Clinical Features and Outcomes of Streptococcus anginosus Group Infective Endocarditis: A Multicenter Matched Cohort Study
Author:
Escrihuela-Vidal Francesc1, López-Cortés Luis Eduardo2, Escolà-Vergé Laura34, De Alarcón González Arístides5, Cuervo Guillermo1ORCID, Sánchez-Porto Antonio6, Fernández-Hidalgo Nuria34, Luque Rafael5, Montejo Miguel7, Miró José M8, Goenaga Miguel Ángel9, Muñoz Patricia10, Valerio Maricela10, Ripa Marco11, Sousa-Regueiro Dolores12, Gurguí Mercé13, Fariñas-Alvarez María Carmen14, Mateu Lourdes15, García Vázquez Elisa16, Gálvez-Acebal Juan2, Carratalà Jordi1, Fernández Sánchez Fernando, Noureddine Mariam, Rosas Gabriel, de la Torre Lima Javier, Bereciartua Elena, Blanco Roberto, Victoria Boado María, Campaña Lázaro Marta, Crespo Alejandro, Guio Carrión Laura, Del Álamo Martínez de Lagos Mikel, Euba Ugarte Gorane, Goikoetxea Josune, Ibarrola Hierro Marta, Ramón Iruretagoyena José, Irurzun Zuazabal Josu, López-Soria Leire, Montejo Miguel, Nieto Javier, Rodrigo David, Rodríguez Regino, Vitoria Yolanda, Voces Roberto, García López Mª Victoria, Ivanova Georgieva Radka, Ojeda Guillermo, Rodríguez Bailón Isabel, Ruiz Morales Josefa, Azkune Galparsoro Harkaitz, Berritu Boronat Elisa, Bustinduy Odriozola Mª Jesús, del Bosque Martín Cristina, Echeverría Tomás, Eizaguirre Yarza Alberto, Fuentes Ana, Ángel Goenaga Miguel, del Río Muskilda Goyeneche, Granda Bauza Ángela, Antonio Iribarren José, Kortajarena Urkola Xabier, Ignacio Pérez-Moreiras López José, Rengel Jiménez Ainhoa, Reviejo Karlos, Sáez Berbejillo Alberto, Sánchez Haza Elou, Sebastián Alda Rosa, Solla Ruiz Itziar, Unamuno Ugartemendia Irati, Vicente Anza Diego, Villanueva Benito Iñaki, Zabalo Arrieta Mar, Carrasco Rafael, Climent Vicente, Llamas Patricio, Merino Esperanza, Plazas Joaquín, Reus Sergio, Álvarez Nemesio, Bravo-Ferrer José María, Castelo Laura, Cuenca José, Llinares Pedro, Miguez Rey Enrique, Rodríguez Mayo María, Sánchez Efrén, Sousa Regueiro Dolores, Javier Martínez Francisco, del Mar Alonso Mª, Castro Beatriz, Delgado Melian Teresa, Fernández Sarabia Javier, García Rosado Dácil, González González Julia, Lacalzada Juan, de la Peña Lissete Lorenzo, Pérez Ramírez Alina, Prada Arrondo Pablo, Rodríguez Moreno Fermín, Plata Ciezar Antonio, Reguera Iglesias José Mª, Asensi Álvarez Víctor, Costas Carlos, de la Hera Jesús, Fernández Suárez Jonnathan, Iglesias Fraile Lisardo, León Arguero Víctor, López Menéndez José, Mencia Bajo Pilar, Morales Carlos, Moreno Torrico Alfonso, Palomo Carmen, Paya Martínez Begoña, Rodríguez Esteban Ángeles, Rodríguez García Raquel, Telenti Asensio Mauricio, Almela Manuel, Ambrosioni Juan, Azqueta Manuel, Brunet Mercè, Bodro Marta, Cartañá Ramón, Falces Carlos, Fita Guillermina, Fuster David, de la Mària Cristina García, García-Pares Delia, Hernández-Meneses Marta, Llopis Pérez Jaume, Marco Francesc, Miró José M, Moreno Asunción, Nicolás David, Ninot Salvador, Quintana Eduardo, Paré Carlos, Pereda Daniel, Pericás Juan M, Pomar José L, Ramírez José, Rovira Irene, Sandoval Elena, Sitges Marta, Soy Dolors, Téllez Adrián, Tolosana José M, Vidal Bárbara, Vila Jordi, Adán Iván, Carlos Alonso Juan, Álvarez-Uría Ana, Bermejo Javier, Bouza Emilio, Cuerpo Caballero Gregorio, Delgado Montero Antonia, González Mansilla Ana, García Leoni Mª Eugenia, Gargallo Esther, González Ramallo Víctor, Kestler Hernández Martha, Mari Hualde Amaia, Machado Marina, Marín Mercedes, Martínez-Sellés Manuel, Muñoz Patricia, Olmedo María, Pedraz Álvaro, Pinilla Blanca, Pinto Ángel, Rincón Cristina, Rodríguez-Abella Hugo, Valerio Maricela, Vázquez Pilar, Verde Moreno Eduardo, Antorrena Isabel, Loeches Belén, Moreno Mar, Ramírez Ulises, Rial Bastón Verónica, Romero María, Rosillo Sandra, Agüero Balbín Jesús, Amado Cristina, Armiñanzas Castillo Carlos, Arnaiz Ana, de las Revillas Francisco Arnaiz, Cobo Belaustegui Manuel, Carmen Fariñas María, Fariñas-Álvarez Concepción, Fernández Sampedro