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      Ciprofloxacin for the treatment of Cardiobacterium hominis prosthetic valve endocarditis

      case-report

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          Abstract

          Prosthetic valve endocarditis due to Cardiobacterium hominis is rare and recommended therapy includes a third generation cephalosporin. We report a case of Cardiobacterium hominis endocarditis post transcatheter aortic valve replacement in a patient with significant beta-lactam antimicrobial sensitivities who was successfully treated with ciprofloxacin monotherapy in conjunction with surgery.

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          HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort

          Stephen T. Chambers, David Murdoch, David M Murdoch … (2013)
          The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34–9.65; p<0.01) and younger age (OR 0.62; CI 0.49–0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.
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            Cardiobacterium hominis endocarditis: Two cases and a review of the literature.

            Alexander Bradley, David M Aronoff, Preeti Malani … (2006)
            Cardiobacterium hominis, a member of the HACEK group (Haemophilus parainfluenzae, Haemophilus aphrophilus, and Haemophilus paraphrophilus, Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella species), is a rare cause of endocarditis. There are 61 reported cases of C. hominis infective endocarditis in the English-language literature, 15 of which involved prosthetic valve endocarditis. There is one reported case of C. hominis after upper endoscopy and none reported after colonoscopy. Presented here are two cases of C. hominis prosthetic valve endocarditis following colonoscopy and a review of the microbiological and clinical features of C. hominis endocarditis. Patients with C. hominis infection have a long duration of symptoms preceding diagnosis (138+/-128 days). The most common symptoms were fever (74%), fatigue/malaise (53%), weight loss/anorexia (40%), night sweats (24%), and arthralgia/myalgia (21%). The most common risk factors were pre-existing cardiac disease (61%), the presence of a prosthetic valve (28%), and history of rheumatic fever (20%). Of the 61 cases reviewed here, the aortic valve was infected in 24 (39%) and the mitral valve in 19 (31%) patients. The average duration of blood culture incubation before growth was detected was 6.3 days (range, 2-21 days). Complications were congestive heart failure (40%), central nervous system (CNS) emboli (21%), arrhythmia (16%), and mycotic aneurysm (9%). C. hominis is almost always susceptible to beta-lactam antibiotics. Ceftriaxone is recommended by the recently published American Heart Association guidelines. The prognosis of C. hominis native valve and prosthetic valve endocarditis is favorable. The cure rate among 60 patients reviewed was 93% (56/60). For prosthetic valve endocarditis, the cure rate was 16/17 (94%). Valve replacement was required in 27 (45%) cases.
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              Direct detection of Cardiobacterium hominis in serum from a patient with infective endocarditis by broad-range bacterial PCR.

              E Malli, George Dalekos, Nikolaos K. Gatselis … (2006)
              Bacterial DNA was detected directly in the serum of a patient with endocarditis by broad-range 16S rRNA PCR followed by sequencing and analysis of the results by the BLAST search. Using these methods, Cardiobacterium hominis was identified in 2 days from the date of serum collection. The microorganism was also isolated and identified using conventional methods (bacterial culture and biochemical tests) 17 days from the date of sample collection. This is the first report showing the direct detection of C. hominis in a patient's serum using molecular-based methods, emphasizing their potential usefulness as additional and rapid diagnostic tools for the detection and identification of fastidious bacteria.
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                Author and article information

                Contributors
                Lisa M. Avery
                Muhammad Hasan
                Journal
                Journal ID (nlm-ta): IDCases
                Journal ID (iso-abbrev): IDCases
                Title: IDCases
                Publisher: Elsevier
                ISSN (Electronic): 2214-2509
                Publication date PMC-release: 06 February 2018
                Publication date Collection: 2018
                Publication date (Electronic): 06 February 2018
                Volume: 11
                Pages: 77-79
                Affiliations
                [a ]Department of Pharmacy, St. Joseph’s Health, Syracuse, NY, USA
                [b ]Department of Pharmacy Practice, St. John Fisher College, Wegmans School of Pharmacy, Rochester, NY, USA
                [c ]Department of Pharmacy, Unity Hospital, Rochester, NY, USA
                [d ]Department of Infectious Diseases, St. Joseph’s Health, Syracuse, NY, USA
                Author notes
                [* ]Corresponding authors at: 301 Prospect Avenue Syracuse, NY 13203, USA. lisa.avery@ 123456sjhsyr.org muhammad.hasan@ 123456sjhsyr.org
                Article
                Publisher ID: S2214-2509(17)30239-1
                DOI: 10.1016/j.idcr.2018.01.016
                PMC ID: 5881436
                PubMed ID: 29619328
                SO-VID: bb8e7c62-f0ba-4581-add6-4d0c059aeb84
                Copyright © © 2018 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 13 December 2017
                Date revision received : 30 January 2018
                Date accepted : 31 January 2018
                Categories
                Subject: Article

                Keywords: cardiobacterium,endocarditis,ciprofloxacin,fluoroquinolones
                Data availability:
                Keywords: cardiobacterium, endocarditis, ciprofloxacin, fluoroquinolones

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