Prevalence of Colorectal Neoplasms Among Patients With Enterococcus faecalis Endocarditis in the GAMES Cohort (2008–2017)

Abstract

Objective: To investigate the rate of colorectal neoplasms (CRNs) in patients who have Enterococcus faecalis infective endocarditis (EFIE) with available colonoscopies and to assess whether this is associated with the identification of a focus the infection. Patients and Methods: Retrospective analysis of data from a prospective multicenter study involving 35 centers who are members of the Grupo de Apoyo para el Manejo de la Endocarditis en España [Support Group for the Management of Infective Endocarditis in Spain] cohort. A specific set of queries regarding information on colonoscopy and histopathology of colorectal diseases was sent to each participating center. Four-hundred sixty-seven patients with EFIE were included from January 1, 2008, to December 31, 2017, from whom data on colonoscopy performance and results were available in 411 patients. Results: One hundred forty-two (34.5%) patients had a colonoscopy close to the EFIE episode. The overall rate of colorectal diseases was 70.4% (100 of 142), whereas the prevalence of CRN (advanced adenomas and colorectal carcinoma) was 14.8% (21 of 142), with no significant differences between the group of EFIE of unknown focus and that with an identified focus. Conclusion:Our study adds to prior evidence suggesting a much higher rate of CRN among patients with EFIE than in the general population of the same age and sex. In addition, our findings suggest that this phenomenon might take place both in EFIE with an unknown and an identified source of infection.

The First Reported Case of Post-Atrioventricular Node Ablation Enterococcus Faecalis Bacteremia in a Patient With Colonic Tubular Adenomas and Chronic Steroid Use

“…Our patient had a known history of colonic tubular adenomas discovered on colonoscopy. Although a causal link has not been established between enterococcal bloodstream infections and colonic dysplasia, there are several case reports and retrospective studies indicating a relationship between the two [2,[6][7][8]. Although currently unclear, enterococcal proliferation in the setting of colonic lesions may allow for increased translocation of gut flora into the bloodstream.…”

Alterations in the Gut Microbiota and Their Metabolites in Colorectal Cancer: Recent Progress and Future Prospects

“…Although Enterococcus faecalis was previously thought to be a normal gram-positive bacterium of the gut microbiome, new evidence reveals that it is inherently connected to CRC (88). There has also been evidence of a link between enterococcal endocarditis and hidden CRC (89). Enterococcus faecalis was found to promote the proliferation of HCT116 colon cancer cells (90).…”

Infective Endocarditis: New Challenges in a Classic Disease

“…65 In more recent years, observational studies of IE caused by E. faecalis have found a high rate of colorectal disease detected by colonoscopy, with a high incidence of neoplastic disease, particularly in those patients with an unknown source of bacteremia. [66][67][68] Finally, regarding microbiological procedures, polymerase chain reaction of samples from explanted heart valves could improve diagnostic performance 69 in comparison with conventional cultures in operated cases.…”