Mervat G Elanany
Cairo University, Egypt
Title: Zoonotic endocarditis.Ten years experience: 2005-2015
Biography
Biography: Mervat G Elanany
Abstract
Infective endocarditis (IE) is a life-threatening disease. Zoonotic bacteria can cause blood culture–negative endocarditis (BCNE). Zoonotic IE is prevalent in North Africa. The study aimed to diagnose IE caused by the zoonotic pathogens Brucella spp., Bartonella spp. and Coxiella burnetii in BCNE by PCR and serology. The study prospectively followed up all patients with suspected IE referred to the Endocarditis Service, Cardiology Department, Cairo University from February 2005 to February 2015. Three sets of blood culture were withdrawn on admission. Resected surgical material was cultured whenever available. Serologic testing was performed for detection of Brucella antibodies using standard agglutination test, IgG titers for Bartonella and IgG, IgM, and IgA antibody titers for Coxiella burnetii using IFA on the sera of all referred patients. A patient was considered to have endocarditis caused by Brucella when antibody titers exceeded 1/320, Bartonella when IgG titers >1:800, and Coxiella when IgG phase I titer >1:800. Broad range bacterial 16S rRNA from blood culture bottles and surgical materials followed by sequencing for identification of positive cases was done. IE was classified as definite or possible in 400 patients; 50% of them had BCNE. Zoonotic endocarditis was diagnosed in 28(7%) patients including 16 cases of Brucella spp. 8 cases of Bartonella spp. and 4 cases of Coxiella burnetii. Zoonotic agents were a cause of 11% of BCNE. Zoonotic agents are important cause of IE in Egypt.