Non-HACEK gram-negative bacillus endocarditis

Susan Morpeth, David Murdoch, Christopher H. Cabell, Adolf W. Karchmer, Paul Pappas, Donald Levine, Francisco Nacinovich, Pierre Tattevin, Núria Fernández-Hidalgo, Stuart Dickerman, Emilio Bouza, Ana Del Río, Tatjana Lejko-Zupanc, Auristela De Oliveira Ramos, Diana Iarussi, John Klein, Catherine Chirouze, Roger Bedimo, G. Ralph Corey, Vance G. FowlerDavid Gordon, Uma Devi, Denis Spelman, Jan T.M. Van Der Meer, Carol Kauffman, Suzanne Bradley, William Armstrong, Efthymia Giannitsioti, Helen Giamarellou, Stamatios Lerakis, Asuncion Moreno, Carlos A. Mestres, Carlos Paré, Cristina Garcia De La Maria, Elisa De Lazzario, Francesc Marco, Jose M. Gatell, José M. Miró, Manel Almela, Manuel Azqueta, Maria Jesús Jiménez-Expósito, Natividad De Benito, Noel Perez, Benito Almirante, Pablo Rodriguez De Vera, Pilar Tornos, Vicente Falcó, Xavier Claramonte, Yolanda Armero, Nisreen Sidani, Souha Kanj-Sharara, Zeina Kanafani, Annibale Raglio, Antonio Goglio, Fabrizio Gnecchi, Fredy Suter, Grazia Valsecchi, Marco Rizzi, Veronica Ravasio, Bruno Hoen, Joel Leroy, Patrick Plesiat, Yvette Bernard, Anna Casey, Peter Lambert, Richard Watkin, Tom Elliott, Mukesh Patel, William Dismukes, Angelo Pan, Giampiero Caros, Amel Brahim Mathiron Christophe Tribouilloy, Thomas Goissen, Armelle Delahaye, Francois Delahaye, Francois Vandenesch, Carla Vizzotti, Francisco M. Nacinovich, Marcelo Marin, Marcelo Trivi, Martin Lombardero, Claudia Cortes, José Horacio Casabé, Javier Altclas, Silvia Kogan, Liliana Clara, Marisa Sanchez, Anita Commerford, Cass Hansa, Eduan Deetlefs, Mpiko Ntsekhe, Patrick Commerford, Dannah Wray, Lisa L. Steed, Preston Church, Robert Cantey, Arthur Morris, Stephen Chambers, Kerry Read, Nigel Raymond, David Holland, Selwyn Lang, Despina Kotsanas, Tony M. Korman, Gail Peterson, Jon Purcell, Paul M. Southern, Manisha Shah, Arjun Reddy, Gaurav Dhar, Alanna Hanlon-Feeney, Margaret Hannan, Sinead Kelly, Andrew Wang, Christopher W. Woods, Daniel J. Sexton, Danny Benjamin, Jay R. McDonald, Jeff Federspiel, John J. Engemann, L. Barth Reller, Laura Drew, L. B. Caram, Martin Stryjewski, Tahaniyat Lalani, Vivian Chu, Bahram Mazaheri, Carl Neuerburg, Christoph Naber, Eugene Athan, Margaret Henry, Owen Harris, Eric Alestig, Lars Olaison, Lotta Wikstrom, Ulrika Snygg-Martin, Johnson Francis, K. Venugopal, Lathi Nair, Vinod Thomas, Jaruwan Chaiworramukkun, Orathai Pachirat, Ploenchan Chetchotisakd, Tewan Suwanich, Adeeba Kamarulzaman, Syahidah Syed Tamin, Manica Mueller Premru, Mateja Logar, Christina Orezzi, Mar Moreno, Marta Rodríguez-Créixems, Mercedes Marín, Miguel Fernández, Patricia Muñoz, Rocío Fernández, Victor Ramallo, Didier Raoult, Franck Thuny, Gilbert Habib, Jean Paul Casalta, Pierre Edouard Fournier, Natalia Chipigina, Ozerecky Kirill, Tatiana Vinogradova, Vadim P. Kulichenko, O. M. Butkevich, Christine Lion, Christine Selton-Suty, Francois Alla, Hélène Coyard, Thanh Doco-Lecompte, Emanuele Durante-Mangoni, Enrico Ragone, Giovanni Dialetto, Marie Françoise Tripodi, Riccardo Utili, Roberta Casillo, A. Sampath Kumar, Gautam Sharma, Alan Street, Damon Peter Eisen, Emma Sue McBryde, Leeanne Grigg, Elias Abrutyn, Christian Michelet, Pierre Yves Donnio, Claudio Querido Fortes, Jameela Edathodu, Mashael Al-Hegelan, Bernat Font, Ignasi Anguera, Joan Raimon Guma, M. Cereceda, Miguel J. Oyonarte, Rodrigo Montagna Mella, Patricia Garcia, Sandra Braun Jones, Marcelo Goulart Paiva, Regina Aparecida De Medeiros Tranchesi, Lok Ley Woon, Luh Nah Lum, Ru San Tan, David Rees, Pam Kornecny, Richard Lawrence, Robyn Dever, Jeffrey Post, Phillip Jones, Suzanne Ryan, John Harkness, Michael Feneley, Ethan Rubinstein, Jacob Strahilewitz, Adina Ionac, Cristian Mornos, Stefan Dragulescu, Davide Forno, Enrico Cecchi, Francesco De Rosa, Massimo Imazio, Rita Trinchero, Franz Wiesbauer, Rainer Gattringer, Greg Deans, Arjana Tambic Andrasevic, Bruno Barsic, Igor Klinar, Josip Vincelj, Suzana Bukovski, Vladimir Krajinovic, Judy Stafford, Khaula Baloch, Thomas Redick, Tina Harding, Arnold S. Bayer, David T. Durack, Phillipe Moreillon, Susannah Eykyn

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. Objective: To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. Design: Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. Setting: 61 hospitals in 28 countries. Patients: Hospitalized patients with definite endocarditis. Measurements: Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. Results: Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). Limitations: Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. Conclusion: In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

Original languageEnglish
Pages (from-to)829-835
Number of pages7
JournalAnnals of Internal Medicine
Volume147
Issue number12
DOIs
Publication statusPublished - 18 Dec 2007

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