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Clinical features and outcomes of streptococcus anginosus group Infective endocarditis: A multicenter matched cohort study

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Date
2021-03-25
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Authors
Escrihuela-Vidal, Francesc ; López-Cortés, Luis Eduardo ; Escolà-Vergé, Laura ; Alarcón González, Arístides de ; Cuervo, Guillermo ; Sánchez-Porto, Antonio ; Fernández-Hidalgo, Nuria ; Luque, Rafael ; Montejo, Miguel ; Miró, José M. ; Goenaga, Miguel Ángel ; Muñoz, Patricia ; Valerio, Maricela ; Ripa, Marco ; Sousa-Regueiro, Dolores ; Gurguí, Mercé ; Fariñas-Álvarez, María Carmen ; Mateu, Lourdes ; García-Vázquez, Elisa ; Gálvez-Acebal, Juan ; Carratalà, Jordi ; Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) ; Barcelona Endocarditis Study Team (BEST)
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Publisher
Oxford University Press
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publication.page.department
Medicina
DOI
https://doi.org/10.1093/ofid/ofab163
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info:eu-repo/semantics/article
Description
©2021 he Author(s). Oxford University Press . This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. This document is the Published, version of a Published Work that appeared in final form in Open Forum Infectious Diseases. To access the final edited and published work see https://doi.org/10.1093/ofid/ofab163
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.
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Infective endocarditis , Streptococcus anginosus , Viridans group streptococci , Streptococcus gallolyticus
Citation
Open Forum Infectious Diseases, Volume 8, Issue 6, June 2021, ofab163
URI
http://hdl.handle.net/10201/142707
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