Bacteriological and Histological profile of heart Valves Resected From Infective Endocarditis Patients

Abstract

The present study was conducted for bacteriological and histopathological study of heartvalves resected from preoperatively treated and intraoperatively suspected infectiveendocarditis (IE) cases undergoing valve replacement surgery at Shahid Gangalal NationalHeart Centre from November 2007 to October 2008. During this study period, 31 heart valve samples resected from 27 patients were studied, 12of the patients being preoperatively treated with antibiotics for IE and rest 15 of them beingintraoperatively suspected for IE.The samples were cultured for the isolation of causativebacteria and examined histopathologically in Hematoxylin-Eosin and Tissue-Gram stainingto assess the evidence of infection and inflammation. Of 31 samples cultured, only three samples were culture positive, of which two were fromtreated IE cases from whichStaphylococcus aureusandEnterococcusfaecaliswere isolatedand one was from suspected case from whichS. aureuswas isolated. All three isolates weresensitive to Ciprofloxacinand Vancomycin and resistant to Penicillin and Amoxycillin.Of 21 samples examined histologically, only five (23.80%) samples showed bacteria inTissue-Gram staining while inHematoxylin-Eosin staining, six (28.57%) samples showedacute inflammation, four (19.04%) showed chronic inflammation and rest 11 (52.38%)showed no signs of inflammation. Among the samples from suspected cases, majority(80%) of them revealed no signs ofinflammation, 10% of samples revealed concealed IE byexhibiting acute inflammation and none of the samples showed bacteria. Among thesamples from treated cases, five (45.45%) samples exhibited bacteria with or without acuteinflammation, three (27.27%) showed chronic inflammation without bacteria and rest three(27.27%) showed no signs of inflammation. Both culture positive samples from the treatedcases revealed bacteria and acute inflammation at histological level. Keywords:Concealed IE,Histopathology,Infective endocarditis (IE),Inflammation