4.4 Article

Clinical Features and Outcomes of Streptococcus anginosus Group Infective Endocarditis: A Multicenter Matched Cohort Study

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OPEN FORUM INFECTIOUS DISEASES
卷 8, 期 6, 页码 -

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OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofab163

关键词

infective endocarditis; Streptococcus anginosus; viridans group streptococci; Streptococcus gallolyticus

资金

  1. Plan Nacional de I+D+i 2013-2016
  2. Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Ciencia, Innovacion y Universidades, Spanish Network for Research in Infectious Diseases [REIPI RD16/0016/0005]
  3. European Development Regional Fund A way to achieve Europe, Operative Program Intelligent Growth 2014-2020
  4. Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

向作者/读者索取更多资源

The study found that Streptococcus anginosus group (SAG) endocarditis has a similar prognosis to endocarditis caused by viridans group streptococci (VGS) or Streptococcus gallolyticus group (SGG), with no significant differences in disease severity and outcomes.
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. In this multicenter matched cohort study, we found that Streptococcus anginosus group endocarditis follows a similar course to endocarditis caused by viridans or gallolyticus group streptococci, regarding valvular complications and prognostic variables such as indication for surgery and mortality.

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