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Cureus Mar 2024A 67-year-old male with coronary artery disease and aortic stenosis after coronary artery bypass graft (CABG) and aortic valve replacement (AVR) presented after a...
A 67-year-old male with coronary artery disease and aortic stenosis after coronary artery bypass graft (CABG) and aortic valve replacement (AVR) presented after a two-day history of dizziness and frequent falls. Initially, he was found to have a subacute infarct of the left temporal lobe, osteomyelitis of the lumbar spine, and an aortic valve vegetation. Further investigations demonstrated gram-positive bacteremia, and, eventually, the causative organism was identified as . He was treated with penicillin and gentamicin in the inpatient setting and then discharged with outpatient intravenous (IV) ceftriaxone for the remainder of the four-week antibiotic course. He did not suffer complications after initiating therapy and recovered. We wish to raise awareness of the existence and complications that can result from endocarditis and encourage further research into effective antibiotic treatment. endocarditis may lead to neurological and orthopedic infective sequelae; understanding and awareness of spp. infections are important to ensure effective treatment of endocarditis.
PubMed: 38659565
DOI: 10.7759/cureus.56904 -
Pediatric Research Jun 2022Premature adrenarche is a condition of childhood adrenal androgen excess (AAE) in the absence of gonadotropin-dependent puberty, and has been linked to insulin...
BACKGROUND
Premature adrenarche is a condition of childhood adrenal androgen excess (AAE) in the absence of gonadotropin-dependent puberty, and has been linked to insulin resistance and progression to metabolic syndrome. Microbial dysbiosis is associated with progression of inflammatory states and chronic diseases. Here, we aimed to examine the salivary microbiomes of children with AAE and assess the relationship with adrenal androgens and metabolic parameters.
METHODS
In a prospective cross-sectional study of children with AAE and healthy controls, adrenal and metabolic parameters were characterized and salivary microbiome was profiled using V3-V4 16S rDNA gene amplicon sequencing.
RESULTS
There was increased α-diversity in AAE (5 M, 15 F) compared to controls (3 M, 8 F), with positive correlation of 11OHA4, 11KA4, testosterone, androstenedione, DHEA, and DHEAS. Subanalyses showed increased α-diversity in both overweight/obese AAE and normal weight AAE compared to normal weight controls. Genus Peptostreptococcus, Veillonella, and Streptococcus salivarius were increased in normal weight AAE. Genus Prevotella, Abiotrophia, and Neisseria were increased in overweight/obese AAE.
CONCLUSION
These pilot data demonstrate differences in salivary microbiome profiles of children with and without AAE. Further studies are needed to assess the causal relationships between adrenal androgens, metabolic dysfunction, and salivary microbiome composition.
IMPACT
This study is the first to report the salivary microbiome of prepubertal children with adrenal androgen excess (AAE). α-Diversity is increased in the salivary microbiome of children with AAE independent of weight status, and in this study cohort several serum androgens are positively associated with α-diversity. Several taxa that have been associated with periodontal disease and inflammation are found to be significantly increased in AAE.
Topics: Androgens; Child; Cross-Sectional Studies; Dehydroepiandrosterone; Humans; Microbiota; Obesity; Overweight; Prospective Studies
PubMed: 34341500
DOI: 10.1038/s41390-021-01661-w -
Antimicrobial Agents and Chemotherapy Aug 2016MICs of 25 Abiotrophia defectiva and 109 Granulicatella adiacens isolates were determined by broth microdilution. Using CLSI breakpoints, the susceptibilities of A....
MICs of 25 Abiotrophia defectiva and 109 Granulicatella adiacens isolates were determined by broth microdilution. Using CLSI breakpoints, the susceptibilities of A. defectiva and G. adiacens isolates were, respectively, 24% and 34% to penicillin, 92% and 22% to ceftriaxone, 48% and 3% to cefepime, 72% and 87% to meropenem, 92% and 10% to cefotaxime, 100% and 97% to levofloxacin, 92% and 80% to clindamycin, and 24% and 50% to erythromycin. All isolates were susceptible to vancomycin. In the penicillin-susceptible subgroup, all A. defectiva isolates were susceptible to ceftriaxone; however, 62% of G. adiacens isolates were ceftriaxone nonsusceptible.
Topics: Abiotrophia; Anti-Infective Agents; Carnobacteriaceae; Cefepime; Cefotaxime; Cephalosporins; Clindamycin; Erythromycin; Levofloxacin; Microbial Sensitivity Tests; Penicillins; Vancomycin
PubMed: 27216060
DOI: 10.1128/AAC.00485-16 -
Journal of Oral Science Jan 2020Granulicatella adiacens (G. adiacens) and Abiotrophia defectiva (A. defectiva) colonize the oral cavity and form part of the normal flora in the intestinal and...
Contribution of different adherent properties of Granulicatella adiacens and Abiotrophia defectiva to their associations with oral colonization and the risk of infective endocarditis.
