxis of endocarditis. Regimens of nafcillin, cefazolin, cefamandole, and vancomycin were compared for efficacy in the prevention of infection caused by two methicillin-resistant strains and a susceptible strain. For the two resistant strains, vancomycin was the most effective drug tested. All regimens were effective against the susceptible strain. The two strains for which prophylaxis with beta-lactam antibiotics failed produced a beta-lactam antibiotic-inducible penicillin-binding protein (PBP) that comigrated in sodium dodecyl sulfate-polyacrylamide gels with the low-affinity PBP 2a that is associated with methicillin resistance in strains of Staphylococcus aureus. Like PBP 2a, this PBP had low binding affinity for beta-lactam antibiotics. Peptide maps after either V8 protease or chymotrypsin digestion of radiolabeled PBP 2a or silver-stained preparations were virtually identical to one another and to maps of PBP 2a from a heterogeneous and a homogeneous strain of S. aureus. Methicillin resistance in coagulase-negative staphylococci and therapeutic failure with beta-lactam antibiotics in vivo is associated with production of PBP 2a, which appears to be highly conserved structurally among different species of staphylococci.
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PMID:Coagulase-negative staphylococci resistant to beta-lactam antibiotics in vivo produce penicillin-binding protein 2a. 343 2

A calf model for reproducible, prosthetic tricuspid valve endocarditis was developed using Staphylococcus aureus. The course of late prosthetic valve endocarditis was characterized as a fulminant disease when untreated with antibiotics. The earliest sign of a colonized valve prosthesis was an elevation of body temperature, which correlated with occurrence of positive blood cultures. The dose required to colonize an endothelialized tricuspid prosthetic valve in the calf model was 10(7) to 10(8) S. aureus organisms. In the model for late prosthetic valve endocarditis, silver-allantoin-heparin (SAH) treatment of the prosthetic valve gave no protection from inoculums of 10(8) S. aureus injected 60 days after operation. SAH treatment may be beneficial in early stages of prosthetic valve endocarditis, but this requires further study. Simultaneous cultures from the right atrium, the right ventricle, and the aorta of 2 animals showed that there was a 1,000- to 10,000-fold decrease in the bacterial titers across the combined pulmonary and systemic capillary beds. Bacterial titers drawn from the jugular vein had a 46% false negative result, and positive cultures from the external jugular vein showed only 1.3 S. aureus organisms per milliliter of blood. These bacteriological findings point out the risks of depending on sampling from the peripheral venous system when culturing for right heart endocarditis.
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PMID:Experimental endocarditis in calf after tricuspid valve replacement. 699 67

A case of community-acquired, culture-negative, infective endocarditis was diagnosed in a 57-year-old construction worker. Small, pleomorphic gram-negative rods were seen in Brown-Hopps tissue gram stains and Warthin-Starry silver stains. The organism was identified as Rochalimaea henselae by polymerase chain reaction amplification and sequencing of the 16S rDNA gene sequence. This is the first report of infective endocarditis caused by R henselae.
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PMID:Endocarditis caused by Rochalimaea henselae. 840 24

The safety and in vitro effectiveness of applying silver to polyethylene terephthalate fabric mechanical heart valve (MHV) sewing cuffs for the prevention of prosthetic valve endocarditis (PVE) were evaluated. PVE is an infrequent but grave complication of cardiac surgery associated with mortality rates potentially exceeding 50%. A poor response to antibiotic therapy is partly responsible for the high mortality rates. Silver is a well known antimicrobial agent with broad effectiveness. Preliminary in vitro microbial challenge studies of the coated fabric using the New York State 63 bacteriostatic test and Dow Corning Shake Flask test showed a > or = 97% reduction for most organisms tested. Sheep mitral valve replacement studies suggest comparable tissue ingrowth of uncoated and coated fabric with a more organized, thinner pannus formed on silver coated fabric. Low levels of silver were present in the serum at all time periods. These results indicate MHVs with silver coated cuffs may provide additional protection against PVE.
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PMID:Silver modification of polyethylene terephthalate textiles for antimicrobial protection. 936 88

Despite progress in the area of antimicrobial treatment and the surgical use of homografts, prosthetic valve endocarditis (PVE) remains one of the most dangerous complications following heart valve replacement. We present the case of a patient treated for acute endocarditis which affected the mitral valve and who developed recurrent PVE and native aortic valve endocarditis. After multiple valve surgery, the infection was controlled following aortic and mitral valve replacement using silver-coated prostheses. The St. Jude Medical (SJM) mechanical heart valve Masters Series with Silzone coating is intended to protect heart valve patients against microbial infection. The Silzone coating is formed by an ion beam-assisted deposition process that incorporates silver into the sewing cuff of the SJM heart valve. It has also been suggested that silver treatment may improve the healing characteristics of the heart valve sewing cuff. This technology may be a valuable option to prevent or cure PVE, in addition to homografts. Although the present patient is an isolated case, it was encouraging to find not only a well-healed mitral valve silver-coated prosthesis but also no persistent or recurrent infection during a nine-month follow up.
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PMID:Definitive cure of recurrent prosthetic endocarditis using silver-coated St. Jude Medical heart valves: a preliminary case report. 979 52

