Relative Frequency of Streptococcaj Endocarditis to Staphylococcal Endocarditis

Abstract

INDTODUCTION: The most predominant organism in bacterial endocarditis is streptococcus, because there are more chances of their invasioninto the blood stream. The next frequent organism is staphylococcus, which causes acute infection but its chances of invasion into the blood stream are less. The present study was undertaken to study the ratio of streptococcal to staphylococcal endocarditis in our patients suspected of bacterial endocarditis. MATERIALS & METHODS: Three lOmi or less venous blood samples preferably before antibiotic therapy were collect ed from each patient at an interval of at least 2 hours over a period of 24---48 hours. Blood was inoculated into blood culture bottles containing base broth at patients bedside and incubated at 37° C. The culture medium were kept for 3 WeekS before discarding. RESULTS: Table : I shows the percentage and the ratio of bacterial species in the positive patients. No gram negative organism was isolated in this study. Of the 18 patients with positive results 13 patients were infected • by gamma hemolytic streptococcus viridians giving a percentage of 72.22% staphylococci were isolated in 4 patients 22.22% and streptococcus faecalis in one 5.55%. the ratio of streptococcal endocarditis to staphylococcal endocarditis was 3.5 : 1. DISCUSSION: The ratio of Streptococcal endocarditis to StaphylocOccai endocarditis was shown to be 3.5:1 in the present study. Pan key (2) reported a ratio of 2.6:1. The present study in comparison reports a higher ratio of streptococcal endocarditis. The ratio is high because the patients had rheumatic or congenital heart disease which predisposes them more to streptococcal infection. This is in agreement with the present study as well, where gamma hemolyt ic streptococcus viridans predominance was seen.