In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective

Objectives: Staphylococcus aureus infective endocarditis is commonly associated with invasive pathology and is worse in prosthetic valve endocarditis. In this study, we aim to examine S. aureus virulence and pathological features of native and prosthetic valve infective endocarditis. Methods: Betwee...

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Main Authors: Haytham Elgharably, MD, Jan Claesen, PhD, Naseer Sangwan, PhD, Muhammad Etiwy, MD, Penny Houghtaling, MS, Gary W. Procop, MD, MS, Nabin K. Shrestha, MD, Brian Griffin, MD, Jose L. Navia, MD, Lars G. Svensson, MD, PhD, Daniel J. Wozniak, PhD, Gosta B. Pettersson, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:JTCVS Open
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666273624004388
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author Haytham Elgharably, MD
Jan Claesen, PhD
Naseer Sangwan, PhD
Muhammad Etiwy, MD
Penny Houghtaling, MS
Gary W. Procop, MD, MS
Nabin K. Shrestha, MD
Brian Griffin, MD
Jose L. Navia, MD
Lars G. Svensson, MD, PhD
Daniel J. Wozniak, PhD
Gosta B. Pettersson, MD, PhD
author_facet Haytham Elgharably, MD
Jan Claesen, PhD
Naseer Sangwan, PhD
Muhammad Etiwy, MD
Penny Houghtaling, MS
Gary W. Procop, MD, MS
Nabin K. Shrestha, MD
Brian Griffin, MD
Jose L. Navia, MD
Lars G. Svensson, MD, PhD
Daniel J. Wozniak, PhD
Gosta B. Pettersson, MD, PhD
author_sort Haytham Elgharably, MD
collection DOAJ
description Objectives: Staphylococcus aureus infective endocarditis is commonly associated with invasive pathology and is worse in prosthetic valve endocarditis. In this study, we aim to examine S. aureus virulence and pathological features of native and prosthetic valve infective endocarditis. Methods: Between 2002 and 2020, 438 patients underwent surgery for left-sided endocarditis caused by S. aureus at our center (59% native and 41% prosthetic valve endocarditis). Endocarditis registry was queried, and pathological features were based on the echocardiography and operative findings. In addition, vegetation samples were collected from 6 patients undergoing surgery for infective endocarditis (3 native and 3 prosthetic valve endocarditis). Total RNA was extracted from all specimens, and messenger RNA sequencing was executed for transcriptomic analysis. Data were pooled into STAR aligner, and gene expression related to virulence factors was compared between 2 groups. Results: Rates of invasive pathology were higher in prosthetic versus native valve infective endocarditis (76% vs 40%, P < .0001), which impacted the complexity of surgical procedures and perioperative course, but not in-hospital mortality. Transcriptomic analysis has shown differences in gene expression between vegetation specimens of native and prosthetic valve endocarditis, including genes for stress response, biofilm formation, and virulence factors. The gene aur (encodes for aureolysin) was highly upregulated in prosthetic valve vegetations compared with native valve vegetations (P = .023). Conclusions: Prosthetic valve endocarditis caused by S. aureus is associated with further invasive pathology compared with native valve endocarditis, which could be related to upregulation of genes responsible for biofilm formation and metalloproteinase production.
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spelling doaj-art-e04106e901a94607a41870c68d45b7fb2025-08-20T03:15:03ZengElsevierJTCVS Open2666-27362025-04-012415616910.1016/j.xjon.2024.12.004In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspectiveHaytham Elgharably, MD0Jan Claesen, PhD1Naseer Sangwan, PhD2Muhammad Etiwy, MD3Penny Houghtaling, MS4Gary W. Procop, MD, MS5Nabin K. Shrestha, MD6Brian Griffin, MD7Jose L. Navia, MD8Lars G. Svensson, MD, PhD9Daniel J. Wozniak, PhD10Gosta B. Pettersson, MD, PhD11Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio; Address for reprints: Haytham Elgharably, MD, Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, 9500 Euclid Ave/Desk J4-1, Cleveland, OH 44195.Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OhioDepartment of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioDepartment of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioDepartment Laboratory Medicine, Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OhioDepartment of Infectious Disease, Cleveland Clinic, Cleveland, OhioDepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OhioDepartment of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioDepartment of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioDepartments of Microbial Infection and Immunity and Microbiology, Ohio State University, Columbus, OhioDepartment of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OhioObjectives: Staphylococcus aureus infective endocarditis is commonly associated with invasive pathology and is worse in prosthetic valve endocarditis. In this study, we aim to examine S. aureus virulence and pathological features of native and prosthetic valve infective endocarditis. Methods: Between 2002 and 2020, 438 patients underwent surgery for left-sided endocarditis caused by S. aureus at our center (59% native and 41% prosthetic valve endocarditis). Endocarditis registry was queried, and pathological features were based on the echocardiography and operative findings. In addition, vegetation samples were collected from 6 patients undergoing surgery for infective endocarditis (3 native and 3 prosthetic valve endocarditis). Total RNA was extracted from all specimens, and messenger RNA sequencing was executed for transcriptomic analysis. Data were pooled into STAR aligner, and gene expression related to virulence factors was compared between 2 groups. Results: Rates of invasive pathology were higher in prosthetic versus native valve infective endocarditis (76% vs 40%, P < .0001), which impacted the complexity of surgical procedures and perioperative course, but not in-hospital mortality. Transcriptomic analysis has shown differences in gene expression between vegetation specimens of native and prosthetic valve endocarditis, including genes for stress response, biofilm formation, and virulence factors. The gene aur (encodes for aureolysin) was highly upregulated in prosthetic valve vegetations compared with native valve vegetations (P = .023). Conclusions: Prosthetic valve endocarditis caused by S. aureus is associated with further invasive pathology compared with native valve endocarditis, which could be related to upregulation of genes responsible for biofilm formation and metalloproteinase production.http://www.sciencedirect.com/science/article/pii/S2666273624004388biofilminfective endocarditisinvasionStaphylococcusvirulence
spellingShingle Haytham Elgharably, MD
Jan Claesen, PhD
Naseer Sangwan, PhD
Muhammad Etiwy, MD
Penny Houghtaling, MS
Gary W. Procop, MD, MS
Nabin K. Shrestha, MD
Brian Griffin, MD
Jose L. Navia, MD
Lars G. Svensson, MD, PhD
Daniel J. Wozniak, PhD
Gosta B. Pettersson, MD, PhD
In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective
JTCVS Open
biofilm
infective endocarditis
invasion
Staphylococcus
virulence
title In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective
title_full In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective
title_fullStr In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective
title_full_unstemmed In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective
title_short In vivo virulence of Staphylococcus aureus in native versus prosthetic left-sided valve endocarditisCentral MessagePerspective
title_sort in vivo virulence of staphylococcus aureus in native versus prosthetic left sided valve endocarditiscentral messageperspective
topic biofilm
infective endocarditis
invasion
Staphylococcus
virulence
url http://www.sciencedirect.com/science/article/pii/S2666273624004388
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