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Title: HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort
Author: Chambers, Stephen T.
Murdoch, David
Morris, Arthur
Holland, David
Pappas, Paul
Almela, M. (Manel)
Fernández Hidalgo, Nuria
Almirante, Benito
Bouza, Emilio
Forno, Davide
Rio, Ana del
Hannan, Margaret M.
Harkness, Jonh
Kanafani, Zeinha A.
Lalani, Tahaniyat
Lang, Selwyn
Raymond, Nigel
Read, Kerry
Vinogradova, Tatiana
Woods, Christopher W
Wray, Dannah
Corey, G. Ralph
Chu, Vivian H.
Sitges Carreño, Marta
Miró Meda, José M.
Moreno Camacho, Ma. Asunción
Anguera Camós, Ignasi
International Collaboration on Endocarditis Prospective Cohort Study (ICE-PCS) Investigators
Keywords: Endocarditis
Control d'infeccions
Infection control
Issue Date: 17-May-2013
Publisher: Public Library of Science (PLoS)
Abstract: The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p<0.01) and younger age (OR 0.62; CI 0.49-0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.
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It is part of: PLoS One, 2013, vol. 8, num. 5, p. e63181
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ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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