Bartonella Endocarditis in Spain: Case Reports of 21 Cases
Abstract
:1. Introduction
2. Results
2.1. Epidemiological Data
2.2. Clinical Features
2.3. Microbiological Diagnosis
2.4. Treatment and Outcome
3. Discussion
4. Materials and Methods
4.1. Patients’ Recruitment
4.2. Definitions
4.3. Statistics
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Bartonella henselae IE | Bartonella quintana IE | Total | |
---|---|---|---|
Nº patients | 13 | 8 | 21 |
Age median (IQR) | 55 (42–58) | 42 (34.5–61.5) | 49 (40–59) |
Male | 7 (53.8%) | 6 (75%) | 13 (61.9%) |
Previous heart disease | 69.2% | 62.5% | 66.7% |
Alcohol abuse | 7.7% | 25% | 14.3% |
Cats/Fleas/Body lice contact | 38.5% | 37.5% | 38% |
Median age-adjusted Charlson comorbidity index (IQR) | 2 (1–4) | 0 (0–2.5) | 1 (0.5–4.5) |
Affected valve/s Aortic/Mitroaortic | 76.9%/23.7% | 100%/50% | 85.7%/38.9% |
Cardiac failure | 61.5% | 87.5% | 66.7% |
Fever | 38.5% | 37.5% | 42.8% |
Mean vegetations size (mm) ±SD | 13.8 ± 6.5 | 10.6 ± 2.2 | 12.7 ± 5.6 |
Intracardiac complications | 69.2% | 37.5% | 57.1% |
Surgery | 61.5% | 100% | 76.2% |
Anemia | 76.9% | 75% | 76.2% |
Median duration of antimicrobial therapy (IQR) | 46 (42–92) | 70.5 (42–110) | 49 (42–103) |
Days of hospital admission median (IQR) | 40 (28–52.5) | 43 (38.5–55.5) | 41 (28.5–54.5) |
Sequelae | 15.4% | 12.5% | 14.3% |
Relapse | 0 | 0 | 0 |
Death (1st year) | 2 (15.4%) | 0 | 2 (9.5%) |
Patient Id. | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21 |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Bartonella spp. | BH | BH | BH | BH | BH | BH | BH | BH | BH | BH | BH | BH | BH | BQ | BQ | BQ | BQ | BQ | BQ | BQ * | BQ |
Age | 42 | 58 | 44 | 40 | 82 | 88 | 59 | 47 | 57 | 57 | 40 | 55 | 40 | 33 | 35 | 72 | 28 | 66 | 60 | 49 | 35 |
Sex | F | M | M | F | F | F | M | F | M | M | M | F | M | F | M | M | M | M | M | F | M |
Country of residence | Spain | Spain | Spain | Spain | Spain | Spain | Spain | Spain | Spain | Spain | Spain | Spain | Morocco | Spain | Spain | Spain | Spain | Spain | Moldova | Morocco | Pakistan |
Year of diagnosis | 2014 | 2017 | 2010 | 2012 | 2018 | 2010 | 2013 | 2019 | 2019 | 2018 | 2020 | 2021 | 2014 | 2012 | 2016 | 2013 | 2019 | 2009 | 2011 | 2018 | 2016 |
Malignancies | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
Previous heart disease | Y | N | N | Y | Y | N | Y | Y | N | Y | Y | Y | Y | Y | N | Y | N | Y | N | Y | Y |
Alcohol abuse | N | N | Y | N | N | N | N | N | N | N | N | N | N | Y | Y | N | N | N | N | N | N |
Other historical conditions | CTD, IT | CLD, HT, HL, VD | RFI, HD, PU | HT, IT, CTD, RFI | CLD, DM, HT, CD, HL | HT, CVD | N | N | CD | DM, HT, HL | N | CTD | HT, CVD, TA. | N | N | DM, HT, HL, VD, RFI. | N | HT, HL, RFI | HL | N | N |
Cats/Fleas/Body lice contact | Y | Y | N | N | Y | N | N | Y | N | N | N | Y | ND | Y | N | N | Y | N | Y | ND | ND |
Age-adjusted charlson comorbidity index | 1 | 3 | 5 | 4 | 7 | 5 | 1 | 0 | 1 | 2 | 1 | 2 | 1 | 1 | 0 | 7 | 0 | 9 | 2 | 0 | 0 |
ETE/ETT | BOTH | BOTH | BOTH | BOTH | TOE | TTE | BOTH | TTE | BOTH | BOTH | TTE | BOTH | BOTH | TTE | BOTH | BOTH | TTE | BOTH | BOTH | BOTH | TTE |
Affected valve/s | AO | AO | AO-MIT | AO | MIT | AO-MIT | MIT | AO | MIT | AO | AO-MIT | AO | AO | AO-MIT | AO-MIT | AO | AO | AO | AO-MIT | AO-MIT | AO |
Vegetations size (mm) | 9 | 12 | 5 | NV | 8 | 15 | 25 | 25 | ND | 12 | ND | 10 | 17 | ND | ND | 12 | ND | 13 | 7 | 12 | 9 |
Cardiac failure (NHYA) | N | Y(III) | N | Y(III) | N | Y(I) | N | Y(III) | Y(III) | Y(IV) | Y(IV) | N | Y(IV) | NO | Y(III) | Y(IV) | Y(III) | Y(IV) | Y(IV) | Y(IV) | Y(IV) |
