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Burke A. Cunha - One of the best experts on this subject based on the ideXlab platform.
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Viridans streptococcal streptococcus mitis biosynthetic aortic prosthetic valve endocarditis pve complicated by complete heart block and paravalvular abscess
Heart & Lung, 2012Co-Authors: Basil Alkhatib, Paul E Schoch, Burke A. CunhaAbstract:Abstract Prosthetic valve endocarditis (PVE) may be classified clinically as early ( 60 days) post-valve replacement PVE. The pathogens of early versus late PVE differ in type and virulence. Early PVE pathogens are virulent, for example, Pseudomonas aeruginosa and Staphylococcus aureus . Late PVE pathogens resemble those of subacute bacterial endocarditis and are due to relatively avirulent and noninvasive organisms, for example, Viridans streptococci. Viridans streptococci vary in their invasiveness and abscess potential. Myocardial abscess and complete heart block are rare complications of late PVE due to Viridans streptococci. We present an unusual case of Streptococcus mitis late aortic PVE complicated by aortic root abscess, myocardial abscess, and complete heart block.
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Viridans streptococcal streptococcus intermedius mitral valve subacute bacterial endocarditis sbe in a patient with mitral valve prolapse after a dental procedure the importance of antibiotic prophylaxis
Heart & Lung, 2010Co-Authors: Burke A. Cunha, Alexis A Delia, Neha Pawar, Paul E SchochAbstract:Background Subacute bacterial endocarditis (SBE) is an infection of the heart involving damaged valves or endothelium. The most common organisms causing SBE are the Viridans streptococci. Viridans streptococci differ in their propensity to cause SBE, which is related to the ability to adhere to damaged heart valves and endothelium, which is a function of extracellular matrix production. Streptococcus intermedius is a member of the S. anginosus group. S. intermedius is one of the many strains of Viridans streptococci and a rare cause of SBE. SBE may result following a high-grade, sustained veridans streptococcal bacteremia in patients with predisposing cardiac lesions. Because Viridans streptococci are relatively avirulent pathogens in normal hosts, they usually present as SBE. Some strains of Viridans streptococci are inherently more virulent (eg, S. intermedius ) and clinically resemble S. lugdunensis or S. aureus. Methods We report a case of S. intermedius SBE in a patient with mitral valve prolapse (MVP). Throughout the patient's life, she received antibiotic prophylaxis for dental procedures and never developed SBE. Because of changes in endocarditis prophylaxis guidelines in 2007, recommending no prophylaxis for dental procedures in patients with MVP, she did not receive prophylaxis for a dental procedure 3 months before admission. The change in prophylaxis recommendations was based on the relatively low incidence of endocarditis with certain cardiac lesions. The recommendations were also based on concern for antibiotic resistance from widespread antibiotic use for antibiotic prophylaxis. There has been no appreciable increase in penicillin resistance, and antimicrobial resistance is not an important consideration among the Viridans streptococci. The incidence of SBE is not high after dental procedures in patients with MVP, but if SBE occurs, it may result in serious consequence for the patient. Results In this case, the patient developed S. intermedius , mitral valve SBE complicated by a cerebral vascular accident, and embolic occlusion of her leg. She was given optimal antibiotic treatment with ceftriaxone 2 g (intravenously) every 24 hours plus gentamicin 120 mg (intravenously) every 24 hours (synergy dose) but failed to respond to antimicrobial therapy. Although her S. intermedius bacteremia was rapidly cleared with antimicrobial therapy, sterilization of her vegetation was not accomplished, and during therapy, the size of her cardiac vegetation actually increased in size. Because of therapeutic failure despite optimal antibiotic therapy, the increasing size of her vegetation necessitated mitral valve replacement, which the patient underwent. Reasons for apparent/real antibiotic failure include inappropriate antimicrobial therapy, inadequately dosed antimicrobial therapy, antibiotic “tolerance,” or increased pathogen virulence. Her strain of S. intermedius was sensitive to all antibiotics and not due to a “tolerant strain”, i.e., her minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were the same ( Conclusion In this case, despite optimal antimicrobial therapy, and in the absence of resistance/tolerance, therapeutic failure was best explained on the basis of S. intermedius virulence. The take-home lesson for clinicians is that it is better to err on the side of antibiotic prophylaxis even in patients with low-risk cardiac lesions. Failure to administer antibiotic prophylaxis for dental procedures may result in SBE and have disastrous consequences for the patient, which, in this case, resulted in a cerebral vascular accident, embolic occlusion of the leg, and mitral valve replacement. In terms of virulence in patients with endocarditis, S. intermedius may resemble S. lugdenesis.
