Background

Rothia sp. are Gram-positive bacteria in the class of Actinobacteria that are part of the physiological oral flora. In rare cases, Rothia aeria and Rothia dentocariosa can cause infective endocarditis (IE). The biofilm potential of Rothia in endocarditis is unknown.

Methods

Specimen from two cases of Rothia endocarditis were obtained during cardiac surgery. One of the patients suffered mitral valve IE from Rothia aeria. In the other case, IE of a prosthetic pulmonary valve was caused by Rothia dentocariosa. Fluorescence in situ hybridization (FISH) was used for visualization of microorganisms within heart valve tissues in combination with PCR and sequencing (FISHseq).

Results

The two heart valve specimens featured mature biofilms of bacteria that were identified by FISHseq as Rothia aeria and Rothia dentocariosa, respectively. FISH showed in situ biofilms of both microorganisms that feature distinct phenotypes for the first time ex vivo. Both of our reported cases were treated successfully by heart valve surgery and antibiotic therapy using beta-lactam antibiotics.

Conclusion

The biofilm potential of Rothia sp. must be taken into account. The awareness of Rothia aeria and Rothia dentocariosa as rare but relevant pathogens for infective endocarditis must be raised. Use of biofilm-effective antibiotics in Rothia IE should be discussed.

中文翻译：

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Rothia aeria和Rothia dentocariosa作为感染性心内膜炎中生物膜的构建者

背景

Rothia sp。属于放线菌属的革兰氏阳性细菌，属于口腔内生理菌群。在极少数情况下，Rothia aeria和Rothia dentocariosa会引起感染性心内膜炎（IE）。Rothia在心内膜炎中的生物膜潜力尚不清楚。

方法

在心脏手术期间从两例Rothia心内膜炎中获取标本。其中一例患者患了Rothia aeria的二尖瓣IE 。在另一种情况下，假体肺动脉瓣的IE是由齿状Rothia dentocariosa引起的。荧光原位杂交（FISH）与PCR和测序（FISHseq）结合用于可视化心脏瓣膜组织内的微生物。

结果

这两个心脏瓣膜标本具有成熟的细菌生物膜，被FISHseq鉴定为分别为Rothia aeria和Rothia dentocariosa。FISH首次在体外显示了两种微生物的原位生物膜，它们具有不同的表型。我们的两个报告病例均通过心脏瓣膜手术和使用β-内酰胺类抗生素的抗生素疗法成功治疗。

结论

Rothia sp。的生物膜潜力。必须考虑在内。必须提高人们对Rothia aeria和Rothia dentocariosa作为传染性心内膜炎的罕见但相关病原体的认识。在Rothia IE中应使用生物膜有效的抗生素。