Abstract
Most cases of infective endocarditis (IE) are caused by gram-positive bacteria such as enterococci, streptococci, and staphylococci. Increasing resistance among these organisms has eroded the utility of mainstay antibiotics and complicated the management of this difficult-to-treat infection. Clinical experience with newer gram-positive antibiotics to treat IE is limited.
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References and Recommended Reading
File TM, Jr.: Overview of resistance in the 1990s. Chest 1999, 115:3S-8S.
Serra P, Brandimarte C, Martino P, et al.: Synergistic treatment of enterococcal endocarditis: in vitro and in vivo studies. Arch Intern Med 1977, 137:1562–1567.
Megran DW: Enterococcal endocarditis. Clin Infect Dis 1992, 15:63–71.
Kazanjian PH: Infective endocarditis--review of 60 cases treated in community hospitals. Infect Dis Clin Pract 1993, 2:41–46.
Hricak V Jr, Kovacik J, Marx P, et al.: Endocarditis due to Enterococcus faecalis: risk factors and outcome in twentyone cases from a five year national survey. Scand J Infect Dis 1998, 30:540–541.
Wilson WR, Wilkowske CJ, Wright AJ, et al.: Treatment of streptomycin-susceptible and streptomycin-resistant enterococcal endocarditis. Ann Intern Med 1984, 100:816–823.
Krogstad DJ, Parquette AR: Defective killing of enterococci--a common property of anti-microbial agents acting on the cell wall. Antimicrob Agents Chemother 1980, 17:965–968.
Le T, Bayer AS: Combination antibiotic therapy for infective endocarditis. Clin Infect Dis 2003, 36:615–621. This comprehensive review summarizes the data supporting the use of combination antibiotic therapy in IE.
Bayer AS, Bolger AF, Taubert KA, et al.: Diagnosis and management of infective endocarditis and its complications. Circulation 1998, 98:2936–2948. This is an excellent overview of the management of endocarditis.
Wilson WR, Karchmer AW, Dajani AS, et al.: Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci, and HACEK microorganisms. American Heart Association. JAMA 1995, 274:1706–1713. Important study.
Olaison L, Schadewitz K: Enterococcal endocarditis in Sweden, 1995–1999: can shorter therapy with aminoglycosides be used? Clin Infect Dis 2001, 34:159–166. Important study.
Moellering RC Jr, Watson BK, Kunz LJ: Endocarditis due to group D streptococci. Comparison of disease caused by Streptococcus bovis with that produced by the enterococci. Am J Med 1974, 57:239–250.
Mandell GL, Kaye D, Levison ME, et al.: Enterococcal endocarditis. An analysis of 38 patients observed at the New York Hospital-Cornell Medical Center. Arch Intern Med 1970, 125:258–264.
Watanakunakorn C, Bakie C: Synergism of vancomycin-gentamicin and vancomycin-streptomycin against enterococci. Antimicrob Agents Chemother 1973, 4:120–124.
Fernandezguerrero ML, Barros C, Tudela JLR, et al.: Aortic endocarditis caused by gentamicin-resistant Enterococcus faecalis. Eur J Clin Microbiol Infect Dis 1988, 7:525–527.
Brandt CM, Rouse MS, Laue NW, et al.: Effective treatment of multidrug-resistant enterococcal experimental endocarditis with combinations of cell wall-active agents. J Infect Dis 1996, 173:909–913.
Gavalda J, Torres C, Tenorio C, et al.: Efficacy of ampicillin plus ceftriaxone in treatment of experimental endocarditis due to Enterococcus faecalis strains highly resistant to aminoglycosides. Antimicrob Agents Chemother 1999, 43:639–646.
Murray BE: Vancomycin-resistant enterococcal infections. N Engl J Med 2000, 342:710–721. This is an elegant review of the pathogenesis, epidemiology, and resistance of the Enterococcus.