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Viridans streptococcal streptococcus intermedius mitral valve subacute bacterial endocarditis sbe in a patient with mitral valve prolapse after a dental procedure the importance of antibiotic prophylaxis
Heart & Lung, 2010Co-Authors: Burke A. Cunha, Alexis A Delia, Neha Pawar, Paul E SchochAbstract:Background Subacute bacterial endocarditis (SBE) is an infection of the heart involving damaged valves or endothelium. The most common organisms causing SBE are the Viridans streptococci. Viridans streptococci differ in their propensity to cause SBE, which is related to the ability to adhere to damaged heart valves and endothelium, which is a function of extracellular matrix production. Streptococcus intermedius is a member of the S. anginosus group. S. intermedius is one of the many strains of Viridans streptococci and a rare cause of SBE. SBE may result following a high-grade, sustained veridans streptococcal bacteremia in patients with predisposing cardiac lesions. Because Viridans streptococci are relatively avirulent pathogens in normal hosts, they usually present as SBE. Some strains of Viridans streptococci are inherently more virulent (eg, S. intermedius ) and clinically resemble S. lugdunensis or S. aureus. Methods We report a case of S. intermedius SBE in a patient with mitral valve prolapse (MVP). Throughout the patient's life, she received antibiotic prophylaxis for dental procedures and never developed SBE. Because of changes in endocarditis prophylaxis guidelines in 2007, recommending no prophylaxis for dental procedures in patients with MVP, she did not receive prophylaxis for a dental procedure 3 months before admission. The change in prophylaxis recommendations was based on the relatively low incidence of endocarditis with certain cardiac lesions. The recommendations were also based on concern for antibiotic resistance from widespread antibiotic use for antibiotic prophylaxis. There has been no appreciable increase in penicillin resistance, and antimicrobial resistance is not an important consideration among the Viridans streptococci. The incidence of SBE is not high after dental procedures in patients with MVP, but if SBE occurs, it may result in serious consequence for the patient. Results In this case, the patient developed S. intermedius , mitral valve SBE complicated by a cerebral vascular accident, and embolic occlusion of her leg. She was given optimal antibiotic treatment with ceftriaxone 2 g (intravenously) every 24 hours plus gentamicin 120 mg (intravenously) every 24 hours (synergy dose) but failed to respond to antimicrobial therapy. Although her S. intermedius bacteremia was rapidly cleared with antimicrobial therapy, sterilization of her vegetation was not accomplished, and during therapy, the size of her cardiac vegetation actually increased in size. Because of therapeutic failure despite optimal antibiotic therapy, the increasing size of her vegetation necessitated mitral valve replacement, which the patient underwent. Reasons for apparent/real antibiotic failure include inappropriate antimicrobial therapy, inadequately dosed antimicrobial therapy, antibiotic “tolerance,” or increased pathogen virulence. Her strain of S. intermedius was sensitive to all antibiotics and not due to a “tolerant strain”, i.e., her minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were the same ( Conclusion In this case, despite optimal antimicrobial therapy, and in the absence of resistance/tolerance, therapeutic failure was best explained on the basis of S. intermedius virulence. The take-home lesson for clinicians is that it is better to err on the side of antibiotic prophylaxis even in patients with low-risk cardiac lesions. Failure to administer antibiotic prophylaxis for dental procedures may result in SBE and have disastrous consequences for the patient, which, in this case, resulted in a cerebral vascular accident, embolic occlusion of the leg, and mitral valve replacement. In terms of virulence in patients with endocarditis, S. intermedius may resemble S. lugdenesis.