Fourty patients with primary and secondary infective endocarditis of the native heart valves as well as patients with rheumatic heart diseases not complicated by infective endocarditis were operated upon in the clinic from 1996 till 1998. The prosthetic heart valves in which the tissue cuff was sutures by blanket suture along the perimeter with a silver thread were implanted to 25 patients. In the other 15 patients (a control group) prosthetics were made using unchanged construction of the prosthesis (without the silver thread). Patients with valve prostheses sutured with the silver thread had smooth postoperative period. They had no prosthetic endocarditis either at the early or at late postoperative periods. In 3 patients of the control group infective endocarditis of the valve prosthesis developed at different periods after operation. All of them were reoperated. The authors consider that defense of the tissue cuff of the prosthetic valve with the silver thread allows risk of the development of prosthetic endocarditis to be substantially reduced. In the cases described it was completely avoided.
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PMID:[Prevention of prosthetic heart valve infection]. 1048 85

Prosthetic valve endocarditis remains as one of the most life-threatening complication of valve replacement surgery. Homografts are the valve of choice with a lower early risk of endocarditis than other valve substitutes, however they are not always available. Recently a new prosthesis has been introduced with a silver-coated sewing cuff (St. Jude Medical with Silzone coating). Silver is an antimicrobial agent that has been proven to reduce bacterial colonization. We present the case of a 48-year-old man with an early prosthetic valve endocarditis which affected an aortic stentless prosthesis. He was successfully treated with a silver-coated prosthesis. Indications for surgery and the use of this prosthesis as a valuable option in this disease entity are discussed. Although the present patient is an isolated case, the interest of this article is the encouraging result obtained with this new prosthesis for this serious complication. Moreover, the clinical experience is reduced with only a few reports in the literature.
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PMID:[Employment of St. Jude "silzone" valve in the surgical treatment of early prosthetic valve endocarditis: a preliminary case report and review of the literature]. 1070 33

The antimicrobial coating of prosthetic heart valve sewing cuffs has been considered a potentially effective method for preventing prosthetic valve endocarditis. Although traditional in vitro bacterial adherence studies are often useful as screening tools, they can be inadequate in examining the antiinfective efficacy of antimicrobial-coated devices. We conducted a pilot in vitro study to directly assess the antimicrobial activity of a silver-coated sewing cuff versus uncoated cuff using confocal scanning laser microscopy. Staphylococcus epidermidis adhered more to the surfaces of the silver-coated sewing cuff compared with the uncoated cuff. These pilot in vitro results cast a doubt on the antiinfective efficacy of silver-coated prosthetic heart valve sewing cuffs and suggest further assessment should be carried out using animal studies.
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PMID:Direct confocal microscopy studies of the bacterial colonization in vitro of a silver-coated heart valve sewing cuff. 1072 20

Two species of the gram-negative bacilli Bartonella, B. henselae and B. quintana, cause disease in HIV-infected patients. If untreated, infection can be fatal. Manifestations include bacillary angiomatosis (BA), bacillary peliosis hepatis (BP), bacteremia, or a combination of these. BA and BP present as lesions, but bacteremia may be subacute and persist for months without diagnosis. Additionally, patients may acquire cat scratch disease (CSD), but this is more common in immunocompetent patients. BA lesions are usually vascular, friable, and bleed profusely when traumatized. They may be confused with Kaposi's sarcoma (KS), pyogenic granuloma, lymphoma and various subcutaneous tumors and infections. Lesions may affect almost any organ, and appear as angiomatous papules, dry scaling lesions, subcutaneous nodules, cellulitic plaques or deep, highly vascularized, soft tissue masses. Patients may have osseus BA lesions (frequently affecting the long bones); hepatic and/or splenic lesions; bacteremia; or endocarditis. To diagnose infection, lesions should be biopsied and examined. Hematoxylin and eosin staining reveal histopathologic changes; darkly staining organisms are evident after Warthin-Starry silver staining; and electron microscopy allows visualization of the bacillus. An indirect immunofluorescence antibody test (IFA) detects bartonella-specific IgG antibodies. Treatment with erythromycin for at least three months is recommended, or with doxycycline if erythromycin is not well-tolerated. Severely ill patients should receive IV doxycycline with either gentamicin or rifampin for at least four months. To prevent infection, HIV-infected people should avoid traumatic cat contact and exposure to the body louse.
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PMID:Bartonella-associated infections in HIV-infected patients. 1136 39

The authors present results of surgical treatment of infective endocarditis of the right chambers of the heart in 22 patients subjected to 23 operations. Primary endocarditis was diagnosed in 14 patients, secondary endocarditis in 8 patients. Four patients died. In 12 patients the operations were performed during the active phase of the process. Positive bacterial hemoculture was detected in 11 patients. The operations were performed on the open heart. For correction of valve lesions artificial heart valves were used either with special antimicrobial cuffs ("Silzone") or cuffs impregnated with silver ions ("St. Inda Med.") or treated with a solution of Rifampicin during operation.
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PMID:[Surgical treatment of infective endocarditis of the right sections of the heart]. 1266 Dec 39


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