Clinical characteristics and outcome of infective endocarditis due to Abiotrophia and Granulicatella compared to Viridans group streptococci - 03/07/22

Doi : 10.1016/j.jinf.2022.05.023

Adrián Téllez ^a,^{^{1
These authors contributed equally to this work.}}, Juan Ambrosioni ^a,^b,^{^{1
These authors contributed equally to this work.}}, Marta Hernández-Meneses ^a,^{^{1
These authors contributed equally to this work.}}, Jaume Llopis ^a,^c,^{^{1
These authors contributed equally to this work.}}, Marco Ripa ^a,^d, Stephen T. Chambers ^e, David Holland ^f, Manel Almela ^a, Núria Fernández-Hidalgo ^b,^g, Benito Almirante ^b,^g, Emilio Bouza ^h, Jacob Strahilevitz ⁱ, Margaret M Hannan ^j, John Harkness ^k, Zeina A. Kanafani ^l, Tahaniyat Lalani ^m, Selwyn Lang ⁿ, Nigel Raymond ^o, Kerry Read ^p, Tatiana Vinogradova ^q, Christopher W. Woods ^r, Dannah Wray ^s, Asuncion Moreno ^a, Vivian H. Chu ^t, Jose M Miro ^a,^b,^⁎
and the
International Collaboration on Endocarditis (ICE) Investigators^²
ICE investigators are listed in the Appendix.
^a Hospital Clinic-IDIBAPS, Infectious Diseases Service, Hospital Clínic, University of Barcelona, Villarroel, 170, Barcelona 08036, Spain
^b CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
^c Department of Genetics, Microbiology and Statistics. Faculty of Biology, University of Barcelona, Barcelona, Spain
^d Unit of Infectious and Tropical Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
^e Department of Pathology, University of Otago, Christchurch and Christchurch Hospital, Christchurch, New Zealand
^f Infectious Diseases Unit, Middlemore Hospital, Auckland, New Zealand
^g Servei de Malalties Infeccioses, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
^h Clinical Microbiology and Infectious Diseases Service, Hospital General Universitario Gregorio Marañon, Madrid, Spain
ⁱ Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University, Jerusalem, Israel
^j Department of Medical Microbiology, Mater Hospitals, Dublin, Ireland
^k Department of Microbiology, St. Vincent's, Sydney, New South Wales, Australia
^l Division of Infectious Diseases, American University of Beirut, Beirut, Lebanon
^m Infectious Disease Clinical Research Program, Uniformed Services University, Bethesda, MD, United States
ⁿ Department of Microbiology, Middlemore Hospital, Auckland, New Zealand
^o Department of Infectious Diseases, Wellington Hospital, Wellington, New Zealand
^p Department of Infectious Diseases, North Shore Hospital, Auckland, New Zealand
^q Institute of Experimental Cardiology, Russian Medical State University, Moscow, Russia
^r Department of Medicine, VA Medical Centre, Durham, NC, United States
^s Infectious Disease Division, Medical University of South Carolina, Charleston, SC, United States
^t Infectious Diseases, Duke University School of Medicine, Durham, NC, United States

^⁎Corresponding author.

Highlights

•	Clinical features and outcomes of Abiotrophia and Granulicatella IE are similar.
•	Patients with Abiotrophia/Granulicatella are younger than viridans streptococci IE.
•	Rate of surgery between Abiotrophia/Granulicatella and Viridans IE is similar.
•	Survival between Abiotrophia/Granulicatella and Viridans IE is similar.

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Summary

Objective

To describe the clinical characteristics and outcome of Abiotrophia and Granulicatella infective endocarditis and compare them with Viridans group streptococci infective endocarditis.

Methods

All patients in the International Collaboration on Endocarditis (ICE) - prospective cohort study (PCS) and the ICE-PLUS cohort were included (n = 8112). Data from patients with definitive or possible IE due to Abiotrophia species, Granulicatella species and Viridans group streptococci was analyzed. A propensity score (PS) analysis comparing the ABI/GRA-IE and VGS-IE groups according to a 1:2 ratio was performed.

Results

Forty-eight (0.64%) cases of ABI/GRA-IE and 1,292 (17.2%) VGS-IE were included in the analysis. The median age of patients with ABI/GRA-IE was lower than VGS-IE (48.1 years vs. 57.9 years; p = 0.001). Clinical features and the rate of in-hospital surgery was similar between ABI/GRA-IE and VGS-IE (52.1% vs. 45.4%; p = 0.366). Unadjusted in-hospital death was lower in ABI/GRA-IE than VGS-IE (2.1% vs. 8.8%; p = 0.003), and cumulative six-month mortality was lower in ABI/GRA-IE than VGS-IE (2.1% vs. 11.9%; p<0.001). After PS analysis, in-hospital mortality was similar in both groups, but six-month mortality was lower in the ABI/GRA IE group (2.1% vs. 10.4%; p = 0.029).

Conclusions

Patients with ABI/GRA-IE were younger, had similar clinical features and rates of surgery and better prognosis than VGS-IE.

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Graphical abstract

Survival curves according to Abiotrophia/Granulicatella infective endocarditis (ABI/GRA-IE) or Viridans group streptococci infective endocarditis (VGS-IE).

Image, graphical abstract

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Keywords : Infective endocarditis, Abiotrophia, Granulicatella, Viridans group streptococci, International collaboration on endocarditis

Plan

Introduction

Methods

Study population and clinical data

Abiotrophia and Granulicatella infective endocarditis

Demographic features, comorbidities and type of infective endocarditis

Clinical presentation and echocardiographic findings

Complications, antibiotic treatment and outcomes

Prognostic factors

Propensity score analysis

Discussion

Conclusions

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Vol 85 - N° 2

P. 137-146 - août 2022 Retour au numéro

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Clinical characteristics and outcome of infective endocarditis due to Abiotrophia and Granulicatella compared to Viridans group streptococci - 03/07/22

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Methods

Results

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Plan

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