Marta, García Iván, González Rico Claudia, Gutierrez-Fernandez Laura, Gutiérrez-Cuadra Manuel, Gutiérrez Díez José, Pajarón Marcos, Antonio Parra José, Teira Ramón, Zarauza Jesús, Calderón Parra Jorge, Cobo Marta, Domínguez Fernando, Fortaleza Alberto, García Pavía Pablo, González Jesús, Fernández Cruz Ana, Múñez Elena, Ramos Antonio, Sánchez Romero Isabel, Centella Tomasa, Manuel Hermida José, Luis Moya José, Martín-Dávila Pilar, Navas Enrique, Oliva Enrique, del Río Alejandro, Rodríguez-Roda Stuart Jorge, Ruiz Soledad, Hidalgo Tenorio Carmen, Almendro Delia Manuel, Araji Omar, Miguel Barquero José, Calvo Jambrina Román, de Cueto Marina, Gálvez Acebal Juan, Méndez Irene, Morales Isabel, López-Cortés Luis Eduardo, de Alarcón Arístides, García Emilio, Luis Haro Juan, Antonio Lepe José, López Francisco, Luque Rafael, Javier Alonso Luis, Azcárate Pedro, Manuel Azcona Gutiérrez José, Ramón Blanco José, Cabrera Villegas Antonio, García-Álvarez Lara, García García Concepción, Antonio Oteo José, de Benito Natividad, Gurguí Mercé, Pacho Cristina, Pericas Roser, Pons Guillem, Álvarez M, Fernández A L, Martínez Amparo, Prieto A, Regueiro Benito, Tijeira E, Vega Marino, Canut Blasco Andrés, Cordo Mollar José, Carlos Gainzarain Arana Juan, García Uriarte Oscar, Martín López Alejandro, de Zárate Zuriñe Ortiz, Antonio Urturi Matos José, Antonio Sánchez-Porto, Iglesias Alejandro Úbeda, Arribas Leal José Mª, García Vázquez Elisa, Hernández Torres Alicia, Blázquez Ana, de la Morena Valenzuela Gonzalo, Alonso Ángel, Aramburu Javier, Elena Calvo Felicitas, Moreno Rodríguez Anai, Tarabini-Castellani Paola, Heredero Gálvez Eva, Maicas Bellido Carolina, Largo Pau José, Antonia Sepúlveda Mª, Toledano Sierra Pilar, Iqbal-Mirza Sadaf Zafar, Cascales Alcolea Eva, Keituqwa Yañez Ivan, Navarro Martínez Julián, Peláez Ballesta Ana, Moreno Escobar Eduardo, Peña Monje Alejandro, Sánchez Cabrera Valme, Vinuesa García David, Arrizabalaga Asenjo María, Cifuentes Luna Carmen, Núñez Morcillo Juana, Pérez Seco Mª Cruz, Villoslada Gelabert Aroa, Aured Guallar Carmen, Fernández Abad Nuria, García Mangas Pilar, Matamala Adell Marta, Palacián Ruiz Mª Pilar, Carlos Porres Juan, Alcaraz Vidal Begoña, Cobos Trigueros Nazaret, Jesús Del Amor Espín María, Antonio Giner Caro José, Jiménez Sánchez Roberto, Jimeno Almazán Amaya, Ortín Freire Alejandro, Viqueira González Monserrat, Pericás Ramis Pere, Ribas Blanco Mª Ángels, de Gopegui Bordes Enrique Ruiz, Vidal Bonet Laura, Bellón Munera Mª Carmen, Escribano Garaizabal Elena, Tercero Martínez Antonia, Carlos Segura Luque Juan, Badía Cristina, Boix Palop Lucía, Xercavins Mariona, Ibars Sónia, Bosch Xerach, Gómez Nebreda Eloy, Horcajada Herrera Ibalia, Menduiña Gallego Irene, Pulido Imanol, Marrero Santiago Héctor, de Miguel Martínez Isabel, Pisos Álamo Elena, Aguilar Blanco Eva Mª, Catalán González Mercedes, Corres Peiretti María Angélica, Eixerés Esteve Andrea, Domínguez Pérez Laura, de Cossío Tejido Santiago, Galván Román Francisco, García Robles José Antonio, López Medrano Francisco, López Gude Mª Jesús, Orellana Miguel Mª Ángeles, Pilkington Patrick, Revilla Ostalaza Yolanda, Ruiz Morales Juan, Ruiz Solís Sebastián, Sabín Collado Ana, Sánchez Fernández Marcos, Solera Rallo Javier, Solís Martín Jorge, Cuervo Guillermo, Escrihuela-Vidal Francesc, Carratalà Jordi, Grau Inmaculada, Grillo Sara, Ardanuy Carmen, Berbel Dámaris, Sánchez Salado Jose Carlos, Alegre Oriol, Ruiz Majoral Alejandro, Sbraga Fabrizio, Blasco Arnau, Gracia Sánchez Laura, Sánchez-Rodríguez Iván, Álvarez Beatriz, Cabello Úbeda Alfonso, Fernández Roblas Ricardo, Navas Lobato Miguel Ángel, María Pello Ana, de la Peña Triguero Mireia, Figueroa Cerón Ruth Esther, Ruiz Gómez Lara, Ble Mireia, Horcajada Gallego Juan Pablo, José Ginel Antonio, López Inmaculada, Mas Alexandra, Mestres Antoni, Molina Lluís, Serrat Ramón, Ribas Núria, Sánchez Francisca, Silverio Ana, Suárez Marina, Sorlí Luisa, Recasens Lluís, Taurón Manuel,
