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Non-HACEK gram-negative bacillus endocarditis.

Publication ,  Journal Article
Morpeth, S; Murdoch, D; Cabell, CH; Karchmer, AW; Pappas, P; Levine, D; Nacinovich, F; Tattevin, P; Fernández-Hidalgo, N; Dickerman, S ...
Published in: Ann Intern Med
December 18, 2007

BACKGROUND: Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. OBJECTIVE: To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. DESIGN: Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. SETTING: 61 hospitals in 28 countries. PATIENTS: Hospitalized patients with definite endocarditis. MEASUREMENTS: Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. RESULTS: Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). LIMITATIONS: Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. CONCLUSION: In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

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Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

December 18, 2007

Volume

147

Issue

12

Start / End Page

829 / 835

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Substance Abuse, Intravenous
  • Prostheses and Implants
  • Prospective Studies
  • Humans
  • Gram-Negative Bacterial Infections
  • Gram-Negative Bacteria
  • General & Internal Medicine
  • Endocarditis, Bacterial
  • Cross Infection
 

Citation

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Morpeth, S., Murdoch, D., Cabell, C. H., Karchmer, A. W., Pappas, P., Levine, D., … International Collaboration on Endocarditis Prospective Cohort Study (ICE-PCS) Investigators, . (2007). Non-HACEK gram-negative bacillus endocarditis. Ann Intern Med, 147(12), 829–835. https://doi.org/10.7326/0003-4819-147-12-200712180-00002
Morpeth, Susan, David Murdoch, Christopher H. Cabell, Adolf W. Karchmer, Paul Pappas, Donald Levine, Francisco Nacinovich, et al. “Non-HACEK gram-negative bacillus endocarditis.Ann Intern Med 147, no. 12 (December 18, 2007): 829–35. https://doi.org/10.7326/0003-4819-147-12-200712180-00002.
Morpeth S, Murdoch D, Cabell CH, Karchmer AW, Pappas P, Levine D, et al. Non-HACEK gram-negative bacillus endocarditis. Ann Intern Med. 2007 Dec 18;147(12):829–35.
Morpeth, Susan, et al. “Non-HACEK gram-negative bacillus endocarditis.Ann Intern Med, vol. 147, no. 12, Dec. 2007, pp. 829–35. Pubmed, doi:10.7326/0003-4819-147-12-200712180-00002.
Morpeth S, Murdoch D, Cabell CH, Karchmer AW, Pappas P, Levine D, Nacinovich F, Tattevin P, Fernández-Hidalgo N, Dickerman S, Bouza E, del Río A, Lejko-Zupanc T, de Oliveira Ramos A, Iarussi D, Klein J, Chirouze C, Bedimo R, Corey GR, Fowler VG, International Collaboration on Endocarditis Prospective Cohort Study (ICE-PCS) Investigators. Non-HACEK gram-negative bacillus endocarditis. Ann Intern Med. 2007 Dec 18;147(12):829–835.

Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

December 18, 2007

Volume

147

Issue

12

Start / End Page

829 / 835

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Substance Abuse, Intravenous
  • Prostheses and Implants
  • Prospective Studies
  • Humans
  • Gram-Negative Bacterial Infections
  • Gram-Negative Bacteria
  • General & Internal Medicine
  • Endocarditis, Bacterial
  • Cross Infection