Infective Endocarditis Caused by Extended-Spectrum Beta-Lactamase-Producing Escherichia coli: A Case Report
| Autor: | Sayoko Kawakami, Liansheng Yu, Yuto Shinkura, Satoru Kawasaki, Motoyuki Sugai, Tsuneaki Kenzaka, Shizuo Kayama |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
ST131 medicine.medical_treatment Case Report Cefmetazole Meropenem meropenem medicine Tobramycin polycyclic compounds Mitral valve prolapse Pharmacology (medical) Mitral Valve Annulus bacteremia Pharmacology business.industry infective endocarditis Mitral valve replacement E. coli biochemical phenomena metabolism and nutrition medicine.disease bacterial infections and mycoses Surgery Infectious Diseases Infective endocarditis Bacteremia bacteria business blaCTX-M-27 ESBL medicine.drug |
| Zdroj: | Infection and Drug Resistance |
| ISSN: | 1178-6973 |
| Popis: | Introduction Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) reportedly accounts for >20% of E. coli infections and 2.0% of infective endocarditis cases. Nonetheless, there is a global paucity of reports on infective endocarditis caused by ESBL-EC. Case An 83-year-old Japanese man who underwent mitral annuloplasty for mitral valve prolapse 5 years ago developed a fever of 38.5°C. The patient was hospitalized the first time for pyelonephritis and bacteremia due to ESBL-EC and treated successfully with the antimicrobial meropenem for 14 days. Two days after discharge, however, the patient was re-admitted with bacteremia due to ESBL-EC. He was treated successfully with the antimicrobial cefmetazole for 14 days. The patient was admitted to our institution for a third time due to bacteremia again, a day after discharge following meropenem antibiotic therapy. Transesophageal echocardiography showed vegetation in the anterior mitral valve annulus. Magnetic resonance imaging of the head showed septic cerebral embolism. The patient was diagnosed with infective endocarditis due to ESBL-EC and underwent mitral valve replacement. After 6 weeks of antibiotic therapy with meropenem and tobramycin, the patient recovered completely. The causative E. coli strain MS6396 was identified as the E. coli clone ST131 by multilocus sequence typing and confirmed the presence of bla CTX-M-27 ESBL gene. Conclusion Only six cases of infective endocarditis associated with ESBL-EC have been reported in the past. Moreover, this is the first report of a patient with infective endocarditis bacteriologically or genetically analyzed for ESBL-EC. In future, factors that may cause infective endocarditis in ESBL-EC infections may be clarified through more thorough bacteriological/genetic analyses of ESBL-EC. |
| Databáze: | OpenAIRE |
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