Paul Loubet1, François-Xavier Lescure1,2,3, Laurent Lepage4, Matthias Kirsch4, Laurence Armand-Lefevre2,3,5, Lila Bouadma6, Sylvie Lariven1, Xavier Duval1, Yazdan Yazdanpanah1,2,3, Veronique Joly1,2,3. 1. a From the Service de Maladies Infectieuses et Tropicales, AP-HP, Hôpital Bichat-Claude Bernard , Paris , France. 2. b INSERM, IAME, UMR 1137 , Paris , France. 3. c Université Paris Diderot, IAME, UMR 1137 , Paris , France. 4. d Service de Chirurgie Cardiaque , Paris , France. 5. e Laboratoire de Bactériologie , Paris , France. 6. f Service de Réanimation Médicale, AP-HP, Hôpital Bichat-Claude Bernard , Paris , France.
Abstract
BACKGROUND: Infective endocarditis (IE) due to gram-negative bacilli (GNB) is rare. However, several studies described a change in the epidemiological profile of patients within the past few years. METHODS: We reviewed all cases diagnosed and followed in the infectious diseases ward of a French teaching hospital in Paris between 2009 and 2014, inclusive. RESULTS: Among the 17 patients with definite GNB-IE (11 male, mean age 54 years), 12 (70%) were due to non-HACEK GNB and 5 (30%) to HACEK group GNB. A prosthetic valve was involved in 10 cases (8 in non-HACEK and 2 in HACEK group). Escherichia coli (4/12 patients) and Pseudomonas aeruginosa (3/12 patients) were the most common pathogens in the first group; all the pathogens in the second group were Haemophilus spp. One-third of the patients with non-HACEK GNB had nosocomial IE, whereas injection drug use-related infections were rare (2/12). All patients with HACEK infection had at least one complication (intracardiac abscess, stroke or other systemic embolization). All patients were treated by antibiotic combination therapy during a median time of 42 days (interquartile range (IQR) = 42-42) and 10 (59%) underwent cardiac surgery. One death at 9 months was observed in the non-HACEK group. CONCLUSIONS: Regarding HACEK IE, this report supports the frequent association with vascular complications. Regarding non-HACEK GNB IE, this report supports the increasing proportion of nosocomial infections. We reported a high proportion of surgery in the therapeutic management of both HACEK and non-HACEK groups associated with no in-hospital mortality.
BACKGROUND: Infective endocarditis (IE) due to gram-negative bacilli (GNB) is rare. However, several studies described a change in the epidemiological profile of patients within the past few years. METHODS: We reviewed all cases diagnosed and followed in the infectious diseases ward of a French teaching hospital in Paris between 2009 and 2014, inclusive. RESULTS: Among the 17 patients with definite GNB-IE (11 male, mean age 54 years), 12 (70%) were due to non-HACEK GNB and 5 (30%) to HACEK group GNB. A prosthetic valve was involved in 10 cases (8 in non-HACEK and 2 in HACEK group). Escherichia coli (4/12 patients) and Pseudomonas aeruginosa (3/12 patients) were the most common pathogens in the first group; all the pathogens in the second group were Haemophilus spp. One-third of the patients with non-HACEK GNB had nosocomial IE, whereas injection drug use-related infections were rare (2/12). All patients with HACEK infection had at least one complication (intracardiac abscess, stroke or other systemic embolization). All patients were treated by antibiotic combination therapy during a median time of 42 days (interquartile range (IQR) = 42-42) and 10 (59%) underwent cardiac surgery. One death at 9 months was observed in the non-HACEK group. CONCLUSIONS: Regarding HACEK IE, this report supports the frequent association with vascular complications. Regarding non-HACEK GNB IE, this report supports the increasing proportion of nosocomial infections. We reported a high proportion of surgery in the therapeutic management of both HACEK and non-HACEK groups associated with no in-hospital mortality.
Authors: Carlos Bea; Sara Vela; Sergio García-Blas; Jose-Angel Perez-Rivera; Pablo Díez-Villanueva; Ana Isabel de Gracia; Eladio Fuertes; Maria Rosa Oltra; Ana Ferrer; Andreu Belmonte; Enrique Santas; Mauricio Pellicer; Javier Colomina; Alberto Doménech; Vicente Bodi; Maria José Forner; Francisco Javier Chorro; Clara Bonanad Journal: J Cardiovasc Dev Dis Date: 2022-06-17
Authors: Marco Falcone; Giusy Tiseo; Emanuele Durante-Mangoni; Veronica Ravasio; Francesco Barbaro; Maria Paola Ursi; Maria Bruna Pasticci; Matteo Bassetti; Paolo Grossi; Mario Venditti; Marco Rizzi Journal: Antimicrob Agents Chemother Date: 2018-03-27 Impact factor: 5.191
Authors: Jonathan D Edgeworth; Domenico Merante; Sanjay Patel; Christopher Young; Paul Jones; Seema Vithlani; Duncan Wyncoll; Peter Roberts; Andrew Jones; Tsutae Den Nagata; Mari Ariyasu; David M Livermore; Richard Beale Journal: Clin Infect Dis Date: 2019-05-17 Impact factor: 9.079