HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort

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.
Liste complète des métadonnées

Littérature citée [39 références]  Voir  Masquer  Télécharger

https://hal.univ-lorraine.fr/hal-01483758
Contributeur : Simpa Ul <>
Soumis le : lundi 6 mars 2017 - 14:38:48
Dernière modification le : lundi 15 janvier 2018 - 12:20:02
Document(s) archivé(s) le : mercredi 7 juin 2017 - 13:56:34

Fichier

journal.pone.0063181.PDF
Fichiers éditeurs autorisés sur une archive ouverte

Identifiants

Collections

Citation

Stephen T. Chambers, David Murdoch, Arthur Morris, David Holland, Paul Pappas, et al.. HACEK Infective Endocarditis: Characteristics and Outcomes from a Large, Multi-National Cohort. PLoS ONE, Public Library of Science, 2013, 8 (5), pp.e63181. 〈http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0063181〉. 〈10.1371/journal.pone.0063181〉. 〈hal-01483758〉

Partager

Métriques

Consultations de la notice

23

Téléchargements de fichiers

59