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A Brief Synopsis of HACEK organisms Michael Addidle.

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Presentation on theme: "A Brief Synopsis of HACEK organisms Michael Addidle."— Presentation transcript:

1 A Brief Synopsis of HACEK organisms Michael Addidle

2 HACEK ORGANISMS H-H. parainfluenzae H-H. parainfluenzae A-Aggregatibacter actinomycetecomitans A-Aggregatibacter actinomycetecomitans - Aggregatibacter aphrophilus and paraphrophilus. - Aggregatibacter aphrophilus and paraphrophilus. C-Cardiobacterium hominus C-Cardiobacterium hominus E-Eikenella corrodens E-Eikenella corrodens K-Kingella species K-Kingella species

3 What do HACEK organisms have in common? Gram negative Gram negative Commensals in oropharyngeal area Commensals in oropharyngeal area Relatively fastidious Relatively fastidious Prefer CO2 enriched atmosphere Prefer CO2 enriched atmosphere All have a propensity to cause endocarditis, usually secondary to rotten teeth or recent dental treatment or combination of both. All have a propensity to cause endocarditis, usually secondary to rotten teeth or recent dental treatment or combination of both. Endocarditis- long interval between first symptoms and dx.Endocarditis- long interval between first symptoms and dx. Frequent embolisationFrequent embolisation May be large vegetations on left sided valves.May be large vegetations on left sided valves. Can all cause non-endocardial infections also. Can all cause non-endocardial infections also.

4 Haemophilus parainfluenzae H. aphrophilus and H. paraphrophilus have moved H. aphrophilus and H. paraphrophilus have moved Cause endocarditis more commonly than H. influenzae but all endocarditis caused by Haemophilus is rare. Cause endocarditis more commonly than H. influenzae but all endocarditis caused by Haemophilus is rare.

5 A-Aggregatibacter actinomycetecomitans Common cause of periodontitis Common cause of periodontitis Most endocarditis caused by this bacteria have underlying heart disease. Most endocarditis caused by this bacteria have underlying heart disease. Star-shaped colonies Star-shaped colonies

6 Cardiobacterium hominis In contrast to other members of the group, almost exclusively associated with endocarditis In contrast to other members of the group, almost exclusively associated with endocarditis May also be commensal of GI tract May also be commensal of GI tract Characteristic Gram stain: bulbous ends and irregular staining. May have a rosette pattern. Characteristic Gram stain: bulbous ends and irregular staining. May have a rosette pattern..

7 Eikenella corrodens Oral commensal. May implicated in bite infections. Oral commensal. May implicated in bite infections. May cause infections at several different sites within the body. May cause infections at several different sites within the body. Slightly yellow colonies after a few days Slightly yellow colonies after a few days Bleach like odour Bleach like odour Pit into agar. Pit into agar. Beta-lactamase strains are not infrequent. Beta-lactamase strains are not infrequent.

8 Eikenella corrodens

9 Kingella species K. kingae, K dentrificans, K.oralis, K. potus K. kingae, K dentrificans, K.oralis, K. potus Square ends, uneven decolorisation on Gram stain. Square ends, uneven decolorisation on Gram stain. May be mildly haemolytic on blood agar May be mildly haemolytic on blood agar Colonise pharynx of many children 6 months to 4 years. Colonise pharynx of many children 6 months to 4 years. Common cause of septic arthritis in this age group. Common cause of septic arthritis in this age group. Infections in adults usually in immunocompromised. Infections in adults usually in immunocompromised. Injection of aspirate into BC media improves detection rates. Injection of aspirate into BC media improves detection rates.

10 Kingella species

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12 Molecular detection In modern blood culture systems, HACEK organsims grow within 5 days. In modern blood culture systems, HACEK organsims grow within 5 days. 16s PCR 16s PCR Most useful for heart valves Most useful for heart valves May also be useful for negative blood cultures where high index of suspicion. May also be useful for negative blood cultures where high index of suspicion.


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