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fatal streptococcus Viridans s oralis aortic prosthetic valve endocarditis pve with paravalvular abscesses related to steroids
Heart & Lung, 2009Co-Authors: Laurence Turnier, Sara Nausheen, Burke A. CunhaAbstract:Streptococcus Viridans (ie, the Viridans streptococci) is a term for avirulent, noninvasive, commensals whose primary habitat is the oral pharynx. Because of their lack of virulence and invasive potential, S. Viridans virtually causes only subacute endocarditis (SBE). To cause SBE, the Viridans streptococcal species require a damaged endothelium and heart valve to adhere to for the infectious process to be initiated. The frequency distribution of Viridans streptococcal strains associated with SBE is directly related to their ability to produce capsule important for adherence. Strains with capsules are more frequently associated in SBE than those species with less abundant capsules. Viridans streptococci rarely cause native prosthetic valve endocarditis (PVE). Clinically, SBE caused by Viridans streptococci is characterized by temperatures of less than 102°F with a cardiac murmur and may be accompanied by splenomegaly and peripheral manifestations. S. Viridans SBE rarely results in valvular destruction or perivalvular abscesses. In contrast, acute bacterial endocarditis caused by virulent pathogens (eg, Staphylococcus aureus) is capable of infecting and destroying normal heart valves and is often accompanied by congestive heart failure, septic emboli, and perivalvular abscess and leaks. PVE may involve mechanical or bioprosthetic valves and clinical presentation, and the severity depends on the pathogen and number of valves affected. The clinical course of PVE caused by relatively avirulent pathogens resembles SBE caused by Viridans streptococci. There are little data on the untoward effects of steroids in patients with S. Viridans SBE. We present a case of aortic PVE caused by S. oralis ,a Viridans streptococcus, treated with steroids. Postmortem examination revealed aortic prosthetic valve involvement with two large periaortic valvular abscesses and a large perivalvular leak that, despite appropriate antibiotic treatment, led to the patient’s precipitous demise. We believe this is the first reported case of fatal aortic valve PVE caused by S. oralis related to steroids. Subacute bacterial endocarditis (SBE) refers to a
Thanh Docolecompte - One of the best experts on this subject based on the ideXlab platform.
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prosthetic valve endocarditis due to coagulase negative staphylococci findings from the international collaboration on endocarditis merged database
European Journal of Clinical Microbiology & Infectious Diseases, 2006Co-Authors: Tahaniyat Lalani, Zeina A Kanafani, G R Corey, Paul A Pappas, Christopher W Woods, Christopher H Cabell, Bruno Hoen, Christine Seltonsuty, L. Moore, Thanh DocolecompteAbstract:Infective endocarditis due to coagulase-negative staphylococci is increasingly recognized as a difficult-to-treat disease associated with poor outcome. The aim of this report is to describe the characteristics and outcome of patients with prosthetic valve endocarditis (PVE) due to coagulase-negative staphylococci versus those of patients with PVE due to Staphylococcus aureus and Viridans streptococci. Patients were identified through the International Collaboration on Endocarditis Merged Database. A total of 54 cases of coagulase-negative staphylococci PVE, 58 cases of S. aureus PVE, and 63 cases of Viridans-streptococci-related PVE were available for analysis. There was no difference between the three groups with respect to the type of valve involved or the rate of embolization. However, heart failure was encountered more frequently with coagulase-negative staphylococci (54%) than with either S. aureus (33%; p=0.03) or Viridans streptococci (32%; p=0.02). In addition, valvular abscesses complicated 39% of infections due to coagulase-negative staphylococci compared with 22% of those due to S. aureus (p=0.06) and 6% of those due to Viridans streptococci (p<0.001). Mortality was highest in patients with S. aureus and coagulase-negative staphylococcal endocarditis (47 and 36%, respectively; p=0.22) and was considerably lower in patients with Viridans streptococcal endocarditis (p=0.002 compared to patients with coagulase-negative staphylococcal endocarditis). The results of this analysis demonstrate the aggressive nature of coagulase-negative staphylococcal PVE and the substantially greater morbidity and mortality associated with this infection compared to PVE caused by other pathogens.
Annelies Verbon - One of the best experts on this subject based on the ideXlab platform.
