Endocarditis caused by penicillin-resistant viridans streptococci: 2 cases and controversies in therapy.

Although penicillin-resistant viridans streptococci have been isolated from samples from the mouth, blood, and wounds in increasing numbers, viridans streptococci isolated from patients with endocarditis have remained sensitive to penicillin for the past 5 decades. We report the cases of 2 patients with penicillin-resistant viridans streptococcal endocarditis, review 6 other cases from the literature, and summarize 2 studies that used an animal model of penicillin-resistant viridans streptococcal endocarditis.

[1]  Ellen Jo Baron,et al.  Manual of clinical microbiology , 1975 .

[2]  R. Levitz.  Prosthetic-valve endocarditis caused by penicillin-resistant Streptococcus mitis. , 1999, The New England journal of medicine.

[3]  W. Wilson,et al.  Treatment of streptococcal infective endocarditis. , 1985, The American journal of medicine.

[4]  F. Martín-Luengo,et al.  Treatment with various antibiotics of experimental endocarditis caused by penicillin-resistant Streptococcus sanguis. , 1995, European Heart Journal.

[5]  J. Parrillo,et al.  Endocarditis due to resistant viridans streptococci during oral penicillin chemoprophylaxis. , 1979, The New England journal of medicine.

[6]  V. Runarsdottir,et al.  Endocarditis due to Streptococcus mitis with high-level resistance to penicillin and cefotaxime. , 1999, The New England journal of medicine.

[7]  C. Sabella,et al.  Endocarditis due to Streptococcus mitis with high-level resistance to penicillin and ceftriaxone. , 2001, JAMA.

[8]  M. Sande,et al.  Penicillin therapy for treatment of experimental endocarditis caused by viridans streptococci in animals. , 1985, The Journal of infectious diseases.

[9]  D. Maki,et al.  Single-antibiotic therapy for streptococcal endocarditis. , 1979, JAMA.

[10]  D. Kaye.  Treatment of Infective Endocarditis , 1996, Annals of Internal Medicine.

[11]  Antibiotic treatment of adults with infective endocarditis due to streptococci, enterococci, staphylococci, and HACEK microorganisms. American Heart Association. , 1995, JAMA.