Mekonen ET, Noskin GA, Hacek DM, et al.: Successful treatment of persistent bacteremia due to vancomycin-resistant, ampicillin-resistant Enterococcus faecium. Microb Drug Resist 1995, 1:249–253.
McNeil SA, Clark NM, Chandrasekar PH, et al.: Successful treatment of vancomycin-resistant Enterococcus faecium bacteremia with linezolid after failure of treatment with synercid (quinupristin/dalfopristin). Clin Infect Dis 2000, 30:403–404.
Babcock HM, Ritchie DJ, Christiansen E, et al.: Successful treatment of vancomycin-resistant Enterococcus endocarditis with oral linezolid. Clin Infect Dis 2001, 32:1373–1375.
Safdar A, Bryan CS, Stinson S, et al.: Prosthetic valve endocarditis due to vancomycin-resistant Enterococcus faecium: treatment with chloramphenicol plus minocycline. Clin Infect Dis 2002, 34:E61-E63.
Cha R, Rybak MJ: Daptomycin against multiple drug-resistant Staphylococcus and Enterococcus isolates in an in vitro pharmacodynamic model with simulated endocardial vegetations. Diagn Microbiol Infect Dis 2003, 47:539–546.
Akins RL, Rybak MJ: Bactericidal activities of two daptomycin regimens against clinical strains of glycopeptide intermediate-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, and methicillin-resistant Staphylococcus aureus isolates in an in vitro pharmacodynamic model with simulated endocardial vegetations. Antimicrob Agents Chemother 2001, 45:454–459.
Levy CS, Kogulan P, Gill VJ, et al.: Endocarditis caused by penicillin-resistant viridans streptococci: 2 cases and controversies in therapy. Clin Infect Dis 2001, 33:577–579.
Ugolini V, Pacifico A, Smitherman TC, et al.: Pneumococcal endocarditis update: analysis of 10 cases diagnosed between 1974 and 1984. Am Heart J 1986, 112:813–819.
Powderly WG, Stanley SL Jr, Medoff G: Pneumococcal endocarditis: report of a series and review of the literature. Rev Infect Dis 1986, 8:786–791.
Bruyn GA, Thompson J, Van der Meer JW: Pneumococcal endocarditis in adult patients. A report of five cases and review of the literature. Q J Med 1990, 74:33–40.
Siegel M, Timpone J: Penicillin-resistant Streptococcus pneumoniae endocarditis: a case report and review. Clin Infect Dis 2001, 32:972–974.
Martinez E, Miro JM, Almirante B, et al.: Effect of penicillin resistance of Streptococcus pneumoniae on the presentation, prognosis, and treatment of pneumococcal endocarditis in adults. Clin Infect Dis 2002, 35:130–139. Important study.
Aronin SI, Mukherjee SK, West JC, et al.: Review of pneumococcal endocarditis in adults in the penicillin era. Clin Infect Dis 1998, 26:165–171.
Karchmer AW, Archer GL, Dismukes WE: Staphylococcus epidermidis causing prosthetic valve endocarditis: microbiologic and clinical observations as guides to therapy. Ann Intern Med 1983, 98:447–455. Important study.
Whitener C, Caputo GM, Weitekamp MR, et al.: Endocarditis due to coagulase-negative staphylococci. Microbiologic, epidemiologic, and clinical considerations. Infect Dis Clin North Am 1993, 7:81–96. Important study.
Etienne J, Eykyn SJ: Increase in native valve endocarditis caused by coagulase negative staphylococci: an Anglo-French clinical and microbiological study. Br Heart J 1990, 64:381–384.
Caputo GM, Archer GL, Calderwood SB, et al.: Native valve endocarditis due to coagulase-negative staphylococci. Clinical and microbiologic features. Am J Med 1987, 83:619–625. Important study.
Drinkovic D, Morris AJ, Pottumarthy S, et al.: Bacteriological outcome of combination versus single-agent treatment for staphylococcal endocarditis. J Antimicrob Chemother 2003, 52:820–825.