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differentiation between streptococcus pneumoniae and other Viridans group streptococci by matrix assisted laser desorption ionization time of flight mass spectrometry
Clinical Microbiology and Infection, 2020Co-Authors: Rachid Y Yahiaoui, W H F Goessens, E E Stobberingh, Annelies VerbonAbstract:Abstract Objectives Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) is becoming the method of choice for bacterial identification. However, correct identification by MALDI-TOF of closely related microorganisms such as Viridans streptococci is still cumbersome, especially in the identification of S. pneumoniae. By making use of additional spectra peaks for S. pneumoniae and other Viridans group streptococci (VGS). We re-identified Viridans streptococci that had been identified and characterized by molecular and phenotypic techniques by MALDI-TOF. Methods VGS isolates (n = 579), 496 S. pneumoniae and 83 non-S. pneumoniae were analysed using MALDI-TOF MS and the sensitivity and specificity of MALDI-TOF MS was assessed. Hereafter, mass spectra analysis was performed. Presumptive identification of proteins represented by discriminatory peaks was performed by molecular weight matching and the corresponding nucleotides sequences against different protein databases. Results Using the Bruker reference library, 495 of 496 S. pneumoniae isolates were identified as S. pneumoniae and one isolate was identified as non-S. pneumoniae. Of the 83 non-S. pneumoniae isolates, 37 were correctly identified as non-S. pneumoniae, and 46 isolates as S. pneumoniae. The sensitivity of the MALDI-TOF MS was 99.8% (95% confidence interval (CI) 98.9–100) and the specificity was 44.6% (95% CI 33.7–55.9). Eight spectra peaks were mostly present in one category (S. pneumoniae or other VGS) and absent in the other category and inversely. Two spectra peaks of these (m/z 3420 and 3436) were selected by logistic regression to generate three identification profiles. These profiles could differentiate between S. pneumoniae and other VGS with high sensitivity and specificity (99.4% and 98.8%, respectively). Conclusions Spectral peaks analysis based identification is a powerful tool to differentiate S. pneumoniae from other VGS species with high specificity and sensitivity and is a useful method for pneumococcal identification in carriage studies. More research is needed to further confirm our findings. Extrapolation of these results to clinical strains need to be deeply investigated.
Paul E Schoch - One of the best experts on this subject based on the ideXlab platform.
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Viridans streptococcal streptococcus mitis biosynthetic aortic prosthetic valve endocarditis pve complicated by complete heart block and paravalvular abscess
Heart & Lung, 2012Co-Authors: Basil Alkhatib, Paul E Schoch, Burke A. CunhaAbstract:Abstract Prosthetic valve endocarditis (PVE) may be classified clinically as early ( 60 days) post-valve replacement PVE. The pathogens of early versus late PVE differ in type and virulence. Early PVE pathogens are virulent, for example, Pseudomonas aeruginosa and Staphylococcus aureus . Late PVE pathogens resemble those of subacute bacterial endocarditis and are due to relatively avirulent and noninvasive organisms, for example, Viridans streptococci. Viridans streptococci vary in their invasiveness and abscess potential. Myocardial abscess and complete heart block are rare complications of late PVE due to Viridans streptococci. We present an unusual case of Streptococcus mitis late aortic PVE complicated by aortic root abscess, myocardial abscess, and complete heart block.
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Viridans streptococcal streptococcus intermedius mitral valve subacute bacterial endocarditis sbe in a patient with mitral valve prolapse after a dental procedure the importance of antibiotic prophylaxis
Heart & Lung, 2010Co-Authors: Burke A. Cunha, Alexis A Delia, Neha Pawar, Paul E SchochAbstract:Background Subacute bacterial endocarditis (SBE) is an infection of the heart involving damaged valves or endothelium. The most common organisms causing SBE are the Viridans streptococci. Viridans streptococci differ in their propensity to cause SBE, which is related to the ability to adhere to damaged heart valves and endothelium, which is a function of extracellular matrix production. Streptococcus intermedius is a member of the S. anginosus group. S. intermedius is one of the many strains of Viridans streptococci and a rare cause of SBE. SBE may result following a high-grade, sustained veridans streptococcal bacteremia in patients with predisposing cardiac lesions. Because Viridans streptococci are relatively avirulent pathogens in normal hosts, they usually present as SBE. Some strains of Viridans streptococci are inherently more virulent (eg, S. intermedius ) and clinically resemble S. lugdunensis or S. aureus. Methods We report a case of S. intermedius SBE in a patient with mitral valve