Fever | N | N | Y | Y | Y | Y | Y | N | N | N | N | N | Y | N | N | Y | N | N | Y | Y | N |
Intracardiac complications | N | N | Y | Y | Y | Y | N | Y | Y | Y | N | Y | Y | N | Y | N | N | N | Y | Y | N |
Embolisms | Y | N | N | N | N | Y | N | N | Y | Y | N | N | N | N | Y | N | N | N | N | N | N |
Surgery | Y | Y | Y | Y | N | N | N | Y | Y | N | N | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y |
CRP (mg/L) ** | 1.5 | 57.5 | 5.6 | 108 | 3 | 1.4 | 20.9 | ND | 11 | 51 | 70 | 11 | ND | ND | 181 | ND | 4.4 | 49 | ND | ND | 7.8 |
ESR (mm/h) | 44 | 141 | ND | 32 | 13 | ND | ND | ND | 25 | ND | ND | ND | 120 | ND | ND | ND | 120 | 123 | 118 | ND | ND |
AST/ALT (U/L) | 115/208 | 17/12 | 19/8 | 30/26 | 23/16 | UNK | 102/107 | 20/19 | 32/61 | 34/30 | 33/25 | 18/8 | 34/30 | 15/16 | 40/35 | 2387/2224 | 34/19 | 68/10 | 17/16 | 10/5 | 14/11 |
Microbiological diagnosis | SER/ PCR | SER/ PCR | SER | SER/ PCR | SER | SER | SER | PCR | SER | SER/ PCR | SER/ PCR | SER/ PCR | PCR | PCR | SER/ PCR | PCR | PCR | SER/ PCR | SER/ PCR | SER/ PCR | SER/ PCR |
Antimicrobial Duration (days) | 207 | 42 | 35 | 35 | 116 | 46 | 42 | 58 | 42 | 68 | 42 | 46 | 123 | 49 | 198 | 25 | 35 | 51 | 90 | 90 | 130 |
Days of hospital admission | 40 | 28 | 3 | 47 | 95 | 47 | 51 | 34 | 54 | 28 | 28 | 23 | 57 | 38 | 56 | 55 | 29 | 56 | 39 | 45 | 41 |
Sequelae | N | N | N | N | Y | N | N | N | Y | N | N | N | N | N | Y | N | N | N | N | N | N |
Outcome | A | A | A | D (IE RELATED) | D (IE RELATED) | D (IE NOT RELATED) | A | A | A | A | A | A | A | A | A | A | A | A | A | A | A |
Microbiological Technique | N (%) | B. henselae | B. quintana |
---|---|---|---|
Blood culture | 1 | 0 | 1 |
PCR Blood Valve/vegetation Blood and valve | 16 (76.2) 2 (9.5) 16 (76.2) 2 (9.5) | 8 1 8 1 | 8 1 8 1 |
Serology a | 17 (80.9) | 11 | 5 |
More than one technique | 12 (57.1) | 6 | 6 |
Only culture Only PCR Only serology Culture and PCR Culture and serology PCR and serology Culture, PCR and serology | - 3 (14.2) 5 (23.8) 1 (4.8) - 11 (52.4) - | - 2 5 - - 6 - | - 1 - 1 - 5 - |
Coincidences | 11 (52.4) | 6 | 5 |
Patient Id. | Antimicrobials |
---|---|
1 | Gentamicin + Ceftriaxone/Gentamicin + Doxycycline |
2 | Ampicillin + Cloxacillin + Gentamicin/Gentamicin + Doxycycline |
3 | Ciprofloxacin/Vancomycin + Gentamicin |
4 | Gentamicin + Doxycycline |
5 | Gentamicin + Daptomycin + Doxycycline/Daptomycin + Ceftriaxone |
6 | Gentamicin + Cloxacillin + Ampicillin/Ceftriaxone |
7 | Ampicillin + Gentamicin + Cloxacillin/Ampicillin + Cloxacillin + Ceftriaxone |
8 | Gentamicin + Daptmycine + Ceftriaxone/Doxycycline |
9 | Ampicillin + Cloxacillin + Ceftriaxone/Doxycycline + Imipenem/Gentamicin + Doxycycline + Rifampicin |
10 | Ceftriaxone + Gentamicin/Doxycycline |
11 | Ceftriaxone + Daptomycine + Cloxacillin/Doxycycline + Rifampicin |
12 | Ampicillin + Ceftriaxone + Cloxacillin/Ceftriaxone + Gentamicin + Doxycycline |
13 | Ampicillin + Ceftriaxone/ Doxycycline |
14 | Ceftriaxone + Doxycycline + Gentamicin |
15 | Ceftriaxone + Gentamicin/Cloxacillin + Ampicillin/Rifampicin + Doxycycline + Gentamicin |
16 | Ampicillin + Cloxacillin + Gentamicine/Daptomycin |
17 | Ceftriaxone + Ampicillin + Cloxacillin/Gentamicin + Doxycycline |
18 | Ampicillin + Gentamicin/Daptomycin + Ceftriaxone + Levofloxacin/Gentamicin + Rifampicin + Doxycycline |
19 | Ceftriaxone/Penicillin + Gentamicin/Doxycycline |
20 | Doxycycline |
21 | Ceftriaxone/Doxycycline |
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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
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 StyleGarcía-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