Non-HACEK gram-negative bacillus endocarditis

Susan Morpeth; David Murdoch; Christopher H. Cabell; Adolf W. Karchmer; Paul Pappas; Donald Levine; Francisco Nacinovich; Pierre Tattevin; Núria Fernández-Hidalgo; Stuart Dickerman; Emilio Bouza; Ana Del Río; Tatjana Lejko-Zupanc; Auristela De Oliveira Ramos; Diana Iarussi; John Klein; Catherine Chirouze; Roger Bedimo; G. Ralph Corey; Vance G. Fowler; International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators

doi:10.7326/0003-4819-147-12-200712180-00002

Non-HACEK gram-negative bacillus endocarditis

Susan Morpeth, David Murdoch, Christopher H. Cabell, Adolf W. Karchmer, Paul Pappas, Donald Levine, Francisco Nacinovich, Pierre Tattevin, Núria Fernández-Hidalgo, Stuart Dickerman, Emilio Bouza, Ana Del Río, Tatjana Lejko-Zupanc, Auristela De Oliveira Ramos, Diana Iarussi, John Klein, Catherine Chirouze, Roger Bedimo, G. Ralph Corey, Vance G. FowlerInternational Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators

Research output: Contribution to journal › Article › Research › peer-review

229 Citations (Scopus)

Abstract

Background: Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. Objective: To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. Design: Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. Setting: 61 hospitals in 28 countries. Patients: Hospitalized patients with definite endocarditis. Measurements: Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. Results: Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). Limitations: Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. Conclusion: In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

Original language	English
Pages (from-to)	829-835
Number of pages	7
Journal	Annals of Internal Medicine
Volume	147
Issue number	12
DOIs	https://doi.org/10.7326/0003-4819-147-12-200712180-00002
Publication status	Published - 18 Dec 2007
Externally published	Yes

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10.7326/0003-4819-147-12-200712180-00002

Cite this

Morpeth, S., Murdoch, D., Cabell, C. H., Karchmer, A. W., Pappas, P., Levine, D., Nacinovich, F., Tattevin, P., Fernández-Hidalgo, N., Dickerman, S., Bouza, E., Del Río, A., Lejko-Zupanc, T., De Oliveira Ramos, A., Iarussi, D., Klein, J., Chirouze, C., Bedimo, R., Corey, G. R., ... International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators (2007). Non-HACEK gram-negative bacillus endocarditis. Annals of Internal Medicine, 147(12), 829-835. https://doi.org/10.7326/0003-4819-147-12-200712180-00002

@article{2a1ee7cac1d24dc696874d0d85c896a2,

title = "Non-HACEK gram-negative bacillus endocarditis",

abstract = "Background: Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. Objective: To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. Design: Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. Setting: 61 hospitals in 28 countries. Patients: Hospitalized patients with definite endocarditis. Measurements: Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. Results: Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). Limitations: Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. Conclusion: In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.",