prolapse (MVP). Throughout the patient's life, she received antibiotic prophylaxis for dental procedures and never developed SBE. Because of changes in endocarditis prophylaxis guidelines in 2007, recommending no prophylaxis for dental procedures in patients with MVP, she did not receive prophylaxis for a dental procedure 3 months before admission. The change in prophylaxis recommendations was based on the relatively low incidence of endocarditis with certain cardiac lesions. The recommendations were also based on concern for antibiotic resistance from widespread antibiotic use for antibiotic prophylaxis. There has been no appreciable increase in penicillin resistance, and antimicrobial resistance is not an important consideration among the Viridans streptococci. The incidence of SBE is not high after dental procedures in patients with MVP, but if SBE occurs, it may result in serious consequence for the patient. Results In this case, the patient developed S. intermedius , mitral valve SBE complicated by a cerebral vascular accident, and embolic occlusion of her leg. She was given optimal antibiotic treatment with ceftriaxone 2 g (intravenously) every 24 hours plus gentamicin 120 mg (intravenously) every 24 hours (synergy dose) but failed to respond to antimicrobial therapy. Although her S. intermedius bacteremia was rapidly cleared with antimicrobial therapy, sterilization of her vegetation was not accomplished, and during therapy, the size of her cardiac vegetation actually increased in size. Because of therapeutic failure despite optimal antibiotic therapy, the increasing size of her vegetation necessitated mitral valve replacement, which the patient underwent. Reasons for apparent/real antibiotic failure include inappropriate antimicrobial therapy, inadequately dosed antimicrobial therapy, antibiotic “tolerance,” or increased pathogen virulence. Her strain of S. intermedius was sensitive to all antibiotics and not due to a “tolerant strain”, i.e., her minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were the same ( Conclusion In this case, despite optimal antimicrobial therapy, and in the absence of resistance/tolerance, therapeutic failure was best explained on the basis of S. intermedius virulence. The take-home lesson for clinicians is that it is better to err on the side of antibiotic prophylaxis even in patients with low-risk cardiac lesions. Failure to administer antibiotic prophylaxis for dental procedures may result in SBE and have disastrous consequences for the patient, which, in this case, resulted in a cerebral vascular accident, embolic occlusion of the leg, and mitral valve replacement. In terms of virulence in patients with endocarditis, S. intermedius may resemble S. lugdenesis.
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Viridans streptococcal streptococcus intermedius mitral valve subacute bacterial endocarditis sbe in a patient with mitral valve prolapse after a dental procedure the importance of antibiotic prophylaxis
Heart & Lung, 2010Co-Authors: Burke A. Cunha, Alexis A Delia, Neha Pawar, Paul E SchochAbstract:Background Subacute bacterial endocarditis (SBE) is an infection of the heart involving damaged valves or endothelium. The most common organisms causing SBE are the Viridans streptococci. Viridans streptococci differ in their propensity to cause SBE, which is related to the ability to adhere to damaged heart valves and endothelium, which is a function of extracellular matrix production. Streptococcus intermedius is a member of the S. anginosus group. S. intermedius is one of the many strains of Viridans streptococci and a rare cause of SBE. SBE may result following a high-grade, sustained veridans streptococcal bacteremia in patients with predisposing cardiac lesions. Because Viridans streptococci are relatively avirulent pathogens in normal hosts, they usually present as SBE. Some strains of Viridans streptococci are inherently more virulent (eg, S. intermedius ) and clinically resemble S. lugdunensis or S. aureus. Methods We report a case of S. intermedius SBE in a patient with mitral valve prolapse (MVP). Throughout the patient's life, she received antibiotic prophylaxis for dental procedures and never developed SBE. Because of changes in endocarditis prophylaxis guidelines in 2007, recommending no prophylaxis for dental procedures in patients with MVP, she did not receive prophylaxis for a dental procedure 3 months before admission. The change in prophylaxis recommendations was based on the relatively low incidence of endocarditis with certain cardiac lesions. The recommendations were also based on concern for antibiotic resistance from widespread antibiotic use for antibiotic prophylaxis. There has been no appreciable increase in penicillin resistance, and antimicrobial resistance is not an important consideration among the Viridans streptococci. The incidence of SBE is not high after dental procedures in patients with MVP, but if SBE occurs, it may result in serious consequence for the patient. Results In this case, the patient