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Serratia marcescens Infectious Endocarditis: Injection Drug Use, Left-Sided Heart Disease, and Poor Outcomes

Schechter, Marcos C., MD*; Spicer, Jennifer O., MD, MPH*; del Mar Aldrete, Sol, MD*; Kraft, Colleen S., MD, MsC*†

Infectious Diseases in Clinical Practice: July 2018 - Volume 26 - Issue 4 - p 216–219
doi: 10.1097/IPC.0000000000000614
Original Articles

Background Serratia marcescens infectious endocarditis (SMIE) is an uncommon disease, and the largest case series were reported from California in the 1970s. We aimed to identify risk factors and outcomes of SMIE in our institution.

Methods Retrospective cohort study of all cases of Serratia marcescens bacteremia (SMB) diagnosed between January 2003 and December 2013.

Results A total of 298 cases of SMB were reviewed, and 5 cases of SMIE were found. Clinical characteristics between SMB and SMIE cases were similar, except for more frequent history of injection drug use among cases of SMIE. Serratia marcescens infectious endocarditis cases had large vegetations, frequent embolic events, and poor outcomes.

Conclusions We confirm the stereotypical description of SMIE as a cause left-sided heart disease in injection drug users with frequent embolic events. Poor outcomes prevailed despite advances in medical care.

Serratia marcescens is a rare of cause of endocarditis. The authors reviewed all cases of S. marcescens bacteremia (SMB) at their institution between 2003–2013 and aimed to identify risk factors and outcomes of endocarditis. SMB cases with and without endocarditis were similar, except for more frequent history of injection drug use among those with endocarditis. Endocarditis cases had large vegetations, frequent embolic events, and poor outcomes.

From the *Division of Infectious Diseases, Department of Medicine, and

Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA.

Correspondence to: Marcos C. Schechter, MD, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, 49 Jesse Hill Jr Dr, Atlanta, GA 30303. E-mail: mcoutin@emory.edu.

This work was supported by the Research and Woodruff Health Sciences IT Division grant (UL1 TR000424).

The authors have no conflicts of interest to disclose.

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