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Article

Bartonella Endocarditis in Spain: Case Reports of 21 Cases

by
Lara García-Álvarez
1,
Concepción García-García
1,
Patricia Muñoz
2,3,4,5,
María del Carmen Fariñas-Álvarez
6,7,8,
Manuel Gutiérrez Cuadra
6,7,8,
Nuria Fernández-Hidalgo
7,9,10,
Elisa García-Vázquez
11,12,
Encarnación Moral-Escudero
11,
María del Mar Alonso-Socas
13,
Dácil García-Rosado
13,
Carmen Hidalgo-Tenorio
14,
Fernando Domínguez
15,
Josune Goikoetxea-Agirre
16,
Juan Carlos Gainzarain
17,
María Ángeles Rodríguez-Esteban
18,
Xerach Bosch-Guerra
19,
José A. Oteo
1,* and
On behalf of Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES)
†
1
Infectious Diseases Department, San Pedro University Hospital-Center for Biomedical Research from La Rioja (CIBIR), 26006 Logroño, Spain
2
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
3
Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
4
CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), 28029 Madrid, Spain
5
Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
6
Servicio de Enfermedades Infecciosas, Hospital Universitario Marqués de Valdecilla IDIVAL, 39008 Santander, Spain
7
CIBER de Enfermedades Infecciosas-CIBERINFEC (CB21/13/00068), Instituto de Salud Carlos III, 28029 Madrid, Spain
8
Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain
9
Servei de Malalties Infeccioses, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain
10
Departamento de Medicina Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
11
Servicio de Medicina Interna-Infecciosas, IMIB, Hospital Clínico Universitario Virgen de la Arrixaca, 30120 Murcia, Spain
12
Facultad de Medicina, Universidad de Murcia, 30100 Murcia, Spain
13
Servicio de Enfermedades Infecciosas, Hospital Universitario de Canarias, 38320 Tenerife, Spain
14
Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
15
Servicio de Cardiología, Hospital Universitario Puerta de Hierro-Majadahonda, 28222 Madrid, Spain
16
Servicio de Enfermedades Infecciosas, Hospital Universitario de Cruces, 48903 Bilbao, Spain
17
Servicio de Medicina Interna, Hospital Universitario de Álava, 01009 Vitoria, Spain
18
Unidad de Cuidados Intensivos Cardiológicos, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
19
Unidad de Enfermedades Infecciosas, Hospital General de Gran Canaria Dr. Negrín, 35010 Las Palmas de Gran Canaria, Spain
 
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*
Author to whom correspondence should be addressed.
†
Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España are listed in Supplementary Material.
Pathogens 2022, 11(5), 561; https://doi.org/10.3390/pathogens11050561
Submission received: 1 April 2022 / Revised: 3 May 2022 / Accepted: 5 May 2022 / Published: 10 May 2022
(This article belongs to the Special Issue The Evolving Biomedical Importance of Bartonella Species Infections)
Versions Notes

Abstract

Blood culture negative endocarditis (BCNE) is frequent in infective endocarditis (IE). One of the causes of BCNE is fastidious microorganisms, such as Bartonella spp. The aim of this study was to describe the epidemiologic, clinical characteristics, management and outcomes of patients with Bartonella IE from the “Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES)”cohort. Here we presented 21 cases of Bartonella IE. This represents 0.3% of a total of 5590 cases and 2% of the BCNE from the GAMES cohort. 62% were due to Bartonella henselae and 38% to Bartonella quintana. Cardiac failure was the main presenting form (61.5% in B. hensalae, 87.5% in B. quintana IE) and the aortic valve was affected in 85% of the cases (76% in B. henselae, 100% in B. quintana IE). Typical signs such as fever were recorded in less than 40% of patients. Echocardiography showed vegetations in 92% and 100% of the patients with B. henselae and B. quintana, respectively. Culture was positive only in one patient and the remaining were diagnosed by serology and PCR. PCR was the most useful tool allowing for diagnosis in 16 patients (100% of the studied valves). Serology, at titers recommended by guidelines, only coincided with PCR in 52.4%. Antimicrobial therapy, in different combinations, was used in all cases. Surgery was performed in 76% of the patients. No in-hospital mortality was observed. One-year mortality was 9.4%. This article remarks the importance for investigating the presence of Bartonella infection as causative agent in all BCNE since the diagnosis needs specific microbiological tools and patients could benefit of a specific treatment.
Keywords: infective endocarditis; blood culture negative endocarditis; Bartonella endocarditis; Bartonella spp. infective endocarditis; blood culture negative endocarditis; Bartonella endocarditis; Bartonella spp.

Share and Cite

MDPI and ACS Style

García-Álvarez, L.; García-García, C.; Muñoz, P.; Fariñas-Álvarez, M.d.C.; Cuadra, M.G.; Fernández-Hidalgo, N.; García-Vázquez, E.; Moral-Escudero, E.; Alonso-Socas, M.d.M.; García-Rosado, D.; et al. Bartonella Endocarditis in Spain: Case Reports of 21 Cases. Pathogens 2022, 11, 561. https://doi.org/10.3390/pathogens11050561

AMA Style

García-Álvarez L, García-García C, Muñoz P, Fariñas-Álvarez MdC, Cuadra MG, Fernández-Hidalgo N, García-Vázquez E, Moral-Escudero E, Alonso-Socas MdM, García-Rosado D, et al. Bartonella Endocarditis in Spain: Case Reports of 21 Cases. Pathogens. 2022; 11(5):561. https://doi.org/10.3390/pathogens11050561

Chicago/Turabian Style

García-Álvarez, Lara, Concepción García-García, Patricia Muñoz, María del Carmen Fariñas-Álvarez, Manuel Gutiérrez Cuadra, Nuria Fernández-Hidalgo, Elisa García-Vázquez, Encarnación Moral-Escudero, María del Mar Alonso-Socas, Dácil García-Rosado, and et al. 2022. "Bartonella Endocarditis in Spain: Case Reports of 21 Cases" Pathogens 11, no. 5: 561. https://doi.org/10.3390/pathogens11050561

APA Style

García-Álvarez, L., García-García, C., Muñoz, P., Fariñas-Álvarez, M. d. C., Cuadra, M. G., Fernández-Hidalgo, N., García-Vázquez, E., Moral-Escudero, E., Alonso-Socas, M. d. M., García-Rosado, D., Hidalgo-Tenorio, C., Domínguez, F., Goikoetxea-Agirre, J., Gainzarain, J. C., Rodríguez-Esteban, M. Á., Bosch-Guerra, X., Oteo, J. A., & On behalf of Grupo de Apoyo al Manejo de la Endocarditis infecciosa en España (GAMES). (2022). Bartonella Endocarditis in Spain: Case Reports of 21 Cases. Pathogens, 11(5), 561. https://doi.org/10.3390/pathogens11050561

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