Advanced

Infective endocarditis due to Streptococcus dysgalactiae : clinical presentation and microbiological features

Bläckberg, Anna LU ; Nilson, Bo LU ; Özenci, Volkan; Olaison, Lars and Rasmussen, Magnus LU (2018) In European Journal of Clinical Microbiology and Infectious Diseases 37(12). p.2261-2272
Abstract

Knowledge of infective endocarditis (IE) caused by Streptococcus dysgalactiae (SD) is limited. This study aimed to identify the clinical and microbiological features of SD-caused IE and to investigate any possible synergy between penicillin and gentamicin on SD isolates. Cases of IE 2008–2016 due to SD reported to the Swedish Registry of Infective Endocarditis (SRIE) were identified. Isolates were emm typed and synergy between antibiotics was determined in time-kill experiments. Medical records were reviewed and SD-cases were compared to cases of IE due to other pathogens reported to the SRIE. Fifty cases of SD-caused IE were confirmed. emm types stC74a, stG62647, and stG643 were most commonly encountered. The patients had a median age... (More)

Knowledge of infective endocarditis (IE) caused by Streptococcus dysgalactiae (SD) is limited. This study aimed to identify the clinical and microbiological features of SD-caused IE and to investigate any possible synergy between penicillin and gentamicin on SD isolates. Cases of IE 2008–2016 due to SD reported to the Swedish Registry of Infective Endocarditis (SRIE) were identified. Isolates were emm typed and synergy between antibiotics was determined in time-kill experiments. Medical records were reviewed and SD-cases were compared to cases of IE due to other pathogens reported to the SRIE. Fifty cases of SD-caused IE were confirmed. emm types stC74a, stG62647, and stG643 were most commonly encountered. The patients had a median age of 74 years (range 38–93) and were significantly older compared to patients with Staphylococcus aureus-caused IE, (65 years (p = 0.003)). The median time to diagnosis from symptom onset was 1 day for patients with SD-caused IE which was less compared to patients with IE due to the other pathogens (2–15 days). Embolization was seen in 46% and the in-hospital mortality was 8%. Etest-based methods did not indicate any synergy between penicillin and gentamicin whereas synergy was noted for four out of nine isolates applying time-kill assays. This is the largest study of SD-caused IE, a condition with an acute onset predominantly affecting elderly people. Synergy between penicillin and gentamicin against some SD isolates was distinguished but the potential benefit of this must be weighed against the risk of aminoglycoside side effects.

(Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antibiotic susceptibility, emm type, Infective endocarditis, Streptococcus dysgalactiae
in
European Journal of Clinical Microbiology and Infectious Diseases
volume
37
issue
12
pages
2261 - 2272
publisher
Springer
external identifiers
  • scopus:85053477023
ISSN
0934-9723
DOI
10.1007/s10096-018-3367-7
language
English
LU publication?
yes
id
c562d995-d3a3-4c2b-a51e-9fc727acf264
date added to LUP
2018-10-24 12:01:15
date last changed
2019-03-19 04:01:35
@article{c562d995-d3a3-4c2b-a51e-9fc727acf264,
  abstract     = {<p>Knowledge of infective endocarditis (IE) caused by Streptococcus dysgalactiae (SD) is limited. This study aimed to identify the clinical and microbiological features of SD-caused IE and to investigate any possible synergy between penicillin and gentamicin on SD isolates. Cases of IE 2008–2016 due to SD reported to the Swedish Registry of Infective Endocarditis (SRIE) were identified. Isolates were emm typed and synergy between antibiotics was determined in time-kill experiments. Medical records were reviewed and SD-cases were compared to cases of IE due to other pathogens reported to the SRIE. Fifty cases of SD-caused IE were confirmed. emm types stC74a, stG62647, and stG643 were most commonly encountered. The patients had a median age of 74 years (range 38–93) and were significantly older compared to patients with Staphylococcus aureus-caused IE, (65 years (p = 0.003)). The median time to diagnosis from symptom onset was 1 day for patients with SD-caused IE which was less compared to patients with IE due to the other pathogens (2–15 days). Embolization was seen in 46% and the in-hospital mortality was 8%. Etest-based methods did not indicate any synergy between penicillin and gentamicin whereas synergy was noted for four out of nine isolates applying time-kill assays. This is the largest study of SD-caused IE, a condition with an acute onset predominantly affecting elderly people. Synergy between penicillin and gentamicin against some SD isolates was distinguished but the potential benefit of this must be weighed against the risk of aminoglycoside side effects.</p>},
  author       = {Bläckberg, Anna and Nilson, Bo and Özenci, Volkan and Olaison, Lars and Rasmussen, Magnus},
  issn         = {0934-9723},
  keyword      = {Antibiotic susceptibility,emm type,Infective endocarditis,Streptococcus dysgalactiae},
  language     = {eng},
  number       = {12},
  pages        = {2261--2272},
  publisher    = {Springer},
  series       = {European Journal of Clinical Microbiology and Infectious Diseases},
  title        = {Infective endocarditis due to Streptococcus dysgalactiae : clinical presentation and microbiological features},
  url          = {http://dx.doi.org/10.1007/s10096-018-3367-7},
  volume       = {37},
  year         = {2018},
}