Management of Gram-negative and fungal endocarditis.
Infective endocarditis is infrequently caused by Gram-negative bacteria or fungi. Gram-negative organisms are responsible for <4% of cases, whilst fungal endocarditis accounts for <1.5% of culture-positive cases worldwide. Endocarditis due to Gram-negative organisms or fungi is a rare but severe disease. It often has a nosocomial origin, is caused by virulent and often resistant organisms and presents a high rate of complications and high mortality. In this article we present the most recent literature data and address the current management of Gram-negative and fungal infective endocarditis. We also discuss the major challenges of antimicrobial treatment and discuss some issues related to surgical decision-making in difficult-to-manage cases. We finally present our centre's experience with Gram-negative infective endocarditis, with a special focus on the demanding issues that the management of these complex and severely ill patients raise.
University of Naples SUN, Monaldi Hospital, Napoli, Italy.
Emanuele
E
Durante-Mangoni
Marie-Françoise
MF
Tripodi
Rosina
R
Albisinni
Riccardo
R
Utili
D000890:Anti-Infective Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D004696:Endocarditis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D015995:Prevalence
D000890:Anti-Infective Agents