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

Chambers, Stephen T., Murdoch, David, Morris, Arthur, Holland, David, Pappas, Paul, Almela, Manel, Fernández-Hidalgo, Nuria, Almirante, Benito, Bouza, Emilio, Forno, Davide, del Rio, Ana, Hannan, Margaret, Harkness, John, Kanafani, Zeina, Lalani, Tahaniya, Lang, Selwyn, Raymond, Nigel, Read, Kerry, Vinogradova, Tatiana, Woods, Christopher, Wray, Dannah, Corey, G. Ralph, Chu, Vivian, International Collaboration on Endocarditis Prospective Cohort Study Investigators, and Athan, Eugene 2013, HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort, PLoS one, vol. 8, no. 5, pp. 1-9, doi: 10.1371/journal.pone.0063181.

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Title HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort
Author(s) Chambers, Stephen T.
Murdoch, David
Morris, Arthur
Holland, David
Pappas, Paul
Almela, Manel
Fernández-Hidalgo, Nuria
Almirante, Benito
Bouza, Emilio
Forno, Davide
del Rio, Ana
Hannan, Margaret
Harkness, John
Kanafani, Zeina
Lalani, Tahaniya
Lang, Selwyn
Raymond, Nigel
Read, Kerry
Vinogradova, Tatiana
Woods, Christopher
Wray, Dannah
Corey, G. Ralph
Chu, Vivian
International Collaboration on Endocarditis Prospective Cohort Study Investigators,
Athan, EugeneORCID iD for Athan, Eugene orcid.org/0000-0001-9838-6471
Journal name PLoS one
Volume number 8
Issue number 5
Article ID e63181
Start page 1
End page 9
Total pages 9
Publisher PLoS
Place of publication San Francisco, Calif.
Publication date 2013
ISSN 1932-6203
Keyword(s) Age Factors
Aggregatibacter
Cardiobacterium
Cohort Studies
Eikenella corrodens
Endocarditis, Bacterial
Haemophilus
Humans
Kingella
Odds Ratio
Prevalence
Statistics, Nonparametric
Treatment Outcome
International Collaboration on Endocarditis Prospective Cohort Study Investigators
Summary 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.
Language eng
DOI 10.1371/journal.pone.0063181
Field of Research 111799 Public Health and Health Services not elsewhere classified
MD Multidisciplinary
Socio Economic Objective 920499 Public Health (excl. Specific Population Health) not elsewhere classified
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30086765

Document type: Journal Article
Collections: School of Medicine
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.