developed S. intermedius , mitral valve SBE complicated by a cerebral vascular accident, and embolic occlusion of her leg. She was given optimal antibiotic treatment with ceftriaxone 2 g (intravenously) every 24 hours plus gentamicin 120 mg (intravenously) every 24 hours (synergy dose) but failed to respond to antimicrobial therapy. Although her S. intermedius bacteremia was rapidly cleared with antimicrobial therapy, sterilization of her vegetation was not accomplished, and during therapy, the size of her cardiac vegetation actually increased in size. Because of therapeutic failure despite optimal antibiotic therapy, the increasing size of her vegetation necessitated mitral valve replacement, which the patient underwent. Reasons for apparent/real antibiotic failure include inappropriate antimicrobial therapy, inadequately dosed antimicrobial therapy, antibiotic “tolerance,” or increased pathogen virulence. Her strain of S. intermedius was sensitive to all antibiotics and not due to a “tolerant strain”, i.e., her minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were the same ( Conclusion In this case, despite optimal antimicrobial therapy, and in the absence of resistance/tolerance, therapeutic failure was best explained on the basis of S. intermedius virulence. The take-home lesson for clinicians is that it is better to err on the side of antibiotic prophylaxis even in patients with low-risk cardiac lesions. Failure to administer antibiotic prophylaxis for dental procedures may result in SBE and have disastrous consequences for the patient, which, in this case, resulted in a cerebral vascular accident, embolic occlusion of the leg, and mitral valve replacement. In terms of virulence in patients with endocarditis, S. intermedius may resemble S. lugdenesis.
Bruno Hoen - One of the best experts on this subject based on the ideXlab platform.
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prosthetic valve endocarditis due to coagulase negative staphylococci findings from the international collaboration on endocarditis merged database
European Journal of Clinical Microbiology & Infectious Diseases, 2006Co-Authors: Tahaniyat Lalani, Zeina A Kanafani, G R Corey, Paul A Pappas, Christopher W Woods, Christopher H Cabell, Bruno Hoen, Christine Seltonsuty, L. Moore, Thanh DocolecompteAbstract:Infective endocarditis due to coagulase-negative staphylococci is increasingly recognized as a difficult-to-treat disease associated with poor outcome. The aim of this report is to describe the characteristics and outcome of patients with prosthetic valve endocarditis (PVE) due to coagulase-negative staphylococci versus those of patients with PVE due to Staphylococcus aureus and Viridans streptococci. Patients were identified through the International Collaboration on Endocarditis Merged Database. A total of 54 cases of coagulase-negative staphylococci PVE, 58 cases of S. aureus PVE, and 63 cases of Viridans-streptococci-related PVE were available for analysis. There was no difference between the three groups with respect to the type of valve involved or the rate of embolization. However, heart failure was encountered more frequently with coagulase-negative staphylococci (54%) than with either S. aureus (33%; p=0.03) or Viridans streptococci (32%; p=0.02). In addition, valvular abscesses complicated 39% of infections due to coagulase-negative staphylococci compared with 22% of those due to S. aureus (p=0.06) and 6% of those due to Viridans streptococci (p<0.001). Mortality was highest in patients with S. aureus and coagulase-negative staphylococcal endocarditis (47 and 36%, respectively; p=0.22) and was considerably lower in patients with Viridans streptococcal endocarditis (p=0.002 compared to patients with coagulase-negative staphylococcal endocarditis). The results of this analysis demonstrate the aggressive nature of coagulase-negative staphylococcal PVE and the substantially greater morbidity and mortality associated with this infection compared to PVE caused by other pathogens.
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native valve endocarditis due to coagulase negative staphylococci report of 99 episodes from the international collaboration on endocarditis merged database
Clinical Infectious Diseases, 2004Co-Authors: Vivian H Chu, Paul A Pappas, Christopher H Cabell, Bruno Hoen, Elias Abrutyn, Ralph G Corey, Jose M Miro, Lars Olaison, Martin E Stryjewski, Kevin J AnstromAbstract:Using a large cohort of patients from the International Collaboration on Endocarditis Merged Database, we compared coagulase-negative staphylococcal (CoNS) native-valve endocarditis (NVE) to NVE caused by more common pathogens. Rates of heart failure and mortality were similar between patients with CoNS NVE and patients with Staphylococcus aureus NVE, but rates for both groups were significantly higher than rates for patients with NVE due to Viridans streptococci. These results emphasize the importance of CoNS as a cause of NVE and the potential for serious complications with this infection.
