The Open Infectious Diseases Journal

2015, 9 : 35-38
Published online 2015 July 30. DOI: 10.2174/1874279301509010035
Publisher ID: TOIDJ-9-35

RESEARCH ARTICLE
 Correct Species Identification of Streptococcus Using Multi Locus Sequence Analysis for Disproving Relapse of Two Episodes of Infective Endocarditis

Stine Odgaard Poulsen1 , Louise Rasmussen2 , Xiaohui C. Nielsen2 , Ulrik S. Justesen3 , Jens J. Christensen2 and Sabine Gill1
1 Department of Cardiology, Odense University Hospital,
2 Departments of Clinical Microbiology, Slagelse Hospital
3 Odense University Hospital, Denmark

* Address correspondence to this author at the Department of Cardiology, Odense University Hospital, Sdr. Boulevard 29, 5000 Odense C, Denmark. Tel: +45 65412626; Fax: +45 63110497; E-mail: Sabine.Gill@rsyd.dk

ABSTRACT

When repetitive infective endocarditis episodes occur in the same patient, accurate species identification is essential for differentiating relapse and a new episode. We report a case, which has had four episodes of IE within 2 years: episode 1 due to Enterococcus faecalis, episode 2 due to Mitis group Streptococcus, Episodes 3 and 4 due to Salivarius group Streptococcus. Detailed molecular examinations using Multi Locus Sequence Analysis (MLSA) convincingly documented that the two strains from episodes 3 and 4 were different. Thus, it was not a relapse, but a new infection and, importantly, not the result of antibiotic treatment failure.

Keywords:

Infective endocarditis , intergenic spacer region (ITS) sequencing, multi locus sequence analysis (MLSA), nonhemolytic streptococci, partial oral endocarditis treatment (POET).