Beta-Hemolytic Streptococcal Infective Endocarditis: Characteristics and Outcomes From a Large, Multinational Cohort.

Journal Article (Journal Article)

BACKGROUND: Beta-hemolytic streptococci (BHS) are an uncommon cause of infective endocarditis (IE). The aim of this study was to describe the clinical features and outcomes of patients with BHS IE in a large multinational cohort and compare them with patients with viridans streptococcal IE. METHODS: The International Collaboration on Endocarditis Prospective Cohort Study (ICE-PCS) is a large multinational database that recruited patients with IE prospectively using a standardized data set. Sixty-four sites in 28 countries reported patients prospectively using a standard case report form developed by ICE collaborators. RESULTS: Among 1336 definite cases of streptococcal IE, 823 were caused by VGS and 147 by BHS. Patients with BHS IE had a lower prevalence of native valve (P < .005) and congenital heart disease predisposition (P = .002), but higher prevalence of implantable cardiac device predisposition (P < .005). Clinically, they were more likely to present acutely (P < .005) and with fever (P = .024). BHS IE was more likely to be complicated by stroke and other systemic emboli (P < .005). The overall in-hospital mortality of BHS IE was significantly higher than that of VGS IE (P = .001). In univariate analysis, variables associated with in-hospital mortality for BHS IE were age (odds ratio [OR], 1.044; P = .004), prosthetic valve IE (OR, 3.029; P = .022), congestive heart failure (OR, 2.513; P = .034), and stroke (OR, 3.198; P = .009). CONCLUSIONS: BHS IE is characterized by an acute presentation and higher rate of stroke, systemic emboli, and in-hospital mortality than VGS IE. Implantable cardiac devices as a predisposing factor were more often found in BHS IE compared with VGS IE.

Full Text

Duke Authors

Cited Authors

  • Fernández Hidalgo, N; Gharamti, AA; Aznar, ML; Almirante, B; Yasmin, M; Fortes, CQ; Plesiat, P; Doco-Lecompte, T; Rizk, H; Wray, D; Lamas, C; Durante-Mangoni, E; Tattevin, P; Snygg-Martin, U; Hannan, MM; Chu, VH; Kanafani, ZA

Published Date

  • May 2020

Published In

Volume / Issue

  • 7 / 5

Start / End Page

  • ofaa120 -

PubMed ID

  • 32462042

Pubmed Central ID

  • PMC7240340

International Standard Serial Number (ISSN)

  • 2328-8957

Digital Object Identifier (DOI)

  • 10.1093/ofid/ofaa120


  • eng

Conference Location

  • United States