Article
Beta-hemolytic streptococcal infective endocarditis: Characteristics and outcomes from a large, multinational cohort
Registro en:
HIDALGO, Núria Fernández et al. Beta-Hemolytic Streptococcal Infective Endocarditis: Characteristics and Outcomes From a Large, Multinational Cohort. Open forum infectious diseases, v. 7, n. 5, p. 1-9, 2020
2328-8957
10.1093/ofid/ofaa120
Autor
Hidalgo, Núria Fernández
Gharamti, Amal A.
Aznar, María Luisa
Almirante, Benito
Yasmin, Mohamad
Fortes, Claudio Querido
Plesiat, Patrick
Doco-Lecompte, Thanh
Rizk, Hussein
Wray, Dannah
Lamas, Cristiane
Durante-Mangoni, Emanuele
Tattevin, Pierre
Snygg-Martin, Ulrika
Hannan, Margaret M.
Chu, Vivian H.
Kanafani, Zeina A.
Resumen
Cristiane Lamas. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento. 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.