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Fulltext Complications of temporary transvenous pacing

Chin K, Singham KT, Anuar M

Med J Malaysia, 1985 Mar;40(1):28-30.
PMID: 3831729

The complications of temporary transvenous endocardial pacing as performed in the University Hospital Kuala Lumpur, from 1971 to 1979 were reviewed. 125 temporary pacings were performed in 111 patients. Different routes of temporary pacing
were used: namely percutaneous subclavian vein and femoral vein puncture and acutecubital vein cutdown. The latter route was associated with a higher incidence of dislodgement and infection. Other common complications encountered were ventricular arrhythymia and generator failure.

Matched MeSH terms: Endocarditis, Bacterial/etiology*
Fulltext Infective endocarditis amongst intravenous drug abusers seen at the University Hospital, Kuala Lumpur

Jayamalar R, Parasakthi N, Puthucheary SD

Med J Malaysia, 1987 Dec;42(4):264-8.
PMID: 3136302

Drug abuse is a major problem in Malaysia. Serious complications of intravenous drug addiction include septicaemia and infective endocarditis. We present nine cases of endocarditis occuring amongst drug abusers. The tricuspid valve was most frequently involved and the common aetiological organisms were S. aureus and Str. faecalis. There was a high mortality rate of 67% in our study, inspite of appropriate therapy. Early recognition of the disease and aggressive treatment is required to improve the associated mortality.

Matched MeSH terms: Endocarditis, Bacterial/etiology*
Fulltext Left ventricular outflow tract (LVOT) vegetations and spontaneous obliteration of a large ruptured intracranial mycotic aneurysm in a case of infective endocarditis

Quah BS, Selladurai BM, Jayakumar CR, Mahendra Raj S

Singapore Med J, 1993 Apr;34(2):172-4.
PMID: 8266164

A 10-year-old girl with mild aortic regurgitation presented with cerebral infarction. Two-dimensional echocardiography showed vegetations on the septal wall of the left ventricular outflow tract without involvement of the aortic valve itself. After successful antibiotic treatment the patient developed an intra-cranial haemorrhage due to rupture of a large intracranial mycotic aneurysm. Consent for surgical treatment of the mycotic aneurysm was not obtained. Twelve months later repeat angiography showed that the aneurysm had undergone spontaneous obliteration.

Matched MeSH terms: Endocarditis, Bacterial/complications*
A rare case of mycotic pseudoaneurysm in a patient post Rastelli procedure with infective endocarditis

Chua C, Then K, Mohd Khalid KF

Cardiol Young, 2023 May;33(5):827-828.
PMID: 36511131 DOI: 10.1017/S1047951122002931

Mycotic pseudoaneurysm secondary to infective endocarditis is an uncommon complication in CHD with conduit placement. We report a case of late presentation of bacterial infective endocarditis with pseudoaneurysm in an 8-year-old girl with underlying pulmonary atresia with ventricular septal defect, post Rastelli procedure done at the age of 3 years old.

Matched MeSH terms: Endocarditis, Bacterial*
Fulltext Echocardiographic Findings Predict In-Hospital and 1-Year Mortality in Left-Sided Native Valve Staphylococcus aureus Endocarditis: Analysis From the International Collaboration on Endocarditis-Prospective Echo Cohort Study

Lauridsen TK, Park L, Tong SY, Selton-Suty C, Peterson G, Cecchi E, et al.

Circ Cardiovasc Imaging, 2015 Jul;8(7):e003397.
PMID: 26162783 DOI: 10.1161/CIRCIMAGING.114.003397

Staphylococcus aureus left-sided native valve infective endocarditis (LNVIE) has higher complication and mortality rates compared with endocarditis from other pathogens. Whether echocardiographic variables can predict prognosis in S aureus LNVIE is unknown.

Matched MeSH terms: Endocarditis, Bacterial/microbiology; Endocarditis, Bacterial/mortality*; Endocarditis, Bacterial/physiopathology; Endocarditis, Bacterial/ultrasonography*
Fulltext A forgotten clinical sign making a comeback

Chiam KH, A Hing CT, Low LL

Med J Malaysia, 2014 Feb;69(1):40-1.
PMID: 24814630 MyJurnal

We report a case of Staphylococcus aureus infective endocarditis in a patient presenting with fever and rare cutaneous manifestations of Osler Nodes and Janeway Lesions. There had not been any distinct risk factors. His echocardiography subsequently revealed vegetation at the anterior mitral valve leaflet. As Staphylococcus aureus infective endocarditis is of utmost significance in morbidity and mortality, a sharp clinical acumen and follow up investigations is required alongside a prolonged course of antibiotics. Our patient was then started on intravenous cloxacillin for 28 days and gentamicin for 5 days to which he made good progress and recovery.

