P1113 Antimicrobial susceptibility of anaerobic and facultative aerobic bacteria isolated from pus specimens of orofacial infections and β-lactamase production

Blandino, G; Milazzo, I.; Fazio, Davide; Puglisi, S.; Speciale, A

doi:10.1016/s0924-8579(07)70953-6

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“…However, in cases with very delayed presentations (up to 23 years after valve surgery) [20], endocarditis most likely occurred due to bacteraemia from a distant focus and secondary seeding of the prosthetic valves. Propionibacteria form part of the normal human oropharyngeal flora [42,43] and bacteraemia may result from invasive dental procedures, a pathogenesis mechanism similar to that of endocarditis due to viridans group streptococci.…”

Section: Discussionmentioning

confidence: 99%

Infective endocarditis due to Propionibacterium species

Sohail

Gray

Baddour

et al. 2009

Clinical Microbiology and Infection

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Propionibacterium species rarely cause infective endocarditis. When identified in blood cultures, they may be inappropriately disregarded as skin flora contaminants. The purpose of this study was to characterize the clinical presentation and management of endocarditis due to Propionibacterium species. All cases of endocarditis due to Propionibacterium species that were treated at the Mayo Clinic, Rochester, USA were retrospectively reviewed, and the English language medical literature was searched for all previously published reports. Seventy cases, which included eight from the Mayo Clinic, were identified (clinical details were available for only 58 cases). The median age of patients was 52 years, and 90% were males. In 79% of the cases, the infection involved prosthetic material (39 prosthetic valves, one left ventricular Teflon patch, one mitral valve ring, one pulmonary artery prosthetic graft, three pacemakers, and one defibrillator). Blood cultures were positive in 62% of cases. All 22 cases with negative blood cultures were microbiologically confirmed by either positive valve tissue cultures (n = 21) or molecular methods (n = 1). Endocarditis was complicated by abscess formation in 36% of cases. The majority (81%) of patients underwent surgery, either for valve replacement and debridement of a cardiac abscess, or removal of an infected device. Crude in-hospital mortality was 16%. The median duration of postoperative antibiotic treatment was 42 days. Patients were commonly treated with a penicillin derivative alone or in combination with gentamicin. On the basis of the above data, it is recommended that infective endocarditis should be strongly suspected when Propionibacterium species are isolated from multiple blood cultures, particularly in the presence of a cardiovascular device.

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Section: Discussionmentioning

confidence: 99%