ArticlePloS one2017
New insights into valve-related intramural and intracellular bacterial diversity in infective endocarditis.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 26 citations in OpenAlex.
- Sonication of heart valves detects more bacteria in infective endocarditis.Scientific reports · 2018Trial
- 16S rRNA Metabarcoding Used to Identify the Etiology of Infective Endocarditis Agents.Sovremennye tekhnologii v meditsine · 2026Article
- Bacterial Diversity in Native Heart Valves in Infective Endocarditis.Biomedicines · 2025Article
- Endocarditis after Transcatheter Aortic Valve Replacement.Journal of clinical medicine · 2023Review
- Utility of Metagenomic Next-Generation Sequencing in Infective Endocarditis: A Systematic Review.Antibiotics (Basel, Switzerland) · 2022Review
- Non-Canonical Host Intracellular Niche Links to New Antimicrobial Resistance Mechanism.Pathogens (Basel, Switzerland) · 2022Review
- Native valve, prosthetic valve, and cardiac device-related infective endocarditis: A review and update on current innovative diagnostic and therapeutic strategies.Frontiers in cell and developmental biology · 2022Review
- Application of Metagenomic Next-Generation Sequencing in the Etiological Diagnosis of Infective Endocarditis During the Perioperative Period of Cardiac Surgery: A Prospective Cohort Study.Frontiers in cardiovascular medicine · 2022Article
- What Does 16S rRNA Gene-Targeted Next Generation Sequencing Contribute to the Study of Infective Endocarditis in Heart-Valve Tissue?Pathogens (Basel, Switzerland) · 2021Article
- Biomarkers in the Light of the Etiopathology of IC/BPS.Diagnostics (Basel, Switzerland) · 2021Review
- Evaluation of 16S rDNA Heart Tissue PCR as a Complement to Blood Cultures for the Routine Etiological Diagnosis of Infective Endocarditis.Diagnostics (Basel, Switzerland) · 2021Article
- Ultrastructure of a late-stage bacterial endocarditis valve vegetation.Journal of thrombosis and thrombolysis · 2021Article
- Sonobactericide: An Emerging Treatment Strategy for Bacterial Infections.Ultrasound in medicine & biology · 2020Review
- Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis.BMC microbiology · 2019Article
- Identification ofSpinal cord series and cases · 2018Article
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Authors and funding
23 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsIn infective endocarditis (IE), a severe inflammatory disease of the endocardium with an unchanged incidence and mortality rate over the past decades, only 1% of the cases have been described as polymicrobial infections based on microbiological approaches. The aim of this study was to identify potential biodiversity of bacterial species from infected native and prosthetic valves. Furthermore, we compared the ultrastructural micro-environments to detect the localization and distribution patterns of pathogens in IE. MATERIAL AND
methodsUsing next-generation sequencing (NGS) of 16S rDNA, which allows analysis of the entire bacterial community within a single sample, we investigated the biodiversity of infectious bacterial species from resected native and prosthetic valves in a clinical cohort of 8 IE patients. Furthermore, we investigated the ultrastructural infected valve micro-environment by focused ion beam scanning electron microscopy (FIB-SEM).
resultsBiodiversity was detected in 7 of 8 resected heart valves. This comprised 13 bacterial genera and 16 species. In addition to 11 pathogens already described as being IE related, 5 bacterial species were identified as having a novel association. In contrast, valve and blood culture-based diagnosis revealed only 4 species from 3 bacterial genera and did not show any relevant antibiotic resistance. The antibiotics chosen on this basis for treatment, however, did not cover the bacterial spectra identified by our amplicon sequencing analysis in 4 of 8 cases. In addition to intramural distribution patterns of infective bacteria, intracellular localization with evidence of bacterial immune escape mechanisms was identified.
conclusionThe high frequency of polymicrobial infections, pathogen diversity, and intracellular persistence of common IE-causing bacteria may provide clues to help explain the persistent and devastating mortality rate observed for IE. Improved bacterial diagnosis by 16S rDNA NGS that increases the ability to tailor antibiotic therapy may result in improved outcomes.
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