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Streptococcus bovis bacteraemia: an evaluation of the long-term effect on cardiac outcomes

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Abstract

Introduction

Streptococcus bovis can lead to bacteraemia, septicaemia, and ultimately endocarditis. The objective of this study was to evaluate the long-term implications of S. bovis endocarditis on cardiac morbidity and mortality.

Methods

A retrospective cohort study was performed between January 2000 and March 2009 to assess all patients diagnosed with S. bovis bacteraemia from the Belfast Health and Social Care Trust. The primary end-point for cardiac investigations was the presence of endocarditis. Secondary end-points included referral for cardiac surgery and overall mortality.

Results

Sixty-one positive S. bovis blood cultures from 43 patients were included. Following echocardiography, seven patients were diagnosed with infective endocarditis (16.3 % of total patients); four patients (9.3 %) had native valve involvement while three (7.0 %) had prosthetic valve infection. Five of these seven patients had more than one positive S. bovis culture (71.4 %). Three had significant valve dysfunction that warranted surgical repair/replacement, one of whom was unfit for surgery. There was a 100 % recurrence rate amongst the valve replacement patients (n = 2) and six patients with endocarditis had colorectal pathology. Patients with endocarditis had similar long-term survival as those with non-endocarditic bacteraemia (57.1 % alive vs. 50 % of non-endocarditis patients, p = 0.73).

Conclusion

Streptococcus bovis endocarditis patients tended to have pre-existing valvular heart disease and those with prosthetic heart valves had higher surgical intervention and relapse rates. These patients experienced a higher rate of co-existing colorectal pathology but currently have reasonable long-term outcomes. This may suggest that they represent a patient population that merits consideration for an early surgical strategy to maximise long-term results, however, further evaluation is warranted.

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery, The Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK

    Gerard J. Fitzmaurice

  2. Department of General Surgery, The Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK

    Adrian J. McKenna & Mark E. O’Donnell

  3. Department of Medical Microbiology, The Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, Northern Ireland, UK

    Ronan McMullan

  4. Department of Colorectal Surgery, Royal London Hospital, London, E1 1BB, UK

    Jamie Murphy

  5. Sports and Exercise Research Institute, Faculty of Life and Health Sciences, University of Ulster, Jordanstown campus, Newtownabbey, BT37 0QB, Northern Ireland, UK

    Mark E. O’Donnell

  6. 11 Wicket Lane, Saintfield, BT24 7FJ, Northern Ireland, UK

    Mark E. O’Donnell

Authors
  1. Gerard J. Fitzmaurice
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  2. Adrian J. McKenna
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  3. Jamie Murphy
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  4. Ronan McMullan
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  5. Mark E. O’Donnell
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Corresponding author

Correspondence to Mark E. O’Donnell.

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Fitzmaurice, G.J., McKenna, A.J., Murphy, J. et al. Streptococcus bovis bacteraemia: an evaluation of the long-term effect on cardiac outcomes. Gen Thorac Cardiovasc Surg 62, 142–148 (2014). https://doi.org/10.1007/s11748-013-0316-3

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  • DOI: https://doi.org/10.1007/s11748-013-0316-3

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