Matched MeSH terms: Endocarditis, Bacterial
Fulltext Knowledge of prescribing antimicrobial among dental practitioners in Klang Valley region

Huda Kh. AbdulKader, Salmiah Mohd Ali, Mohamed Ibrahim Abu Hassan, Mohamed Mansor Manan

Malaysian Dental Journal, 2010;31(1):35-43.
MyJurnal

There is a major concern about the increased use of antibiotics in dental practice and the emergence of resistant bacterial strains. In recent years, dentists have reported a shift from narrow-spectrum to broad-spectrum antibiotic prescriptions due to increasing antibiotic resistance. The aims of this study are to investigate the prescribing patterns of the therapeutic and prophylactic use for antibiotics in various dental situations by dental practitioners. The study also specifically investigates the prescribing habits of dental practitioners regarding certain cardiac conditions and related dental procedures in patients predisposed to infective endocarditis. This study utilized a questionnaire which was designed to investigate the antibiotic prescribing patterns by dental practitioners in the Klang Valley region. The returned questionnaires were analyzed using SPSS, to identify compliance to antibiotic guidelines by Malaysia National Clinical Guidelines (MNCG) (2003) and American Heart Association Guidelines (AHAG) (2008). 217 dentists responded to the questionnaire and the responses show that there is a wide variety of antibiotic prescriptions among dentists and there is also misuse of antibiotics in some clinical dental conditions. The results also show that there is a large variation in the antibiotic prescriptions patterns for prophylaxis against infective endocarditis. Furthermore, there is uncertainty as to which cardiac conditions required prophylaxis and for which particular dental procedures. This study concludes that there is a clear need for the development of prescribing guidelines, regular monitoring of antibiotic prescriptions by dental practitioners and educational initiatives to encourage the rational and appropriate use of the antibiotics.

Matched MeSH terms: Endocarditis, Bacterial
Fulltext Distinct Biological Potential of Streptococcus gordonii and Streptococcus sanguinis Revealed by Comparative Genome Analysis

Zheng W, Tan MF, Old LA, Paterson IC, Jakubovics NS, Choo SW

Sci Rep, 2017 06 07;7(1):2949.
PMID: 28592797 DOI: 10.1038/s41598-017-02399-4

Streptococcus gordonii and Streptococcus sanguinis are pioneer colonizers of dental plaque and important agents of bacterial infective endocarditis (IE). To gain a greater understanding of these two closely related species, we performed comparative analyses on 14 new S. gordonii and 5 S. sanguinis strains using various bioinformatics approaches. We revealed S. gordonii and S. sanguinis harbor open pan-genomes and share generally high sequence homology and number of core genes including virulence genes. However, we observed subtle differences in genomic islands and prophages between the species. Comparative pathogenomics analysis identified S. sanguinis strains have genes encoding IgA proteases, mitogenic factor deoxyribonucleases, nickel/cobalt uptake and cobalamin biosynthesis. On the contrary, genomic islands of S. gordonii strains contain additional copies of comCDE quorum-sensing system components involved in genetic competence. Two distinct polysaccharide locus architectures were identified, one of which was exclusively present in S. gordonii strains. The first evidence of genes encoding the CylA and CylB system by the α-haemolytic S. gordonii is presented. This study provides new insights into the genetic distinctions between S. gordonii and S. sanguinis, which yields understanding of tooth surfaces colonization and contributions to dental plaque formation, as well as their potential roles in the pathogenesis of IE.

Matched MeSH terms: Endocarditis, Bacterial
Fulltext Infective Endocarditis and Chronic Kidney Disease: How to Deal with Complications

Habib Khan Y, Sarriff A, Hayat Khan A, Azreen Syazril A, Mallhi TH

Malays J Med Sci, 2015 Jul-Aug;22(4):73-5.
PMID: 26715911 MyJurnal

Infective endocarditis (IE) is the one of the most important causes of increased mortality and morbidity among haemodialysis patients. The reason for this increasing prevalence of infection among these patients is the use of haemodialysis catheters during dialysis, as these patients are highly susceptible to infections that are easily transmitted via blood access points. The present case was a geriatric end stage renal disease (ESRD) patient who was readmitted to the hospital two days after her scheduled haemodialysis session with symptoms of nosocomial endocarditis. Her concurrent medical complications were hypertension, non-insulin dependent diabetes mellitus, and ischemic heart disease. Based on her previous medical history and current examination, the patient was suspected to have IE due to catheter related infection. The goal of therapy is to manage the comorbidities and infection by provision of appropriate treatment based on close monitoring of the patient condition.

