Clinical Features and Outcomes of Streptococcus anginosus Group Infective Endocarditis

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. We performed a retrospective analysis of prospectively collected data from consecutive patients with de...

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Detalles Bibliográficos
Autores: Escrihuela-Vidal, Francesc|||0000-0003-3652-3121, López Cortés, Luis Eduardo|||0000-0002-9347-527X, Escolà-Vergé, Laura|||0000-0002-5608-3090, Alarcón González, Arístides de|||0000-0002-4548-4462, Cuervo, Guillermo|||0000-0002-7075-943X, Sánchez-Porto, Antonio, Fernández-Hidalgo, Nuria|||0000-0002-2115-344X, Luque, Rafael, Montejo, Miguel, Miró, José M.|||0000-0001-8057-7755, Goenaga, Miguel Ángel, Munoz, Patricia|||0000-0001-5706-5583, Valerio, Maricela, Ripa, Marco, Sousa-Regueiro, Dolores, Gurguí, Mercè|||0000-0002-0474-3528, Fariñas, Mª Carmen, Mateu, Lourdes|||0000-0001-7223-7611, García Vázquez, Elisa, Gálvez-Acebal, Juan, Carratalà, Jordi|||0000-0003-3209-2563
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:256421
Acceso en línea:https://ddd.uab.cat/record/256421
https://dx.doi.org/urn:doi:10.1093/ofid/ofab163
Access Level:acceso abierto
Palabra clave:Infective endocarditis
Streptococcus anginosus
Viridans group streptococci
Streptococcus gallolyticus
Descripción
Sumario: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. 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. 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. 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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