Rothia spp.: An unusual cause of infective endocarditis

Abstract

Introduction

Rothia spp. are commensal organisms involved in serious infections such as infective endocarditis (IE). There is a significant lack of information regarding de clinical course and management of Rothia spp. IE in immunocompetent patients.

Methods

This study describes 11 cases of Rothia spp. bacteremia over a 10-year period in a secondary hospital, analyzing clinical, demographic, and microbiological data. True infection was defined based on clinical signs, microbiological criteria, and radiological evidence.

Results

Three cases (27.3%) were confirmed as true infections, all presenting as infective endocarditis. All three infections were caused by Rothia mucilaginosa in non-immunocompromised patients. Identified risk factors included type 2 diabetes, pre-existing valvular disease, prosthetic implants, and odontogenic foci. 100% of cases developed severe central nervous system complications. Total bacterial eradication without recurrence was achieved, and no acute valve surgery was required.

Conclusions

Rothia spp. can cause true bacteremia and IE in non-immunocompromised patients. Time to positivity (TTP) and clinical correlation are fundamental to distinguish between true infection and contamination. Individualized shorter antibiotic regimens might be explored in selected cases, although conventional durations remain the standard due to the severity of complications.