Emergence of Coagulase-Negative Staphylococci as a Cause of Native Valve Endocarditis

Chu, Vivian H.; Woods, Christopher W.; Miró, José M.; Hoën, Bruno; Cabell, Christopher H.; Pappas, Paul; Federspiel, Jerome J.; Athan, Eugene; Stryjewski, Martín E.; Nacinovich, Francisco; Marco, Francesc; Levine, Donald P.; Elliott, Tom; Fortes, Cláudio Querido; Tornos, Pilar; Gordon, David L.; Utili, Riccardo; Delahaye, François; Corey, G. Ralph; Fowler, Vance G.

doi:10.1086/524666

Cited by 165 publications

(109 citation statements)

References 21 publications

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“…oagulase-negative staphylococci (CoNS) are normal inhabitants of the human skin that lately have revealed themselves as significant etiological agents causing nosocomial infections, particularly in medical devices (1)(2)(3)(4). Until recently, the phenotypic identification of Ͼ40 currently recognized CoNS species remained a challenge, because the technique was labor-intensive and uncommon CoNS were usually not identified (5,6).…”

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confidence: 99%

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

et al. 2015

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The use of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for staphylococcal identification is now considered routine in laboratories compared with the conventional phenotypical methods previously used. We verified its microbiological relevance for identifying the main species of coagulase-negative staphylococci (CoNS) by randomly selecting 50 isolates. From 1 January 2007 to 31 August 2008, 12,479 staphylococci were isolated with phenotypic methods, of which 4,594 were identified as Staphylococcus aureus and 7,885 were coagulase negative staphylococci. Using MALDI-TOF MS from 1 January 2011 to 31 August 2012, 14,913 staphylococci were identified, with 5,066 as S. aureus and 9,847 as CoNS. MALDI-TOF MS allowed the identification of approximately 85% of the CoNS strains, whereas only 14% of the CoNS strains were identified to the species level with phenotypic methods because they were often considered contaminants. Furthermore, the use of MALDI-TOF MS revealed the occurrence of recently characterized Staphylococcus species, such as S. pettenkoferi, S. condimenti, and S. piscifermentans. Microbiological relevance analysis further revealed that some species displayed a high rate of microbiological significance, i.e., 40% of the S. lugdunensis strains included in the analysis were associated with infection risk. This retrospective microbiological study confirms the role of MALDI-TOF MS in clinical settings for the identification of staphylococci with clinical consequences. The species distribution reveals the occurrence of the recently identified species S. pettenkoferi and putative virulent species, including S. lugdunensis. C oagulase-negative staphylococci (CoNS) are normal inhabitants of the human skin that lately have revealed themselves as significant etiological agents causing nosocomial infections, particularly in medical devices (1-4). Until recently, the phenotypic identification of Ͼ40 currently recognized CoNS species remained a challenge, because the technique was labor-intensive and uncommon CoNS were usually not identified (5, 6). Until recently, CoNS identification at the species level was performed only for clinical isolates that were considered clinically significant according to clinical or microbiological criteria. Meanwhile, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has emerged as a reliable, fast, and cost-effective alternative for bacterial species identification and is now widely used in microbiology laboratories (7,8). This method allows the identification of all staphylococci isolated in the clinical setting, thus rendering the use of well-known tests, such as free or bound coagulase tests, unnecessary. Previous reports have shown that MALDI-TOF MS is a reliable method to identify Staphylococcus at the species level; however, questions regarding the impact of such methods in clinical settings remain uncertain (9). Staphylococcus epidermidis is probably the major CoNS species causing nosocomial inf...

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Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

et al. 2015

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“…Indeed, staphylococci and streptococci account for more than 80 % of all cases of endocarditis and, among them, Staph. aureus is the leading cause of endocarditis worldwide (Murdoch et al, 2009), while CoNS are the third leading cause of IE after streptococci, mostly in native valves (Chu et al, 2008).…”

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Diagnosis of infective endocarditis: comparison of the LightCycler SeptiFast real-time PCR with blood culture

Mencacci

Leli

Montagna

et al. 2012

Journal of Medical Microbiology

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“…S. epidermidis and S. haemolyticus are the most frequently isolated staphylococcus species. 2 The most challenging problem in diagnosing infections with CoNS is the assessment of their clinical relevance.…”

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confidence: 99%

“…However, they are now emerging as an important cause of NVE in both community and healthcare settings. 2 At the same time, DRESS syndrome is a life threatening condition unless diagnosis and management are done promptly and acurately.…”

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confidence: 99%

Treatment of native valve endocarditis due to coagulase negative staphylococci, complicated by a drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)

Silva¹,

Jayatilleka²,

Subasinghe³

et al. 2017

Sri Lankan J Infec Dis

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Coagulase negative staphylococci (CoNS) are a rare cause of native valve endocarditis (NVE). However, they are emerging as important pathogens of NVE. We describe a 61 year old male who developed NVE caused by CoNS and presented with cerebral embolic phenomena. He was treated with vancomycin and subsequently with linezolid. He developed a drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) to linezolid which was managed successfully. The patient's recovery was good after six weeks of treatment with anti-staphylococcal antibiotics.

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Emergence of Coagulase-Negative Staphylococci as a Cause of Native Valve Endocarditis

Abstract: CoNS have emerged as an important cause of NVE in both community and health care settings. Despite high rates of surgical therapy, NVE caused by CoNS is associated with poor outcomes.

Cited by 165 publications

References 21 publications

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

Implementation of Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry in Routine Clinical Laboratories Improves Identification of Coagulase-Negative Staphylococci and Reveals the Pathogenic Role of Staphylococcus lugdunensis

Diagnosis of infective endocarditis: comparison of the LightCycler SeptiFast real-time PCR with blood culture

Treatment of native valve endocarditis due to coagulase negative staphylococci, complicated by a drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)

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