Serratia marcescens and other non-AACEK GNB endocarditis: A case report and review of literature  

作　　者：Helena Mertes Marielle Morissens Bhavna Mahadeb Evelyne Maillart Anthony Moreau Philippe Clevenbergh 

机构地区：[1]Infectious Disease Department,Ziekenhuis Netwerk Antwerpen Middelheim,Antwerpen 2020,Belgium [2]Cardiology Department,Brugmann University Hospital,Brussels 1020,Belgium [3]Microbiology Department,Brugmann University Hospital,Brussels 1020,Belgium [4]Infectious Diseases Department,Brugmann University Hospital,Brussels 1020,Belgium [5]Intensive Care Unit,Erasmus University Hospital,Intensive Care Unit,Brussels 1070,Belgium

出　　处：《World Journal of Clinical Infectious Diseases》2019年第3期23-30,共8页世界临床传染病学杂志

摘　　要：BACKGROUND Non-Aggregatibacter aphrophilus,Aggregatibacter actinomycetemcomitans,Cardiobacterium hominis,Eikenella corrodens,Kingella spp.(non-AACEK)gramnegative bacilli(GNBs)are an infrequent and challenging cause of endocarditis associated previously with mainly intravenous drug use.Currently,this pathology has increasingly become a healthcare-associated issue.Current guidelines do not clearly define the management of non-AACEK GNB endocarditis due to a lack of prospective trials.We review characteristics,outcomes and treatment of non-AACEK GNB endocarditis,in particular Serratia marcescens endocarditis.CASE SUMMARY We describe the case report of a 46-year-old man who presented to the emergency department with high-grade fever and a purulent exudate on an intracardiac device site.Serratia marcescens mitral valve endocarditis as a consequence of complicated generator pocket infection was diagnosed.The patient was treated with complete device removal and a long course of broadspectrum antibiotics for 6 wk after surgery with intravenous piperacillintazobactam and ciprofloxacin,which was later switched to oral ciprofloxacin and sulfamethoxazole-trimethoprim.The patient had complete resolution of symptoms and inflammatory parameters at the end of the treatment and at follow-up.CONCLUSION Long-term dual-antibiotic therapy containing a beta-lactam is indicated for most non-AACEK GNB endocarditis, whereas valve surgery may not be necessary inall patients.BACKGROUND Non-Aggregatibacter aphrophilus, Aggregatibacter actinomycetemcomitans,Cardiobacterium hominis, Eikenella corrodens, Kingella spp.(non-AACEK) gramnegative bacilli(GNBs) are an infrequent and challenging cause of endocarditis associated previously with mainly intravenous drug use. Currently, this pathology has increasingly become a healthcare-associated issue. Current guidelines do not clearly define the management of non-AACEK GNB endocarditis due to a lack of prospective trials. We review characteristics,outcomes and treatment of non-AACEK GNB endocarditis, in particular Serratia marcescens endocarditis.CASE SUMMARY We describe the case report of a 46-year-old man who presented to the emergency department with high-grade fever and a purulent exudate on an intracardiac device site. Serratia marcescens mitral valve endocarditis as a consequence of complicated generator pocket infection was diagnosed. The patient was treated with complete device removal and a long course of broadspectrum antibiotics for 6 wk after surgery with intravenous piperacillintazobactam and ciprofloxacin, which was later switched to oral ciprofloxacin and sulfamethoxazole-trimethoprim. The patient had complete resolution of symptoms and inflammatory parameters at the end of the treatment and at follow-up.CONCLUSION Long-term dual-antibiotic therapy containing a beta-lactam is indicated for most non-AACEK GNB endocarditis, whereas valve surgery may not be necessary in all patients.

关 键 词：Non-AACEK GRAM-NEGATIVE BACILLI ENDOCARDITIS Serratia marcescens HEALTHCARE-ASSOCIATED Intravenous drug use Case report Dual-antibiotic therapy 

分 类 号：R73[医药卫生—肿瘤]