Matched MeSH terms: Endocarditis, Bacterial
Patent ductus arteriosus in Malaysia

Singham KT, Wong HO

Aust N Z J Med, 1979 Apr;9(2):174-6.
PMID: 287460 DOI: 10.1111/j.1445-5994.1979.tb04323.x

Findings are reviewed of isolated Patent Ductus Arteriosus after infancy as seen in 181 patients studied at the University Hospital, Kuala Lumpur, during the period 1967 to 1975. The ages of patients ranged from nine months to 54 years. Eighty-two patients underwent cardiac catheterization. More than 50% of patients were above ten years of age; the sex ratio was 1 male: 2.93 females. Thirty-two per cent of the patients had significant effort dyspnoea or were in heart failure. The complications noted were elevated pulmonary vascular resistance, Eisenmenger syndrome, bacterial endocarditis and cardiac failure.

Matched MeSH terms: Endocarditis, Bacterial/etiology
Red man syndrome during administration of prophylactic antibiotic against infective endocarditis

Ngeow WC, Chai WL, Moody AB

J Ir Dent Assoc, 2000;46(3):92-4.
PMID: 11323942

Red man syndrome (RMS) is the occurrence flushing, pruritus, chest pain, muscle spasm or hypotension during vancomycin infusion. It usually happens as a result of rapid infusion of the drug but may also occur after slow administration. The frequency and severity of this phenomenon diminish with repeated administration of vancomycin. A case is presented whereby RMS occurred while prophylactic antibiotic against infective endocarditis was administered.

Matched MeSH terms: Endocarditis, Bacterial/prevention & control*
Fulltext Genome analysis of streptococcus gordonii sk12

Khairuldin AM, Ibrahim IK, Wakiyuddin SB, Z, Wenning, AO, Lesley, SJ, Nicholas, et al.

Ann Dent, 2014;21(2):17-26.
MyJurnal

The gram-positive, mesophilic and non-motile coccus Streptococcus gordonii is an important causative agent of infective endocarditis (IE). This pioneer species of dental plaque also causes bacteraemia in immune-supressed patients. In this study, we analysed the genome of a representative strain, Streptococcus gordonii SK12 that was originally isolated from the oral cavity. To gain a better understanding of the biology, virulence and phylogeny, of this potentially pathogenic organism, high-throughput Illumina HiSeq technology and different bioinformatics approaches were performed. Genome assembly of SK12 was performed using CLC Genomic Workbench 5.1.5 while RAST annotation revealed the key genomic features. The assembled draft genome of Streptococcus gordonii SK12 consists of 27 contigs, with a genome size of 2,145,851 bp and a G+C content of 40.63%. Phylogenetic inferences have confirmed that SK12 is closely related to the widely studied strain Streptococcus gordonii Challis. Interestingly, we predicted 118 potential virulence genes in SK12 genome which may contribute to bacterial pathogenicity in infective endocarditis. We also discovered an intact prophage which might be recently integrated into the SK12 genome. Examination of genes present in genomic islands revealed that this oral strain
might has potential to acquire new phenotypes/traits including strong defence system, bacitracin
resistance and collateral detergent sensitivity. This detailed analysis of S. gordonii SK12 further improves our understanding of the genetic make-up of S. gordonii as a whole and may help to elucidate how this species is able to transition between living as an oral commensal and potentially causing the lifethreatening condition infective endocarditis.

