M Kestler1, P Muñoz2, M Marín3, M A Goenaga4, P Idígoras Viedma4, A de Alarcón5, J A Lepe5, D Sousa Regueiro6, J M Bravo-Ferrer6, M Pajarón7, C Costas8, M V García-López9, C Hidalgo-Tenorio10, M Moreno11, E Bouza12. 1. Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERES, Spain. Electronic address: kestler.martha@gmail.com. 2. Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERES, Spain; CIBER de Enfermedades Respiratorias -CIBERES(CB06/06/0058), Madrid, Spain. Electronic address: pmunoz@micro.hggm.es. 3. Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERES, Spain. 4. Hospital Universitario de Donosti, Spain. 5. Hospital Universitario Virgen del Rocío, Spain. 6. Hospital Universitario A Coruña, Spain. 7. Hospital Universitario Marqués de Valdecilla, Spain. 8. Hospital Universitario Central de Asturias, Spain. 9. Hospital Universitario Virgen de la Victoria, Spain. 10. Hospital Universitario Virgen de las Nieves, Spain. 11. Hospital Universitario La Paz, Spain. 12. Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERES, Spain; CIBER de Enfermedades Respiratorias -CIBERES(CB06/06/0058), Madrid, Spain.
Abstract
BACKGROUND: Infective endocarditis (IE) caused by anaerobic bacteria is a rare and poorly characterized disease. Most data reported in the literature are from case reports [1-3]. Therefore, we assessed the situation of anaerobic IE (AIE) in Spain using the database of the Spanish Collaboration on Endocarditis (GAMES). METHODS: We performed a prospective study from 2008 to 2016 in 26 Spanish centers. We included 2491 consecutive cases of definite IE (Duke criteria). RESULTS: Anaerobic bacteria caused 22 cases (0.9%) of definite IE. Median age was 66 years (IQR, 56-73), and 19 (86.4%) patients were men. Most patients (14 [63.6%]) had prosthetic valve IE and all episodes were left-sided: aortic valves, 12 (54.5%); and mitral valves, 8 (36.4%). The most common pathogens were Propionibacterium acnes (14 [63.6%]), Lactobacillus spp (3 [13.63%]), and Clostridium spp. (2 [9.0%]), and the infection was mainly odontogenic. Fifteen of the 22 patients (68.2%) underwent cardiac surgery. Mortality was 18.2% during admission and 5.5% after 1 year of follow-up. When patients with AIE were compared with the rest of the cohort, we found that although those with AIE had a similar age and Charlson comorbidity index, they were more likely to have community-acquired IE (86.4% vs. 60.9%, p = 0.01), have undergone cardiac surgery (68.2% vs 48.7% p = 0.06), and have had lower mortality rates during admission (18.2% vs. 27.3%). CONCLUSION: IE due to anaerobic bacteria is an uncommon disease that affects mainly prosthetic valves and frequently requires surgery. Otherwise, there are no major differences between AIE and IE caused by other microorganisms.
BACKGROUND: Infective endocarditis (IE) caused by anaerobic bacteria is a rare and poorly characterized disease. Most data reported in the literature are from case reports [1-3]. Therefore, we assessed the situation of anaerobic IE (AIE) in Spain using the database of the Spanish Collaboration on Endocarditis (GAMES). METHODS: We performed a prospective study from 2008 to 2016 in 26 Spanish centers. We included 2491 consecutive cases of definite IE (Duke criteria). RESULTS: Anaerobic bacteria caused 22 cases (0.9%) of definite IE. Median age was 66 years (IQR, 56-73), and 19 (86.4%) patients were men. Most patients (14 [63.6%]) had prosthetic valve IE and all episodes were left-sided: aortic valves, 12 (54.5%); and mitral valves, 8 (36.4%). The most common pathogens were Propionibacterium acnes (14 [63.6%]), Lactobacillus spp (3 [13.63%]), and Clostridium spp. (2 [9.0%]), and the infection was mainly odontogenic. Fifteen of the 22 patients (68.2%) underwent cardiac surgery. Mortality was 18.2% during admission and 5.5% after 1 year of follow-up. When patients with AIE were compared with the rest of the cohort, we found that although those with AIE had a similar age and Charlson comorbidity index, they were more likely to have community-acquired IE (86.4% vs. 60.9%, p = 0.01), have undergone cardiac surgery (68.2% vs 48.7% p = 0.06), and have had lower mortality rates during admission (18.2% vs. 27.3%). CONCLUSION: IE due to anaerobic bacteria is an uncommon disease that affects mainly prosthetic valves and frequently requires surgery. Otherwise, there are no major differences between AIE and IE caused by other microorganisms.
Authors: Silvia Limonta; Emmanuelle Cambau; Marie-Line Erpelding; Caroline Piau-Couapel; François Goehringer; Patrick Plésiat; Matthieu Revest; Véronique Vernet-Garnier; Vincent Le Moing; Bruno Hoen; Xavier Duval; Pierre Tattevin Journal: Open Forum Infect Dis Date: 2020-04-13 Impact factor: 3.835
Authors: Christian Johann Lerche; Franziska Schwartz; Mia Marie Pries-Heje; Emil Loldrup Fosbøl; Kasper Iversen; Peter Østrup Jensen; Niels Høiby; Ole Hyldegaard; Henning Bundgaard; Claus Moser Journal: Front Cell Infect Microbiol Date: 2022-02-03 Impact factor: 5.293