HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.
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 endocardi...
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oai:doaj.org-article:1b602b0ad0f64ccbb1724256026ba2de2021-11-18T07:45:21ZHACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.1932-620310.1371/journal.pone.0063181https://doaj.org/article/1b602b0ad0f64ccbb1724256026ba2de2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23690995/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203The 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.Stephen T ChambersDavid MurdochArthur MorrisDavid HollandPaul PappasManel AlmelaNuria Fernández-HidalgoBenito AlmiranteEmilio BouzaDavide FornoAna del RioMargaret M HannanJohn HarknessZeina A KanafaniTahaniyat LalaniSelwyn LangNigel RaymondKerry ReadTatiana VinogradovaChristopher W WoodsDannah WrayG Ralph CoreyVivian H ChuInternational Collaboration on Endocarditis Prospective Cohort Study InvestigatorsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e63181 (2013) |
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Medicine R Science Q Stephen T Chambers David Murdoch Arthur Morris David Holland Paul Pappas Manel Almela Nuria Fernández-Hidalgo Benito Almirante Emilio Bouza Davide Forno Ana del Rio Margaret M Hannan John Harkness Zeina A Kanafani Tahaniyat Lalani Selwyn Lang Nigel Raymond Kerry Read Tatiana Vinogradova Christopher W Woods Dannah Wray G Ralph Corey Vivian H Chu International Collaboration on Endocarditis Prospective Cohort Study Investigators HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| description |
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. |
| format |
article |
| author |
Stephen T Chambers David Murdoch Arthur Morris David Holland Paul Pappas Manel Almela Nuria Fernández-Hidalgo Benito Almirante Emilio Bouza Davide Forno Ana del Rio Margaret M Hannan John Harkness Zeina A Kanafani Tahaniyat Lalani Selwyn Lang Nigel Raymond Kerry Read Tatiana Vinogradova Christopher W Woods Dannah Wray G Ralph Corey Vivian H Chu International Collaboration on Endocarditis Prospective Cohort Study Investigators |
| author_facet |
Stephen T Chambers David Murdoch Arthur Morris David Holland Paul Pappas Manel Almela Nuria Fernández-Hidalgo Benito Almirante Emilio Bouza Davide Forno Ana del Rio Margaret M Hannan John Harkness Zeina A Kanafani Tahaniyat Lalani Selwyn Lang Nigel Raymond Kerry Read Tatiana Vinogradova Christopher W Woods Dannah Wray G Ralph Corey Vivian H Chu International Collaboration on Endocarditis Prospective Cohort Study Investigators |
| author_sort |
Stephen T Chambers |
| title |
HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| title_short |
HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| title_full |
HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| title_fullStr |
HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| title_full_unstemmed |
HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| title_sort |
hacek infective endocarditis: characteristics and outcomes from a large, multi-national cohort. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/1b602b0ad0f64ccbb1724256026ba2de |
| work_keys_str_mv |
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