Granulicatella adiacens (G. adiacens) and Abiotrophia defectiva (A. defectiva) colonize the oral cavity and form part of the normal flora in the intestinal and genitourinary tracts. As reported previously, the frequency of isolation of G. adiacens from the oral cavity was much higher than that of A. defectiva. However, it has been reported that compared with G. adiacens, A. defectiva was isolated at considerably higher frequencies from the blood of patients with infective endocarditis (IE). Hence, in this study, the in vitro interaction of G. adiacens and A. defectiva strains with host surfaces and biofilm formation was examined to assess whether their different adhesive properties contribute to their associations with oral colonization and IE, respectively. G. adiacens exhibited an increased binding ability to saliva-coated hydroxyapatite beads than A. defectiva following the addition of CaCl. Furthermore, biofilm formation was observed only for G. adiacens with the use of a polystyrene tube and scanning electron microscopy analysis. Conversely, A. defectiva displayed significantly greater adherence to human umbilical vein endothelial cells and immobilized fibronectin than G. adiacens. These findings suggest that differences in binding properties to host components imply specific binding mechanisms in G. adiacens and A. defectiva, which might mediate selective colonization in the oral cavity or are associated with the pathogenicity of endocarditis.
Topics: Abiotrophia; Endocarditis, Bacterial; Endothelial Cells; Humans; Streptococcus
PubMed: 31708553
DOI: 10.2334/josnusd.19-0021 -
European Heart Journal. Case Reports Oct 2022Patients with a bicuspid aortic valve have increased risk of infective endocarditis, but common organisms are not always the culprit. We describe a case of an otherwise...
BACKGROUND
Patients with a bicuspid aortic valve have increased risk of infective endocarditis, but common organisms are not always the culprit. We describe a case of an otherwise healthy young gentleman with bicuspid aortic valve who experienced endocarditis. The aim of this case report is to highlight an uncommon cause of endocarditis associated with significant morbidity and mortality in order to improve the care provided by trainees and clinicians.
CASE SUMMARY
A 37-year-old male presented with a 1-month history of fever, weight loss, myalgia, and night sweats. On transoesophageal echocardiography, he was found to have a bicuspid aortic valve with large vegetation and severe aortic insufficiency. Blood cultures were positive for . The endocarditis was successfully treated with surgical aortic valve replacement and 6 weeks of antibiotic therapy.
DISCUSSION
Bicuspid valves are known to have increased susceptibility to endocarditis. The difficulty of isolating typically leads to delayed diagnosis and significant complications. This case is a reminder to have a high degree of suspicion for organisms which are rare and difficult to isolate because prompt recognition and surgical intervention may improve the outcome of care.
PubMed: 36225809
DOI: 10.1093/ehjcr/ytac394 -
Journal of Medical Cases Sep 2019(ABI), a nutritional variant (NVS), is an uncommon cause of infective endocarditis (IE) involving both native and prosthetic heart valves. Due to the fastidious nature...
(ABI), a nutritional variant (NVS), is an uncommon cause of infective endocarditis (IE) involving both native and prosthetic heart valves. Due to the fastidious nature and special nutritional requirements, contribution of ABI to IE had been underestimated. Here we describe a case of native valve endocarditis in a 40-year-old female intravenous drug user who did not have any other potential source of infection. Blood cultures grew ABI along with perhaps from licking the needle before injecting. Transesophageal echocardiogram showed mobile vegetations attached to tricuspid and mitral valves. Susceptibility testing is important due to underlying differences in susceptibility to both penicillin and ceftriaxone between ABI and other genera of NVS, though both antibiotics are recommended alternate empiric first-line therapies along with synergistic gentamicin use in accordance with established guidelines to treat NVS endocarditis. She was successfully treated with intravenous ceftriaxone and gentamicin for 6 weeks with clinical and echocardiographic resolution of IE. This case highlights the importance of modern microbial techniques and equipment for accurate and rapid identification of challenging pathogens.
PubMed: 34434323
DOI: 10.14740/jmc3348 -
Scientific Reports Aug 2022Down syndrome creates an abnormal oral environment, including susceptibility to periodontal disease at a young age, but there are no detailed studies of the oral...
Down syndrome creates an abnormal oral environment, including susceptibility to periodontal disease at a young age, but there are no detailed studies of the oral microbiome in children with Down syndrome. In this study, we performed a comprehensive analysis of the oral bacteria of 40 children with Down syndrome and 40 non-Down syndrome children. Microbial DNA was extracted from dental plaque specimens and the V4 hypervariable region of the bacterial 16S rRNA gene was analyzed using the MiSeq platform. There were significant differences between the Down syndrome and non-Down syndrome groups in mean numbers of operational taxonomic units, and α- and β-diversity (P < 0.05). Interestingly, significant differences in α- and β-diversity between the two groups were only observed in subjects with gingival inflammation, but not in those without gingival inflammation (P < 0.05). Taxonomic analysis at the genus or species levels showed significant differences in relative abundance levels of certain bacteria between the Down syndrome and non-Down syndrome groups, including Corynebacterium, Abiotrophia and Lautropia (P < 0.05). These results suggest that children with Down syndrome may have a unique oral microbiome that could impact the development of dental diseases common in people with the syndrome.
