Outcome and treatment of Bartonella endocarditis.
BACKGROUND
Endocarditis caused by Bartonella species is a potentially lethal infection characterized by a subacute evolution and severe valvular lesions.


OBJECTIVE
To evaluate the outcome of patients with Bartonella endocarditis and to define the best antibiotic regimen using the following measures: recovery, relapse, or death.


METHODS
We performed a retrospective study on 101 patients who were diagnosed in our laboratory as having Bartonella endocarditis between January 1, 1995, and April 30, 2001. Bartonella infection was diagnosed using immunofluorescence with a 1:800 cutoff, polymerase chain reaction amplification of DNA, and/or culture findings of Bartonella species from whole blood, serum, and/or valvular biopsy specimens. A standardized questionnaire was completed by investigators for each patient.


RESULTS
Twelve of the 101 patients died and 2 relapsed. Patients receiving an aminoglycoside were more likely to fully recover (P =.02), and those treated with aminoglycosides for at least 14 days were more likely to survive than those with shorter therapy duration (P =.02).


CONCLUSIONS
Effective antibiotic therapy for Bartonella endocarditis should include an aminoglycoside prescribed for a minimum of 2 weeks.
Raoult
Didier
D
Unité des Rickettsies, Faculté de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille CEDEX 05, France. didier.raoult@medecine.univ-mrs.fr
Fournier
Pierre-Edouard
PE
Vandenesch
François
F
Mainardi
Jean-Luc
JL
Eykyn
Susannah J
SJ
Nash
James
J
James
Edward
E
Benoit-Lemercier
Catherine
C
Marrie
Thomas J
TJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001474:Bartonella Infections / Q000188:drug therapy*; D004697:Endocarditis, Bacterial / Q000188:drug therapy*; D006349:Heart Valve Diseases / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents