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Prosthetic valve endocarditis caused by Propionibacterium species: a national registry-based study of 51 Swedish cases
Section of Infectious Diseases, Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department of Infectious Diseases, Uppsala University Hospital, Uppsala, Sweden.
Örebro University, School of Medical Sciences. Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5939-2932
Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden; Swedish Registry of Infective Endocarditis, Swedish Society of Infectious Diseases, Gothenburg, Sweden; Department of Infectious Diseases, Sahlgrenska University Hospital, Göteborg, Sweden.
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2018 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 37, no 4, p. 765-771Article in journal (Refereed) Published
Abstract [en]

Propionibacterium spp. are a rare cause of infective endocarditis (IE). The diagnosis is difficult because the bacteria are slow-growing and growth in blood cultures is often misinterpreted as contamination from the skin flora. The aim of this study was to describe all cases of Propionibacterium spp. endocarditis in the Swedish national registry of IE. The registry was searched for all cases of IE from 1995 to 2016 caused by Propionibacterium spp. Data concerning clinical characteristics, treatment, and outcome were registered. A total of 51 episodes of definitive prosthetic valve endocarditis (PVE) caused by Propionibacterium spp. were identified, comprising 8% of cases of PVE during the study period. Almost all cases (n = 50) were male. The median time from surgery to diagnosis of IE was 3 years. Most patients were treated mainly with beta-lactams, partly in combination with aminoglycosides. Benzyl-penicillin was the most frequently used beta-lactam. A total of 32 patients (63%) underwent surgery. Overall, 47 patients (92.1%) were cured, 3 (5.9%) suffered relapse, and 1 (2.0%) died during treatment. IE caused by Propionibacterium spp. almost exclusively affects men with a prosthetic valve and findings of Propionibacterium spp. in blood cultures in such patients favors suspicion of a possible diagnosis of IE. In patients with prosthetic valves, prolonged incubation of blood cultures up to 14 days is recommended. The prognosis was favorable, although a majority of patients required cardiac surgery during treatment. Benzyl-penicillin should be the first-line antibiotic treatment option for IE caused by Propionibacterium spp.

Place, publisher, year, edition, pages
Springer, 2018. Vol. 37, no 4, p. 765-771
National Category
Infectious Medicine Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-64849DOI: 10.1007/s10096-017-3172-8ISI: 000428247300021PubMedID: 29380224Scopus ID: 2-s2.0-85041116111OAI: oai:DiVA.org:oru-64849DiVA, id: diva2:1180988
Available from: 2018-02-07 Created: 2018-02-07 Last updated: 2018-04-13Bibliographically approved

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Söderquist, BoKällman, Jan

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