IMR Press / FBE / Volume 14 / Issue 3 / DOI: 10.31083/j.fbe1403023
Open Access Original Research
Abiotrophia spp. and Granulicatella spp. Infective Endocarditis: A Contemporary Perspective
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1 Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón (HGUGM), 28007 Madrid, Spain
2 Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
3 Medicine Department, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
4 Centro de Investigación Biomédica en Red (CIBER) de Enfermedades Respiratorias-CIBERES (CB06/06/0058), 28029 Madrid, Spain
5 Internal Medicine Department, HGUGM, 28007 Madrid, Spain
6 Cardiology Department, HGUGM, 28007 Madrid, Spain
7 CIBER Enfermedades Cardiovasculares-CIBERCV, 28029 Madrid, Spain
8 Cardiac Surgery Department, HGUGM, 28007 Madrid, Spain
9 Universidad Europea de Madrid, Universidad Complutense de Madrid, 28670-28040 Madrid, Spain
*Correspondence: (Agustín Estévez); (Maricela Valerio)
These authors contributed equally.
§GAME-HGUGM: Grupo de Apoyo al Manejo de la Endocarditis Infecciosa of Hospital General Universitario Gregorio Marañón. GAME-HGUGM group members are listed in the acknowledgments.
Academic Editor: Suresh G. Joshi
Front. Biosci. (Elite Ed) 2022, 14(3), 23;
Submitted: 27 June 2022 | Revised: 6 July 2022 | Accepted: 18 July 2022 | Published: 18 August 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Abiotrophia spp. and Granulicatella spp. are Gram-positive cocci, formerly known as nutritionally variant or deficient Streptococcus. Their role as causative agents of infective endocarditis (IE) is numerically uncertain, as well as diagnostic and clinical management of this infection. The aim of our study is to describe the clinical, microbiological, therapeutic, and prognosis of patients with IE caused by these microorganisms in a large microbiology department. Methods: Retrospective analysis of all the patients with Abiotrophia spp. and Granulicatella spp. IE registered in our centre in the period 2004–2021. Results: Of the 822 IE in the study period, 10 (1.2%) were caused by Abiotrophia spp. (7) or Granulicatella spp. (3). The species involved were A.defectiva (7), G.adiacens (2) and G.elegans (1). Eight patients were male, their mean age was 46 years and four were younger than 21 years. The most frequent comorbidities were congenital heart disease (4; 40%) and the presence of intracardiac prosthetic material (5; 50%). IE occurred on 5 native valves and 5 prosthetic valve or material. Blood cultures were positive in 8/10 patients, within a mean incubation period of 18.07 hours. In the other two patients, a positive 16SPCR from valve or prosthetic material provided the diagnosis. Surgery for IE was performed in seven patients (70%) and in all cases positive 16S rRNA PCR and sequencing from valve or prosthetic material was demonstrated. Valves and/or prosthetic removed material cultures were positive in four patients. Nine patients received ceftriaxone (4 in monotherapy and 5 in combination with other antibiotics). The mean length of treatment was 6 weeks and IE-associated mortality was 20% at one year follow-up. Conclusions: Abiotrophia spp. or Granulicatella spp. IE were infrequent but not exceptional in our environment and particularly affected patients with congenital heart disease or prosthetic material. Blood cultures and molecular methods allowed the diagnosis. Most of them required surgery and the associated mortality, in spite of a mean age of 46 years, was high.

infective endocarditis
Fig. 1.
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