Cutibacterium acnes infective endocarditis-an emerging pathogen

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Shekhar Saha - , Klinikum der Ludwig-Maximilians-Universität (LMU) München (Autor:in)
  • Dominik Joskowiak - , Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) - Standort München (Autor:in)
  • Mateo Marin-Cuartas - , Herzzentrum Leipzig (Autor:in)
  • Manuela De La Cuesta - , Herzzentrum Leipzig (Autor:in)
  • Carolyn Weber - , Universitätsklinikum Köln (Autor:in)
  • Maximillian Luehr - , Universitätsklinikum Köln (Autor:in)
  • Asen Petrov - , Klinik für Kardiochirurgie (am Herzzentrum) (Autor:in)
  • Elda Dzilic - , Klinikum Rechts der Isar (MRI TUM) (Autor:in)
  • Rodrigo Sandoval-Boburg - , Universitätsklinikum Tübingen (Autor:in)
  • Spiros Lukas Marinos - , Universitätsklinikum Tübingen (Autor:in)
  • Philipp Pfeiffer - , Universitätsmedizin Mainz (Autor:in)
  • Konstanze Maria Horke - , Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) - Standort München (Autor:in)
  • Philipp Schnackenburg - , Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) - Standort München (Autor:in)
  • Nora Hertel - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • George Awad - , Otto-von-Guericke-Universität Magdeburg (Autor:in)
  • Max Wacker - , Otto-von-Guericke-Universität Magdeburg (Autor:in)
  • Isabell Moter - , München Klinik Bogenhausen, Technische Universität München (Autor:in)
  • Tulio Caldonazo - , Universitätsklinikum Jena (Autor:in)
  • Timur Kyashif - , Universitätsklinikum Jena (Autor:in)
  • Johannes Petersen - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Björn Sill - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Annette Moter - , MoKi Analytics GmbH (Autor:in)
  • Walter Eichinger - , München Klinik Bogenhausen, Technische Universität München (Autor:in)
  • Hermann Reichenspurner - , Universitätsklinikum Hamburg-Eppendorf (UKE) (Autor:in)
  • Daniel Dohle - , Universitätsmedizin Mainz (Autor:in)
  • Aron-Frederik Popov - , Medizinische Hochschule Hannover (MHH) (Autor:in)
  • Markus Krane - , Klinikum Rechts der Isar (MRI TUM) (Autor:in)
  • Klaus Matschke - , Klinik für Kardiochirurgie (am Herzzentrum) (Autor:in)
  • Thorsten Wahlers - , Universitätsklinikum Köln (Autor:in)
  • Torsten Doenst - , Universitätsklinikum Jena (Autor:in)
  • Micheal Borger - , Herzzentrum Leipzig (Autor:in)
  • Martin Misfeld - , University of Sydney (Autor:in)
  • Christian Hagl - , Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK) - Standort München (Autor:in)

Abstract

OBJECTIVES: The study aimed to review a multicentre experience of patients undergoing surgical intervention for infective endocarditis caused by Cutibacterium acnes and to analyse the diagnostic challenges and operative results.

METHODS: We retrospectively reviewed 8812 patients undergoing cardiac surgery for endocarditis at 12 cardiac surgical departments across Germany. The overall population was divided based on the type of endocarditis (i.e. native and prosthetic valve endocarditis). Primary outcomes were in-hospital mortality, 1- and 5-year survival.

RESULTS: Cutibacterium acnes caused endocarditis in 269 patients (3.1%). Median age was 65 years (54-72 years) and 237 (88.1%) were male. We observed significantly higher rates of native valve endocarditis in patients aged 21-40, whereas prosthetic valve endocarditis was more frequent in all other age groups (P < 0.001). The median EuroSCORE II of the cohort was 10.7 (5.0-29.6), with it being significantly higher in the prosthetic valve endocarditis group (P < 0.001). Blood culture-negative infective endocarditis was initially reported in 54.3% of the patients. The in-hospital mortality was comparable between the groups (P = 0.340). Survival at 1 and 5 years was significantly higher in the native valve endocarditis group (P < 0.001).

CONCLUSIONS: Cutibacterium acnes causes native valve endocarditis, especially in younger patients. The incidence of endocarditis caused by C.acnes is alarming and is at par with well-known endocarditis pathogens such as the HACEK group. The pathogen has a low virulence and presents with a rather indolent course. The diagnosis of C.acnes endocarditis is challenging and requires a multimodal specialized approach. Surgical treatment is associated with acceptable outcomes.

Details

OriginalspracheEnglisch
Aufsatznummerezae422
FachzeitschriftEuropean Journal of Cardio-thoracic Surgery
Jahrgang66
Ausgabenummer6
PublikationsstatusVeröffentlicht - 28 Nov. 2024
Peer-Review-StatusJa

Externe IDs

Scopus 85212040208

Schlagworte

Schlagwörter

  • Adult, Aged, Cardiac Surgical Procedures/adverse effects, Endocarditis, Bacterial/microbiology, Female, Germany/epidemiology, Gram-Positive Bacterial Infections/microbiology, Heart Valve Prosthesis/adverse effects, Hospital Mortality, Humans, Male, Middle Aged, Propionibacteriaceae/isolation & purification, Prosthesis-Related Infections/microbiology, Retrospective Studies, Young Adult