Topics: Bacteria; Child; Gingivitis; Humans; Inflammation; Microbiota; RNA, Ribosomal, 16S
PubMed: 35986204
DOI: 10.1038/s41598-022-18409-z -
Microbiology and Immunology 2000Serological variations were examined among 12 type or reference strains and 91 oral isolates of vitamin B6-dependent Abiotrophia and Granulicatella spp. Rabbits were...
Serological variations were examined among 12 type or reference strains and 91 oral isolates of vitamin B6-dependent Abiotrophia and Granulicatella spp. Rabbits were immunized with whole cells of 12 selected strains and 10 typing antisera were obtained, which were unreactive with the Lancefield group A to G antigen preparations. The reactivity of the antisera and autoclaved cell surface antigen extracts was tested by double diffusion in agar gel and a capillary precipitin test. These typing antisera categorized all Abiotrophia defectiva strains, all except one Granulicatella elegans strain, three-quarters of the Granulicatella adiacens, and half of the Granulicatella paraadiacens into 8 serotypes and 2 subserotypes. The Granulicatella balaenopterae type strain was unserotypable. All A. defectiva strains were serotype I, some of which were divided into subserotype I-1 and/or I-5. The G. adiacens strains generally belonged to serotype II or III, and the G. paraadiacens strains to serotype IV, V or VI. All G. adiacens or G. paraadiacens serotype II strains were also subserotype I-5. The G. elegans strains were serotype VII or VIII. These Abiotrophia and Granulicatella serotypes were undetectable among 33 strains of the other 11 species including the bacteriolytic enzyme-producing but vitamin B6-independent strains of Streptococcus, Enterococcus, Dolosigranulum and Aerococcus. The proposed serotyping system for Abiotrophia and Granulicatella spp. would be helpful in the identification and classification of these unique coccal isolates in ecological and epidemiological studies.
Topics: Animals; Antibodies, Bacterial; Rabbits; Serotyping; Streptococcal Infections; Streptococcus
PubMed: 11220686
DOI: 10.1111/j.1348-0421.2000.tb02593.x -
IDCases 2023Belonging to the normal oral, gastrointestinal, and urogenital flora, is responsible for 1-2 % of all infective endocarditis (IE) cases. The manifestation of...
Belonging to the normal oral, gastrointestinal, and urogenital flora, is responsible for 1-2 % of all infective endocarditis (IE) cases. The manifestation of endocarditis may by atypical, without fever. Difficult to isolate pathogen requires special culture media. A 45-year-old female was admitted due to anemia and progressive weight loss (8 kg in 6 months). She had a history of benign mitral valve (MV) prolapse and non-stenotic bicuspid aortic valve (BAV). In echocardiography, large vegetations on MV and small vegetation on BAV were found. An enriched medium for fastidious pathogens was used. was identified using biochemical analysis with VITEK-2 Compact. In the fourth week of antibiotic therapy, she required urgent MV replacement due to MV regurgitation progression while vegetation on BAV disappeared. Although patient's frailty and underweight caused prolonged postoperative wound healing, she was transferred to rehabilitation in good conditions. No relapse of IE was observed during five-month follow-up.
PubMed: 37867569
DOI: 10.1016/j.idcr.2023.e01906 -
Proceedings of the National Academy of... Oct 2019is associated with aggressive periodontitis resulting in premature tooth loss in adolescents. Tooth adherence and biofilm persistence are prerequisites for survival in...
is associated with aggressive periodontitis resulting in premature tooth loss in adolescents. Tooth adherence and biofilm persistence are prerequisites for survival in the oral domain. Here, using a rhesus monkey model, 16S rRNA sequencing, and weighted network analysis, we assessed colonization of variants and ascertained microbial interactions in biofilm communities. Variants in leukotoxin () were created, labeled, inoculated, and compared with their progenitor strain for in vivo colonization. Samples of tooth-related plaque were assessed for colonization at baseline and after debridement and inoculation of labeled strains. Null, minimal, and hyper-Ltx-producing strains were created and assessed for hydroxyapatite binding and biofilm formation in vitro. Ltx-hyperproducing strains colonized with greater prevalence and at higher levels than wild type or mutants ( = 0.05). Indigenous and inoculated strains that attached were associated with lactate-producing species (i.e., Leptotrichia, Abiotrophia, and Streptoccocci). was found at 0.13% of the total flora at baseline and at 0.05% 4 wk after inoculation. In vivo data were supported by in vitro results. We conclude that hyper-Ltx production affords these strains with an attachment advantage providing a foothold for competition with members of the indigenous microbiota. Increased attachment can be linked to gene expression and up-regulation of adherence-associated genes. Growth of attached in vivo was enhanced by lactate availability due to consorting species. These associations provide with the constituents required for its colonization and survival in the complex and competitive oral environment.
Topics: Aggregatibacter actinomycetemcomitans; Animals; Bacterial Adhesion; Biofilms; Durapatite; Exotoxins; Lactic Acid; Macaca mulatta; Male; Microbiota; Mouth; Periodontitis
PubMed: 31611409
DOI: 10.1073/pnas.1905238116