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Infective Endocarditis Related to Unusual Microorganisms: A Prospective Population-Based Study

Title: Infective Endocarditis Related to Unusual Microorganisms: A Prospective Population-Based Study
Authors: Limonta, Silvia; Cambau, Emmanuelle; Erpelding, Marie-Line; Piau-Couapel, Caroline; Goehringer, François; Plésiat, Patrick; Revest, Matthieu; Vernet-Garnier, Véronique; Moing, Vincent Le; Hoen, Bruno; Duval, Xavier; Tattevin, Pierre; Hoen, B; Duval, X; Alla, F; Bouvet, A; Briançon, S; Cambau, E; Celard, M; Chirouze, C; Danchin, N; Doco-Lecompte, T; Delahaye, F; Etienne, J; Iung, B; Le Moing, V; Obadia, J F; Leport, C; Poyart, C; Revest, M; Selton-Suty, C; Strady, C; Tattevin, P; Vandenesch, F; Bernard, Y; Chocron, S; Plesiat, P; Abouliatim, I; De Place, C; Donnio, P Y; Carteaux, J P; Lion, C; Aissa, N
Contributors: French Ministry of Health; Société Française de Cardiologie; European Society of Clinical Microbiology and Infectious Diseases; Novartis
Source: Open Forum Infectious Diseases ; volume 7, issue 5 ; ISSN 2328-8957
Publisher Information: Oxford University Press (OUP)
Publication Year: 2020
Description: Background Increased access to heart valves through early surgery and progress in molecular microbiology have reduced the proportion of infective endocarditis (IE) with no microbiological documentation and increased the proportion of IE associated with unusual microorganisms. Methods We performed an ancillary study of a large prospective population-based survey on IE. Unusual-microorganism IE was defined as definite IE (Duke-Li criteria) due to microorganisms other than streptococci, staphylococci, or enterococci. Results Of 471 cases of documented IE, 46 (9.8%) were due to unusal microorganisms; the following were involved in >1 case: Candida albicans (n = 4), Cutibacterium acnes (n = 4), Pseudomonas aeruginosa (n = 3), Cardiobacterium hominis (n = 3), and Coxiella burnetii (n = 2). Cases were documented with blood cultures (n = 37, 80.4%), heart valve polymerase chain reaction (PCR; n = 5), heart valve culture (n = 2), PCR on vertebral biopsy (n = 1), or serology (n = 1). As compared with IE due to staphylococci, streptococci, or enterococci (n = 420), IE due to unusual microorganisms occurred more frequently in patients with previously known heart disease (69.0% vs 44.3%; P = .002), prosthetic valve (40.5% vs 18.1%; P = .0006), longer duration of fever (mean, 35.1 ± 46.8 days vs 12.5 ± 17.8; P = .003), and who were more often nosocomial (38.1% vs 20.2%; P = .02). Conclusions In this population-based study, 9.8% of IE cases were due to unusual microorganisms, with a predominance of anaerobes, yeast, and gram-negative bacilli. As compared with IE related to staphylococci, streptococci, or enterococci, IE cases related to unusual microorganisms were associated with previously known heart disease, prosthetic valve, longer duration of fever, and nosocomial acquisition. Trial registration ORCID 0000-0003-3617-5411
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ofid/ofaa127
DOI: 10.1093/ofid/ofaa127/33041356/ofaa127.pdf
Availability: https://doi.org/10.1093/ofid/ofaa127; http://academic.oup.com/ofid/advance-article-pdf/doi/10.1093/ofid/ofaa127/33041356/ofaa127.pdf; http://academic.oup.com/ofid/article-pdf/7/5/ofaa127/33206670/ofaa127.pdf
Rights: http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.2C845D4B
Database: BASE