Arber N, Militianu A, Ben Yehuda A, et al.: Native valve Staphylococcus epidermidis endocarditis: report of seven cases and review of the literature. Am J Med 1991, 90:758–762.
Sanabria TJ, Alpert JS, Goldberg R, et al.: Increasing frequency of staphylococcal infective endocarditis. Experience at a university hospital, 1981 through 1988. Arch Intern Med 1990, 150:1305–1309.
Cabell CH, Jollis JG, Peterson GE, et al.: Changing patient characteristics and the effect on mortality in endocarditis. Arch Intern Med 2002, 162:90–94. Important study.
Fowler VG Jr, Sanders LL, Kong LK, et al.: Infective endocarditis due to Staphylococcus aureus: 59 prospectively identified cases with follow-up. Clin Infect Dis 1999, 28:106–114. Important study.
Jensen AG, Wachmann CH, Poulsen KB, et al.: Risk factors for hospital-acquired Staphylococcus aureus bacteremia. Arch Intern Med 1999, 159:1437–1444. Important study.
Heiro M, Nikoskelainen J, Engblom E, et al.: Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med 2000, 160:2781–2787. Important study.
Roder BL, Wandall DA, Espersen F, et al.: Neurologic manifestations in Staphylococcus aureus endocarditis: a review of 260 bacteremic cases in nondrug addicts. Am J Med 1997, 102:379–386.
Tunkel AR, Kaye D: Neurologic complications of infective endocarditis. Neurol Clin 1993, 11:419–440.
Sandre RM, Shafran SD: Infective endocarditis: review of 135 cases over 9 years. Clin Infect Dis 1996, 22:276–286.
Roder BL, Wandall DA, Frimodt-Moller N, et al.: Clinical features of Staphylococcus aureus endocarditis: a 10-year experience in Denmark. Arch Intern Med 1999, 159:462–469.
Petti CA, Fowler VG Jr.: Staphylococcus aureus bacteremia and endocarditis. Cardiol Clin 2003, 21:219–233, vii. This is a thorough review of the literature regarding S. aureus bloodstream infections.
Sklaver AR, Hoffman TA, Greenman RL: Staphylococcal endocarditis in addicts. South Med J 1978, 71:638–643.
Murray HW, Wigley FM, Mann JJ, et al.: Combination antibiotic therapy in staphylococcal endocarditis. The use of methicillin sodium-gentamicin sulfate therapy. Arch Intern Med 1976, 136:480–483.
Korzeniowski O, Sande MA: Combination antimicrobial therapy for Staphylococcus aureus endocarditis in patients addicted to parenteral drugs and in nonaddicts: a prospective study. Ann Intern Med 1982, 97:496–503. Important study.
Steckelberg JM, Rouse MS, Tallan BM, et al.: Relative efficacies of broad-spectrum cephalosporins for treatment of methicillin-susceptible Staphylococcus aureus experimental infective endocarditis. Antimicrob Agents Chemother 1993, 37:554–558.
Nannini EC, Singh KV, Murray BE: Relapse of type A beta-lactamase-producing Staphylococcus aureus native valve endocarditis during cefazolin therapy: revisiting the issue. Clin Infect Dis 2003, 37:1194–1198.
Levine DP, Fromm BS, Reddy BR: Slow response to vancomycin or vancomycin plus rifampin in methicillin-resistant Staphylococcus aureus endocarditis. Ann Intern Med 1991, 115:674–680. Important study.
Small PM, Chambers HF: Vancomycin for Staphylococcus aureus endocarditis in intravenous drug users. Antimicrob Agents Chemother 1990, 34:1227–1231.
Fortun J, Navas E, Martinez-Beltran J, et al.: Short-course therapy for right-side endocarditis due to Staphylococcus aureus in drug abusers: cloxacillin versus glycopeptides in combination with gentamicin. Clin Infect Dis 2001, 33:120–125.