Matched MeSH terms: Endocarditis, Bacterial
Dental caries in Malaysian children with heart defects

Johnson RO, Grieve AW

Med J Malaysia, 1978 Sep;33(1):44-6.
PMID: 750895
Matched MeSH terms: Endocarditis, Bacterial
Fulltext Clinical Manifestations and Risk Factors of Streptococcus suis Mortality Among Northern Thai Population: Retrospective 13-Year Cohort Study

Rayanakorn A, Katip W, Goh BH, Oberdorfer P, Lee LH

Infect Drug Resist, 2019;12:3955-3965.
PMID: 32021313 DOI: 10.2147/IDR.S233326

Purpose: Streptococcus suis (S. suis) is an emerging zoonotic disease mainly in pigs, causing serious infections in humans with high prevalence in Southeast Asia. Despite a relatively high mortality rate, there are limited data regarding the risk factors of this life-threatening infection. Therefore, a 13-year retrospective cohort study in Chiang Mai, Thailand during 2005-2018 was conducted to explore risk factors associated with S. suis mortality and to update the outcomes of the disease.
Patients and methods: S. suis positive cases were derived from those with positive S. suis isolates from microbiological culture results and Matrix-Assisted Laser Desorption Ionization Time of Flight (MALDI-TOF). Potential risk factors of mortality were identified using univariate and multivariate logistic regression.
Results: Of 133 patients with culture-proven S. suis infection identified, there were 92 males and 41 females. The mean age was 56.47 years. Septicemia (55.64%) was the most common clinical manifestation followed by meningitis (37.59%) and infective endocarditis (25.56%). Alcohol drinking and raw pork consumption were documented in 66 (49.62%) and 49 (36.84%) cases respectively. The overall mortality rate was 12.03% (n=16). According to the multivariate analysis, the independent risk factors for mortality were prolonged bacteremia ≥ 6 days (OR = 43.57, 95% CI = 2.46-772.80, P =0.010), septic shock (OR = 13.34, 95% CI = 1.63-109.03, P =0.016), and direct bilirubin > 1.5 mg/dL (OR = 12.86, 95% CI = 1.91-86.59, P =0.009).
Conclusion: S. suis is not infrequent in Northern Thailand, where the cultural food habit of raw pork eating is still practiced. To the best of our knowledge, this is the largest series focusing on risk factors of S. suis mortality which has been conducted in Thailand. Prolonged bacteremia ≥ 6 days, septic shock, and direct bilirubin > 1.5 mg/dL were strong predictors associated with S. suis mortality. The mortality risk factors identified may be further utilized in clinical practice and future research to improve patient outcomes.

Matched MeSH terms: Endocarditis, Bacterial
Fulltext Evolving trends in infective endocarditis in a developing country: a consequence of medical progress?

Sunil M, Hieu HQ, Arjan Singh RS, Ponnampalavanar S, Siew KSW, Loch A

Ann Clin Microbiol Antimicrob, 2019 Dec 17;18(1):43.
PMID: 31847847 DOI: 10.1186/s12941-019-0341-x

BACKGROUND: Staphylococcus has replaced streptococcus as the most common cause of infective endocarditis (IE) in developed health care systems. The trend in developing countries is less clear.
AIM: To examine the epidemiological trends of infective endocarditis in a developing nation.
METHODS: Single-centre, retrospective study of patients admitted with IE to a tertiary hospital in Malaysia over a 12-year period.
RESULTS: The analysis included 182 patients (n = 153 Duke's definite IE, n = 29 possible IE). The mean age was 51 years. Rheumatic heart disease was present in 42%, while 7.6% were immunocompromised. IE affected native valves in 171 (94%) cases. Health-care associated IE (HCAIE) was recorded in 68 (37.4%). IE admission rates increased from 25/100,000 admissions (2012) to 59/100,000 admissions (2017). At least one major complication on admission was detected in 59 (32.4%) patients. Left-sided IE was more common than right-sided IE [n = 159 (87.4%) vs. n = 18 (9.9%)]. Pathogens identified by blood culture were staphylococcus group [n = 58 (40.8%)], streptococcus group [n = 51 (35.9%)] and Enterococcus species [n = 13 (9.2%)]. staphylococcus infection was highest in the HCAIE group. In-hospital death occurred in 65 (35.7%) patients. In-hospital surgery was performed for 36 (19.8%) patients. At least one complication was documented in 163 (85.7%).
CONCLUSION: Staphylococcus is the new etiologic champion, reflecting the transition of the healthcare system. Streptococcus is still an important culprit organism. The incidence rate of IE appears to be increasing. The rate of patients with underlying rheumatic heart disease is still high.

Matched MeSH terms: Endocarditis, Bacterial
Prophylactic antibiotics in children

Sinniah D

Med J Malaya, 1971 Dec;26(2):84-9.
PMID: 4260865
Matched MeSH terms: Endocarditis, Bacterial/prevention & control

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