Affiliation:
1. Department of Infectious Diseases, Hospital Universitari de Bellvitge, Institut d´Investigació Biomèdica de Bellvitg e, University of Barcelona, Barcelona, Spain 2. Clinical Unit of Infectious Diseases and Microbiology, Hospital Universitario Virgen Macarena Institute of Biomedicine of Seville, Universidad de Sevilla, Sevilla, Spain 3. Department of Infectious Diseases, Hospital Universitari Vall d´Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain 4. Spanish Network for Research in Infectious Diseases, Madrid, Spain 5. Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases Research Group, Institute of Biomedicine of Seville, University of Seville/Centro Superior de Investigaciones Científicas (CSIC)/University Virgen del Rocío and Virgen Macarena, Sevilla, Spain 6. Department of Infectious Diseases, Hospital Servicio Andaluz de Salud (SAS) Línea de la Concepción, Cádiz, Spain 7. Unit of Infectious Diseases, Hospital Universitario de Cruces, Universidad del País Vasco, Bilbao, Spain 8. Infectious Diseases Service, Hospital Clínic-Institut d’Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain 9. Department of Infectious Diseases, Hospital Universitario Donosti, San Sebastián, Spain 10. Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red (CIBER) Enfermedades Respiratorias, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain 11. Unit of Infectious and Tropical Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Scientific Institute, Milan, Italy 12. Department of Infectious Diseases, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain 13. Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Barcelona, Spain 14. Department of Infectious Diseases, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain 15. Department of Infectious Diseases, Hospital Germans Trias i Pujol, Badalona, Spain 16. Department of Infectious Diseases and Internal Medicine, Instituto Murciano de Investigación Biosanitaria (IMIB), Hospital Clínico Universitario Virgen de la Arrixaca, Facultad de Medicina, Universidad de Murcia, Murcia, Spain
Abstract
Abstract
Background
Although Streptococcus anginosus group (SAG) endocarditis is considered a severe disease associated with abscess formation and embolic events, there is limited evidence to support this assumption.
Methods
We performed a retrospective analysis of prospectively collected data from consecutive patients with definite SAG endocarditis in 28 centers in Spain and Italy. A comparison between cases due to SAG endocarditis and viridans group streptococci (VGS) or Streptococcus gallolyticus group (SGG) was performed in a 1:2 matched analysis.
Results
Of 5336 consecutive cases of definite endocarditis, 72 (1.4%) were due to SAG and matched with 144 cases due to VGS/SGG. SAG endocarditis was community acquired in 64 (88.9%) cases and affected aortic native valve in 29 (40.3%). When comparing SAG and VGS/SGG endocarditis, no significant differences were found in septic shock (8.3% vs 3.5%, P = .116); valve disorder, including perforation (22.2% vs 18.1%, P = .584), pseudoaneurysm (16.7% vs 8.3%, P = .108), or prosthesis dehiscence (1.4% vs 6.3%, P = .170); paravalvular complications, including abscess (25% vs 18.8%, P = .264) and intracardiac fistula (5.6% vs 3.5%, P = .485); heart failure (34.7% vs 38.9%, P = .655); or embolic events (41.7% vs 32.6%, P = .248). Indications for surgery (70.8% vs 70.8%; P = 1) and mortality (13.9% vs 16.7%; P = .741) were similar between groups.
Conclusions
SAG endocarditis is an infrequent but serious condition that presents a prognosis similar to that of VGS/SGG.
Funder
Instituto de Salud Carlos III Ministerio de Ciencia, Innovación y Universidades Spanish Network for Research in Infectious Diseases European Development Regional Fund
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Oncology
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