HACEK infective endocarditis: epidemiology, clinical features outcome: A case-control study
| Autor: | Ambrosioni, Juan, Martínez García, Clara, Llopis, Jaume, García de la Mària, Cristina, Hernández-Meneses, Marta, Tellez, Adrian, Falces Salvador, Carles, Almela, Manel, Vidal, Bàrbara, Sandoval, Elena, Fuster, David, Quintana, Eduard, Tolosana, José M. (José María), Marco, Francesc, Moreno, Asunción, Miró, José M., The Hospital Clinic Infective Endocarditis Investigators |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) medicine.medical_specialty Epidemiology Aggregatibacter 030106 microbiology Haemophilus Cardiobacterium 030204 cardiovascular system & hematology lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Eikenella corrodens Interquartile range Internal medicine Humans Medicine Endocarditis lcsh:RC109-216 Epidemiologia Retrospective Studies Medicina clínica biology business.industry Case-control study Endocarditis Bacterial General Medicine Middle Aged biology.organism_classification medicine.disease Confidence interval Infectious Diseases Viridans streptococci Infective endocarditis Clinical medicine Female Kingella business |
| Zdroj: | Dipòsit Digital de la UB Universidad de Barcelona International Journal of Infectious Diseases, Vol 76, Iss, Pp 120-125 (2018) |
| Popis: | Objectives: The study aimed to describe the epidemiological, microbiological, and clinical features of a population sample of 17 patients with HACEK infective endocarditis (HACEK-IE) and to compare them with matched control patients with IE caused by viridans group streptococci (VGS-IE). Methods: Cases of definite (n = 14, 82.2%) and possible (n = 3, 17.6%) HACEK-IE included in the Infective Endocarditis Hospital Clinic of Barcelona (IE-HCB) database between 1979 and 2016 were identified and described. Furthermore, a retrospective case–control analysis was performed, matching each case to three control subjects with VGS-IE registered in the same database during the same time period. Results: Seventeen out of 1209 IE cases (1.3%, 95% confidence interval 0.69–1.91%) were due to HACEK group organisms. The most frequently isolated HACEK species were Aggregatibacter spp (n = 11, 64.7%). Intracardiac vegetations were present in 70.6% of cases. Left heart failure (LHF) was present in 29.4% of cases. Ten patients (58.8%) required in-hospital surgery and none died during hospitalization. In the case–control analysis, there was a trend towards larger vegetations in the HACEK-IE group (median (interquartile range) size 11.5 (10.0–20.0) mm vs. 9.0 (7.0–13.0) mm; p = 0.068). Clinical manifestations, echocardiographic findings, LHF rate, systemic emboli, and other complications were all comparable (p > 0.05). In-hospital surgery and mortality were similar in the two groups. One-year mortality was lower for HACEK-IE (1/17 vs. to 6/48; p = 0.006). Conclusions: HACEK-IE represented 1.3% of all IE cases. Clinical features and outcomes were comparable to those of the VGS-IE control group. Despite the trend towards a larger vegetation size, the embolic event rate was not higher and the 1-year mortality was significantly lower for HACEK-IE. Keywords: Endocarditis, HACEK, Viridans group streptococci, epidemiology, clinical characteristics, outcome, case-control |
| Databáze: | OpenAIRE |
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