Incidence and Outcome of Documented Fungal Endocarditis

Parisa Badiee; Ahmad Ali  Amirghofran; Mohammad  Ghazi Nour; Masih  Shafa; Mohammad Hassan  Nemati

International Cardiovascular Research Journal

The Official Annually Journal of Cardiovascular Research Center, Shiraz University of Medical Sciences

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Incidence and Outcome of Documented Fungal Endocarditis

Author(s):

Parisa Badiee^1,*,

Ahmad Ali Amirghofran²,

Mohammad Ghazi Nour²,

Masih Shafa²,

Mohammad Hassan Nemati²

1Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2Cardiothoracic Surgery Unit, Shiraz University of Medical Sciences, Shiraz, Iran

International Cardiovascular Research Journal:Vol. 8, issue 4; e11678

Published online:Dec 01, 2014

Article type:Research Article

Received:Apr 19, 2017

Accepted:Apr 13, 2014

How to Cite:Parisa BadieeAhmad Ali AmirghofranMohammad Ghazi NourMasih ShafaMohammad Hassan NematiIncidence and Outcome of Documented Fungal Endocarditis.Int Cardiovasc Res J.8(4):e11678.

Abstract

Background: Fungal endocarditis, the most severe form of infective endocarditis, is characterized by excessive mortality and morbidity.

Objectives: The present study aimed to analyze the characteristics of fungal endocarditis to improve the management of these patients.

Materials and Methods: In this cross-sectional study, vegetations on the mitral or tricuspid valves and embolic material surgically removed from the patients with suspected infective endocarditis between December 2009 and November 2011 were examined for fungal infection by direct smear and culture, and the susceptibility patterns of the isolated species were determined. Then, blood samples were cultured on BACTEC media and real-time PCR was done with blood and tissue samples.

Results: Of the 31 patients with suspected infective endocarditis who did not respond to antibacterial therapy, 11 had confirmed fungal endocarditis. The most frequent predisposing risk factors were previous surgery and drug abuse. The organisms isolated were Aspergillus spp. and Candida albicans. Resistance to amphotericin B and itraconazole was observed in Aspergillus species, and to fluconazole in Candida albicans. Positive PCR results were obtained in blood and tissue samples.

Conclusions: Fungal endocarditis should be considered in the patients not responsive to antimicrobials. Moreover, management of these patients can be improved with molecular diagnostic methods and by determining the susceptibility patterns of the etiologic agents.

Keywords

Endocarditis

Aspergillus

Candida

Fungus Susceptibility

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