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Antimicrobial management of Tropheryma whipplei endocarditis: the Spanish Collaboration on Endocarditis (GAMES) experience

2019; Oxford University Press; Volume: 74; Issue: 6 Linguagem: Inglês

10.1093/jac/dkz059

1460-2091

Lara García-Álvarez, M Mercedes Sanz, Mercedes Marín, M. Carmen Fariñas, Miguel Montejo, Josune Goikoetxea, Raquel Rodríguez-García, Arístides de Alarcón, Manuel Almela, Núria Fernández-Hidalgo, M. M. Alonso Socas, Miguel Ángel Goenaga, Enrique Navas, Luís Vicioso, José A. Oteo, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre, José I. Aramendi, Elena Bereciartúa, María Victoria Boado, Marta Campaña Lázaro, Josune Goikoetxea, J.J. Goiti, José L. Hernández, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Pedro María Pérez, Regino Rodríguez, Roberto Voces, Radka Ivanova Georgieva, Manuel Márquez, Isabel Rodríguez Bailón, Josefa Ruíz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, José María Bravo-Ferrer, Laura Castelo, José J. Cuenca‐Castillo, Pedro Llinares, Enrique Míguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco António, M.M. Alonso, Beatriz Castro, Dácil García Marrero, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan La Calzada, Ibrahim Nassar, Antonio Plata, José Ma Reguera Iglesias, Víctor Asensi, Carlos Costas, Jesús de la Hera, Jonathan Fernández-Suarez, Lisardo Iglesias Fraile, Víctor León, José López Menéndez, Pilar Mencía Bajo, Carlos Montilla, Alfonso Moreno Torrico, Carmen Palomo, B. Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez-García, Mauricio Telenti Asensio, Manuel Almela, Juan Ambrosioni, Yolanda Armero, Manuel Azqueta, Merçè Brunet, Ramón Cartañá, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, José M. Gatell, Jaume Llopis Pérez, Christian Manzardo, Francesc Marco, José M. Miró, Asunción Moreno, Salvador Pié i Ninot, Eduard Quintana, Carlos Paré, Daniel Pereda, Juan M. Pericàs, José Luís Pomar, José Ramírez, Irene Rovira, Marta Sitges, Dolors Soy, Adrián Téllez, Bàrbara Vidal, Jordi Vilà, Javier Bermejo, Emilio Bouza, Gregorio Cuerpo, Viviana de Egea, Alia Eworo, Ana Fernández‐Cruz, Ma Eugenia García Leoni, Marcela González del Vecchio, Víctor José González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez‐Sellés, Ma Cruz Menárguez, Patricia Muñóz, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez‐Créixems, Blanca Pinilla, Ángel González Pinto, Maricela Valerio, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Carlos Armiñanzas Castillo, Ana María Arnáiz-García, José R. Berrazueta, Sara Bellisco, Manuel Cobo Belaustegui, Raquel Rodríguez-García, MaCarmen Fariñas, Concepción Fariñas-Álvarez, Carlos Fernández Mazarrasa, Rubén Gómez Izquierdo, Claudia González-Rico, José Gutiérrez Díez, Rafael Martín Durán, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavía, Jesús Santos González, Beatriz Orden, António Ramos, Elena Rodríguez‐González, Tomasa Centella, José Manuel Hermida, José Luis Betrán Moya, Pilar Martín‐Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruíz, Carmen Hidalgo Tenorio, Antonio de Castro, Marina de Cueto, Pastora Gallego, Juan Gálvez-Acebal, Jesús Rodríguez‐Baño, Arístides de Alarcón, Emilio Gutiérrez, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, Pedro Azcárate, José Manuel Azcona, José Ramón Blanco, Lara García-Álvarez, José A. Oteo, Mercedes Sanz, Natividad Benito, Mercè Gurguí, Cristina Pacho, R. Pericás, Guillem Pons, Mar Álvarez, Ángel L. Fernández, Amparo Martínez, A. Prieto, Benito Regueiro, E Tijeira, E Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz de Zárate, José Antonio Urturi Matos, Ma Belén Nacle, Antonio Sánchez-Porto, Luis Vallejo, José María Arribas, Elisa García Vázquez, Alicia Hernández Torres, Ana Lozano-Blázquez, Gonzalo de la Morena, Ángel Barajas, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, Jose Roca, Eduardo Moreno Escobar, Alejandro Peña Monje, Valme Sánchez Cabrera, David Vinuesa García, Carmen Luna, Juana Núñez Morcillo, Ma Cruz Pérez Seco,

Antimicrobial Resistance in Staphylococcus

Tropheryma whipplei has been detected in 3.5% of the blood culture-negative cases of endocarditis in Spain. Experience in the management of T. whipplei endocarditis is limited. Here we report the long-term outcome of the treatment of previously reported patients who were diagnosed with infective endocarditis (IE) caused by T. whipplei from the Spanish Collaboration on Endocarditis-Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) and discuss potential options for antimicrobial therapy for IE caused by T. whipplei. Seventeen patients with T. whipplei endocarditis were recruited between 2008 and 2014 in 25 Spanish hospitals. Patients were classified according to the therapeutic regimen: ceftriaxone and trimethoprim/sulfamethoxazole, doxycycline + hydroxychloroquine and other treatment options. Follow-up data were obtained from 14 patients. The median follow-up was 46.5 months. All patients completed the antibiotic treatment prescribed, with a median duration of 13 months. Six patients were treated with ceftriaxone and trimethoprim/sulfamethoxazole (median duration 13 months), four with doxycycline + hydroxychloroquine (median duration 13.8 months) and four with other treatment options (median duration 22.3 months). The follow-up after the end of the treatments was between 5 and 84 months (median 24 months). All treatment lines were effective and well tolerated. Therapeutic failures were not detected during the treatment. None of the patients died or experienced a relapse during the follow-up. Only six patients received antibiotic treatment in accordance with guidelines. These data suggest that shorter antimicrobial treatments could be effective.