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PLoS One. 2013 May 17;8(5):e63181. doi: 10.1371/journal.pone.0063181. Print 2013.

HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.

Collaborators (323)

Clara L, Sanchez M, Nacinovich F, Oses P, Ronderos R, Sucari A, Thierer J, Casabé J, Cortes C, Altclas J, Sanatorio, Kogan S, Spelman D, Athan E, Harris O, Kennedy K, Tan R, Gordon D, Papanicolas L, Eisen D, Grigg L, Street A, Korman T, Kotsanas D, Dever R, Jones P, Konecny P, Lawrence R, Rees D, Ryan S, Feneley MP, Harkness J, Jones P, Ryan S, Jones P, Ryan S, Jones P, Post J, Reinbott P, Ryan S, Gattringer R, Wiesbauer F, Andrade AR, de Brito AC, Guimarães AC, Grinberg M, Mansur AJ, Siciliano RF, Strabelli TM, Vieira ML, de Medeiros Tranchesi RA, Paiva MG, Fortes CQ, Ramos Ade O, Ferraiuoli G, Golebiovski W, Lamas C, Santos M, Weksler C, Karlowsky JA, Keynan Y, Morris AM, Rubinstein E, Jones SB, Garcia P, Cereceda M, Fica A, Mella RM, Barsic B, Bukovski S, Krajinovic V, Pangercic A, Rudez I, Vincelj J, Freiberger T, Pol J, Zaloudikova B, Ashour Z, El Kholy A, Mishaal M, Rizk H, Aissa N, Alauzet C, Alla F, Campagnac C, Doco-Lecompte T, Selton-Suty C, Casalta JP, Fournier PE, Habib G, Raoult D, Thuny F, Delahaye F, Delahaye A, Vandenesch F, Donal E, Donnio PY, Michelet C, Revest M, Tattevin P, Violette J, Chevalier F, Jeu A, Rusinaru D, Sorel C, Tribouilloy C, Bernard Y, Chirouze C, Hoen B, Leroy J, Plesiat P, Naber C, Neuerburg C, Mazaheri B, Naber C, Neuerburg C, Athanasia S, Giannitsioti E, Mylona E, Paniara O, Papanicolaou K, Pyros J, Skoutelis A, Sharma G, Francis J, Nair L, Thomas DM, Venugopal K, Hannan M, Hurley J, Gilon D, Israel S, Korem M, Strahilevitz J, Rubinstein E, Strahilevitz J, Tripodi MF, Casillo R, Cuccurullo S, Dialetto G, Durante-Mangoni E, Irene M, Ragone E, Utili R, Cecchi E, De Rosa F, Forno D, Imazio M, Trinchero R, Tebini A, Grossi P, Lattanzio M, Toniolo A, Goglio A, Raglio A, Ravasio V, Rizzi M, Suter F, Carosi G, Magri S, Signorini L, Baban T, Kanafani Z, Kanj SS, Sfeir J, Yasmine M, Abidin I, Tamin SS, Martínez ER, Nieto GI, Chávez I, van der Meer JT, Chambers S, Holland D, Morris A, Raymond N, Read K, Murdoch DR, Dragulescu S, Ionac A, Mornos C, Butkevich OM, Chipigina N, Kirill O, Vadim K, Vinogradova T, Edathodu J, Halim M, Lum LN, Tan RS, Lejko-Zupanc T, Logar M, Mueller-Premru M, Commerford P, Commerford A, Deetlefs E, Hansa C, Ntsekhe M, Almela M, Armero Y, Azqueta M, Castañeda X, Cervera C, del Rio A, Falces C, Garcia-de-la-Maria C, Fita G, Gatell JM, Marco F, Mestres CA, Miró JM, Moreno A, Ninot S, Paré C, Pericas J, Ramirez J, Rovira I, Sitges M, Anguera I, Font B, Guma JR, Bermejo J, Bouza E, Fernández MA, Gonzalez-Ramallo V, Marín M, Muñoz P, Pedromingo M, Roda J, Rodríguez-Créixems M, Solis J, Almirante B, Fernandez-Hidalgo N, Tornos P, de Alarcón A, Parra R, Alestig E, Johansson M, Olaison L, Snygg-Martin U, Pachirat O, Pachirat P, Pussadhamma B, Senthong V, Casey A, Elliott T, Lambert P, Watkin R, Eyton C, Klein JL, Bradley S, Kauffman C, Bedimo R, Chu VH, Corey G, Crowley AL, Douglas P, Drew L, Fowler VG, Holland T, Lalani T, Mudrick D, Samad Z, Sexton D, Stryjewski M, Wang A, Woods CW, Lerakis S, Cantey R, Steed L, Wray D, Dickerman SA, Bonilla H, DiPersio J, Salstrom SJ, Baddley J, Patel M, Peterson G, Stancoven A, Afonso L, Kulman T, Levine D, Rybak M, Cabell CH, Baloch K, Chu VH, Corey G, Dixon CC, Fowler VG Jr, Harding T, Jones-Richmond M, Pappas P, Park LP, Redick T, Stafford J, Anstrom K, Athan E, Bayer AS, Cabell CH, Chu VH, Corey G, Fowler VG Jr, Bruno H, Karchmer AW, Miró JM, Murdoch DR, Sexton DJ, Wang A, Bayer rS, Cabell CH, Chu V, Corey G, Durack DT, Phil D, Eykyn S, Fowler VG Jr, Bruno H, Miró JM, Moreillon P, Olaison L, Raoult D, Rubinstein E, Sexton DJ.

Author information

1
Department of Pathology, University of Otago, Christchurch and Christchurch Hospital, Christchurch, New Zealand. steve.chambers@cdhb.govt.nz

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.

PMID:
23690995
PMCID:
PMC3656887
DOI:
10.1371/journal.pone.0063181
[Indexed for MEDLINE]
Free PMC Article

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