Gram Stain, Culture, and Histopathological Examination Findings for Heart Valves Removed because of Infective Endocarditis

Retrospective chart review was undertaken for 480 patients who underwent a total of 506 valve replacements or repair procedures for infective endocarditis. The influence of preoperative antimicrobial treatment on culture, Gram stain, and histopathological examination findings for resected valve spec...

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Bibliographic Details
Published in:Clinical infectious diseases 2003-03, Vol.36 (6), p.697-704
Main Authors: Morris, Arthur J., Drinkovic, Dragana, Pottumarthy, Sudha, Strickett, Marianne G., MacCulloch, Donald, Lambie, Neil, Kerr, Alan R.
Format: Article
Language:English
Subjects:
Antimicrobials
Bacterial diseases
Bacterial endocarditis, myocarditis and pericarditis. Bacterial diseases of the aorta, limb vessels and lymphatic vessels
Biological and medical sciences
Blood
Endocarditis
Endocarditis, Bacterial - etiology
Endocarditis, Bacterial - microbiology
Endocarditis, Bacterial - pathology
Female
Gentian Violet
Gram positive cocci
Heart Valve Prosthesis - microbiology
Heart valves
Heart Valves - surgery
Homologous transplantation
Human bacterial diseases
Humans
Infectious diseases
Inflammation
Major Articles
Male
Medical sciences
Microbiology
Pathology
Phenazines
Prosthesis-Related Infections - microbiology
Vegetation
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Summary:Retrospective chart review was undertaken for 480 patients who underwent a total of 506 valve replacements or repair procedures for infective endocarditis. The influence of preoperative antimicrobial treatment on culture, Gram stain, and histopathological examination findings for resected valve specimens was examined. When valves were removed before the end of treatment, organisms were seen on the Gram stain of ground valve material performed in the microbiology laboratory and on Gram-stained histopathological sections in 231 (81%) of 285 and 140 (67%) of 208 specimens, respectively (P =.0007). Gram-positive cocci were either cultured from or observed in excised valve tissue in 42 (67%) of 63 episodes involving negative preoperative blood cultures. Positive Gram stain results for microbiological specimens should be reintroduced into the definite pathological criteria for infective endocarditis. When deciding on how long to continue antimicrobial therapy after valve replacement for endocarditis, valve culture results should be the only laboratory finding taken into account, because it takes months for dead bacteria to be removed from sterile vegetations.
ISSN:1058-4838
1537-6591
DOI:10.1086/367842