Non-HACEK Gram-negative bacillus endocarditis

• Published in: Médecine et maladies infectieuses 2019-11, Vol.49 (8), p.616-620
• Main Authors: Ertugrul Mercan, M., Arslan, F., Ozyavuz Alp, S., Atilla, A., Seyman, D., Guliyeva, G., Kayaaslan, B., Sari, S., Mutay Suntur, B., Isik, B., Mert, A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibiotics; Bactéries à Gram négatif; Catheterization; Catheters; Cathétérisme; E coli; Endocardite; Endocarditis; Endocarditis, Bacterial - diagnosis; Endocarditis, Bacterial - microbiology; Endocarditis, Bacterial - therapy; Escherichia coli; Fatalities; Female; Gram-negative bacteria; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - therapy; Humans; Male; Medical instruments; Middle Aged; Patients; Pseudomonas aeruginosa; Retrospective Studies; Surgery
• ISSN: 0399-077X; 1769-6690
• DOI: 10.1016/j.medmal.2019.03.013

•Data on non-HACEK Gram-negative infective endocarditis is limited to case reports and case series.•Clinicians may encounter non-HACEK Gram-negative infective endocarditis in medical wards mostly because of the high number of intravascular interventions performed and elderly patients treated.•While environmental pathogens are pan-susceptible to antimicrobials, Klebsiella species endocarditis is associated with an increased risk of drug resistance. Retrospective analysis of clinical data using 26 diagnosed non-HACEK Gram-negative infective endocarditis cases from nine hospitals in Turkey. Mean age of patients was 53 (28–84) years, with a 23% case fatality. Nineteen (73%) of the 26 patients had at least one predisposing factor. The presence of a central venous catheter was the most common predisposing factor (7/26 patients). Pseudomonasaeruginosa (7/26 patients) and Escherichiacoli (7/26 patients) were the most common pathogens. The median duration of the antibiotic therapy was 42 days (range 3–84 days). Surgical procedures were performed in 10 patients. The case fatality was similar in patients who did or did not undergo surgery (20% vs. 25%). Analyse rétrospective des données cliniques sur 26 cas d’endocardite infectieuse à bacilles à Gram négatif non HACEK dans neuf hôpitaux turcs. L’âge moyen de la cohorte de patients était de 53 ans (28–84 ans). La létalité était de 23 %. Parmi les 26 patients, 19 (73 %) avaient au moins un facteur prédisposant. La présence d’un cathéter veineux central était le facteur prédisposant le plus fréquent (7/26 patients). Pseudomonasaeruginosa (7/26 patients) et Escherichiacoli (7/26 patients) étaient les pathogènes les plus fréquents. La durée médiane de l’antibiothérapie était de 42jours (3 à 84jours). Des interventions chirurgicales ont été réalisées chez 10 patients. La létalité était similaire chez les patients ayant ou non subi une intervention chirurgicale (20 % vs 25 %).