Infective Endocarditis Related to Unusual Microorganisms: A Prospective Population-Based Study
Author:
Limonta Silvia1, Cambau Emmanuelle2, Erpelding Marie-Line3, Piau-Couapel Caroline4, Goehringer François5, Plésiat Patrick6, Revest Matthieu1, Vernet-Garnier Véronique7, Moing Vincent Le8, Hoen Bruno5, Duval Xavier9, Tattevin Pierre1ORCID, 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, Chirouze C, Hoen B, Plesiat P, Abouliatim I, De Place C, Tattevin P, Revest M, Donnio P Y, Alla F, Carteaux J P, Doco-Lecompte T, Lion C, Aissa N, Selton-Suty C, Baehrel B, Jaussaud R, Nazeyrollas P, Strady C, Vernet V, Cambau E, Duval X, Iung B, Nataf P, Chidiac C, Celard M, Delahaye F, Obadia J F, Vandenesch F, Aumaître H, Frappier J M, Le Moing V, Oziol E, Sotto A, Sportouch C, Poyart C, Bouvet A, Vandenesch F, Celard M, Bes M, Abassade P, Abrial E, Acar C, Aissa N, Alexandra J F, Amireche N, Amrein D, Andre P, Appriou M, Arnould M A, Assayag P, Atoui A, Aziza F, Baille N, Bajolle N, Battistella P, Baumard S, Ben Ali A, Bertrand J, Bialek S, Bois Grosse M, Boixados M, Borlot F, Bouchachi A, Bouche O, Bouchemal S, Bourdon J L, Bouvet A, Brasme L, Bricaire F, Brochet E, Bruntz J F, Cady A, Cailhol J, Caplan M P, Carette B, Carteaux J P, Cartry O, Cazorla C, Celard M, Chamagne H, Champagne H, Chanques G, Chastre J, Chevalier B, Chirouze C, Chometon F, Christophe C, Cohen A, Colin de Verdiere N, Danchin N, Daneluzzi V, David L, De Lentdecker P, Delahaye F, Delcey V, Deleuze P, Donal E, Duval X, Deroure B, Descotes-Genon V, Didier Petit K, Dinh A, Doat V, Duchene F, Duhoux F, Dupont M, Ederhy S, Epaulard O, Evest M, Faucher J F, Fantin B, Fauveau E, Ferry T, Fillod M, Floch T, Fraisse T, Frapier J M, Freysz L, Fumery B, Gachot B, Gallien S, Gandjbach I, Garcon P, Gaubert A, Genoud J L, Ghiglione S, Godreuil C, Grentzinger A, Groben L, Gherissi D, Guéret P, Hagege A, Hammoudi N, Heliot F, Henry P, Herson S, Hoen B, Houriez P, Hustache-Mathieu L, Huttin O, Imbert S, Iung B, Jaureguiberry S, Kaaki M, Konate A, Kuhn J M, Kural Menasche S, Lafitte A, Lafon B, Lanternier F, Le Chenault V, Le Moing V, Lechiche C, Lefèvre-Thibaut S, Lefort A, Leguerrier A, Lemoine J, Lepage L, Leport C, Lepousé C, Leroy J, Lesprit P, Letranchant L, Loisance D, Loncar G, Lorentz C, Mabo P, Magnin-Poull I, May T, Makinson A, Man H, Mansouri M, Marcxon O, Maroni J P, Masse V, Maurier F, Meyohas M C, Michel P L, Michelet C, Mechaï F, Merceron O, Messika-Zeitoun D, Metref Z, Meyssonnier V, Mezher C, Micheli S, Monsigny M, Mouly S, Mourvillier B, Nallet O, Nataf P, Nazeyrollas P, Noel V, Obadia J F, Oziol E, Papo T, Payet B, Pelletier A, Perez P, Petit J S, Philippart F, Piet E, Plainvert C, Popovic B, Porte J M, Pradier P, Ramadan R, Revest M, Richemond J, Rodermann M, Roncato M, Roigt I, Ruyer O, Saada M, Schwartz J, Selton-Suty C, Simon M, Simorre B, Skalli S, Spatz F, Strady C, Sudrial J, Tartiere L, Terrier De La Chaise A, Thiercelin M C, Thomas D, Thomas M, Toko L, Tournoux F, Tristan A, Trouillet J L, Tual L, Vahanian A, Verdier F, Vernet Garnier V, Vidal V, Weyne P, Wolff M, Wynckel A, Zannad N, Zinzius P Y,
Affiliation:
1. Maladies Infectieuses et Reanimation Médicale, Inserm CIC 1414, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Université Rennes 1, Rennes, France 2. UF Urgences Microbiologiques et Mycobactériologie, Département des Agents Infectieux, DMU BioGem APHP-Nord, Hôpital Lariboisière, Université de Paris, Inserm UMR 1137 IAME, Paris, France 3. Inserm, Centre Hospitalier Régional Universitaire, Université de Lorraine, CIC-1433 Epidemiologie Clinique, Nancy, France 4. Microbiologie, Hôpital Pontchaillou, Centre Hospitalo-Universitaire, Rennes, France 5. Maladies Infectieuses et Tropicales, Centre Hospitalier Régional Universitaire, Université de Lorraine, Nancy, France 6. Bactériologie, Centre Hospitalier Régional Universitaire, Hôpital Jean Minjoz, Besançon, France 7. Microbiologie, Centre Hospitalier Universitaire, Reims, France 8. Maladies Infectieuses et Tropicales, Centre Hospitalo-Universitaire, Université de Montpellier, Montpellier, France 9. Inserm CIC 1425, AP-HP Nord, Hôpital Bichat, Inserm UMR-1137, IAME, Centre Hospitalo-Universitaire, Université de Paris, UFR de Médecine-Bichat, Paris, France
Abstract
Abstract
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
Funder
French Ministry of Health Société Française de Cardiologie European Society of Clinical Microbiology and Infectious Diseases Novartis
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
Reference22 articles.
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