Ruiz ME, Guerrero IC, Tuazon CU: Endocarditis caused by methicillin-resistant Staphylococcus aureus: treatment failure with linezolid. Clin Infect Dis 2002, 35:1018–1020.
Eliopoulos GM: Quinupristin-dalfopristin and linezolid: evidence and opinion. Clin Infect Dis 2003, 36:473–481.
Drew RH, Perfect JR, Srinath L, et al.: Treatment of methicillinresistant staphylococcus aureus infections with quinupristindalfopristin in patients intolerant of or failing prior therapy. For the Synercid Emergency-Use Study Group. J Antimicrob Chemother 2000, 46:775–784.
Olsen KM, Rebuck JA, Rupp ME: Arthralgias and myalgias related to quinupristin-dalfopristin administration. Clin Infect Dis 2001, 32:e83-e86.
Sakoulas G, Eliopoulos GM, Alder J, et al.: Efficacy of daptomycin in experimental endocarditis due to methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 2003, 47:1714–1718.
Chambers HF, Miller RT, Newman MD: Right-sided Staphylococcus aureus endocarditis in intravenous drug abusers: two-week combination therapy. Ann Intern Med 1988, 109:619–624.
DiNubile MJ: Short-course antibiotic therapy for right-sided endocarditis caused by Staphylococcus aureus in injection drug users. Ann Intern Med 1994, 121:873–876.
Ribera E, Gomez-Jimenez J, Cortes E, et al.: Effectiveness of cloxacillin with and without gentamicin in short-term therapy for right-sided Staphylococcus aureus endocarditis. A randomized, controlled trial. Ann Intern Med 1996, 125:969–974.
Mylonakis E, Calderwood SB: Infective endocarditis in adults. N Engl J Med 2001, 345:1318–1330. This is an outstanding review of current issues associated with endocarditis.
Dworkin RJ, Lee BL, Sande MA, et al.: Treatment of right-sided Staphylococcus aureus endocarditis in intravenous drug users with ciprofloxacin and rifampicin. Lancet 1989, 2:1071–1073.
Heldman AW, Hartert TV, Ray SC, et al.: Oral antibiotic treatment of right-sided staphylococcal endocarditis in injection drug users: prospective randomized comparison with parenteral therapy. Am J Med 1996, 101:68–76.
Rouse MS, Wilcox RM, Henry NK, et al.: Ciprofloxacin therapy of experimental endocarditis caused by methicillin-resistant Staphylococcus epidermidis. Antimicrob Agents Chemother 1990, 34:273–276.
Karchmer AW, Longworth DL: Infections of intracardiac devices. Infect Dis Clin North Am 2002, 16:477–505, xii.
Stanbridge TN, Isalska BJ: Aspects of prosthetic valve endocarditis. J Infect 1997, 35:1–6.
John MD, Hibberd PL, Karchmer AW, et al.: Staphylococcus aureus prosthetic valve endocarditis: optimal management and risk factors for death. Clin Infect Dis 1998, 26:1302–1309. Important study.
Vikram HR, Buenconsejo J, Hasbun R, et al.: Impact of valve surgery on 6-month mortality in adults with complicated, left-sided native valve endocarditis--a propensity analysis. JAMA 2003, 290:3207–3214. Important study.
Anguera I, Miro JM, de Lazzari E, et al.: Prognostic factors of mortality in aorto-cavitary fistulous tract formation in infective endocarditis [poster 46 2003]. Abstract presented at the 7th International Symposium on Modern Concepts in Endocarditis and Cardiovascular Infections. Chamonix Mont-Blanc, France, June 26, 2003.
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Stryjewski, M.E., Chu, V.H., Cabell, C.H. et al. Issues in the management of endocarditis caused by resistant gram-positive organisms. Curr Infect Dis Rep 6, 283–291 (2004). https://doi.org/10.1007/s11908-004-0049-7
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DOI: https://doi.org/10.1007/s11908-004-0049-7