author = "Susan Morpeth and David Murdoch and Cabell, {Christopher H.} and Karchmer, {Adolf W.} and Paul Pappas and Donald Levine and Francisco Nacinovich and Pierre Tattevin and N{\'u}ria Fern{\'a}ndez-Hidalgo and Stuart Dickerman and Emilio Bouza and {Del R{\'i}o}, Ana and Tatjana Lejko-Zupanc and {De Oliveira Ramos}, Auristela and Diana Iarussi and John Klein and Catherine Chirouze and Roger Bedimo and Corey, {G. Ralph} and Fowler, {Vance G.} and {International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators} and David Gordon and Uma Devi and Denis Spelman and {Van Der Meer}, {Jan T.M.} and Carol Kauffman and Suzanne Bradley and William Armstrong and Efthymia Giannitsioti and Helen Giamarellou and Stamatios Lerakis and Asuncion Moreno and Mestres, {Carlos A.} and Carlos Par{\'e} and {Garcia De La Maria}, Cristina and {De Lazzario}, Elisa and Francesc Marco and Gatell, {Jose M.} and Mir{\'o}, {Jos{\'e} M.} and Manel Almela and Manuel Azqueta and Jim{\'e}nez-Exp{\'o}sito, {Maria Jes{\'u}s} and {De Benito}, Natividad and Noel Perez and Benito Almirante and {Rodriguez De Vera}, Pablo and Pilar Tornos and Vicente Falc{\'o} and Xavier Claramonte and Yolanda Armero and Nisreen Sidani and Souha Kanj-Sharara and Zeina Kanafani and Annibale Raglio and Antonio Goglio and Fabrizio Gnecchi and Fredy Suter and Grazia Valsecchi and Marco Rizzi and Veronica Ravasio and Bruno Hoen and Joel Leroy and Patrick Plesiat and Yvette Bernard and Anna Casey and Peter Lambert and Richard Watkin and Tom Elliott and Mukesh Patel and William Dismukes and Angelo Pan and Giampiero Caros and Tribouilloy, {Amel Brahim Mathiron Christophe} and Thomas Goissen and Armelle Delahaye and Francois Delahaye and Francois Vandenesch and Carla Vizzotti and Nacinovich, {Francisco M.} and Marcelo Marin and Marcelo Trivi and Martin Lombardero and Claudia Cortes and Casab{\'e}, {Jos{\'e} Horacio} and Javier Altclas and Silvia Kogan and Liliana Clara and Marisa Sanchez and Anita Commerford and Cass Hansa and Eduan Deetlefs and Mpiko Ntsekhe and Patrick Commerford and Dannah Wray and Steed, {Lisa L.} and Preston Church and Robert Cantey and Arthur Morris and Stephen Chambers and Kerry Read and Nigel Raymond and David Holland and Selwyn Lang and Despina Kotsanas and Korman, {Tony M.} and Gail Peterson and Jon Purcell and Southern, {Paul M.} and Manisha Shah and Arjun Reddy and Gaurav Dhar and Alanna Hanlon-Feeney and Margaret Hannan and Sinead Kelly and Andrew Wang and Woods, {Christopher W.} and Sexton, {Daniel J.} and Danny Benjamin and McDonald, {Jay R.} and Jeff Federspiel and Engemann, {John J.} and Reller, {L. Barth} and Laura Drew and Caram, {L. B.} and Martin Stryjewski and Tahaniyat Lalani and Vivian Chu and Bahram Mazaheri and Carl Neuerburg and Christoph Naber and Eugene Athan and Margaret Henry and Owen Harris and Eric Alestig and Lars Olaison and Lotta Wikstrom and Ulrika Snygg-Martin and Johnson Francis and K. Venugopal and Lathi Nair and Vinod Thomas and Jaruwan Chaiworramukkun and Orathai Pachirat and Ploenchan Chetchotisakd and Tewan Suwanich and Adeeba Kamarulzaman and Tamin, {Syahidah Syed} and {Mueller Premru}, Manica and Mateja Logar and Christina Orezzi and Mar Moreno and Marta Rodr{\'i}guez-Cr{\'e}ixems and Mercedes Mar{\'i}n and Miguel Fern{\'a}ndez and Patricia Mu{\~n}oz and Roc{\'i}o Fern{\'a}ndez and Victor Ramallo and Didier Raoult and Franck Thuny and Gilbert Habib and Casalta, {Jean Paul} and Fournier, {Pierre Edouard} and Natalia Chipigina and Ozerecky Kirill and Tatiana Vinogradova and Kulichenko, {Vadim P.} and Butkevich, {O. M.} and Christine Lion and Christine Selton-Suty and Francois Alla and H{\'e}l{\`e}ne Coyard and Thanh Doco-Lecompte and Emanuele Durante-Mangoni and Enrico Ragone and Giovanni Dialetto and Tripodi, {Marie Fran{\c c}oise} and Riccardo Utili and Roberta Casillo and Kumar, {A. Sampath} and Gautam Sharma and Alan Street and Eisen, {Damon Peter} and McBryde, {Emma Sue} and Leeanne Grigg and Elias Abrutyn and Christian Michelet and Donnio, {Pierre Yves} and Fortes, {Claudio Querido} and Jameela Edathodu and Mashael Al-Hegelan and Bernat Font and Ignasi Anguera and Guma, {Joan Raimon} and M. Cereceda and Oyonarte, {Miguel J.} and Mella, {Rodrigo Montagna} and Patricia Garcia and Jones, {Sandra Braun} and Paiva, {Marcelo Goulart} and Tranchesi, {Regina Aparecida De Medeiros} and Woon, {Lok Ley} and Lum, {Luh Nah} and Tan, {Ru San} and David Rees and Pam Kornecny and Richard Lawrence and Robyn Dever and Jeffrey Post and Phillip Jones and Suzanne Ryan and John Harkness and Michael Feneley and Ethan Rubinstein and Jacob Strahilewitz and Adina Ionac and Cristian Mornos and Stefan Dragulescu and Davide Forno and Enrico Cecchi and {De Rosa}, Francesco and Massimo Imazio and Rita Trinchero and Franz Wiesbauer and Rainer Gattringer and Greg Deans and Andrasevic, {Arjana Tambic} and Bruno Barsic and Igor Klinar and Josip Vincelj and Suzana Bukovski and Vladimir Krajinovic",

year = "2007",

month = dec,

day = "18",

doi = "10.7326/0003-4819-147-12-200712180-00002",

language = "English",

volume = "147",

pages = "829--835",

journal = "Annals of Internal Medicine",

issn = "0003-4819",

publisher = "American College of Physicians",

number = "12",

}

Morpeth, S, Murdoch, D, Cabell, CH, Karchmer, AW, Pappas, P, Levine, D, Nacinovich, F, Tattevin, P, Fernández-Hidalgo, N, Dickerman, S, Bouza, E, Del Río, A, Lejko-Zupanc, T, De Oliveira Ramos, A, Iarussi, D, Klein, J, Chirouze, C, Bedimo, R, Corey, GR, Fowler, VG & International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators 2007, 'Non-HACEK gram-negative bacillus endocarditis', Annals of Internal Medicine, vol. 147, no. 12, pp. 829-835. https://doi.org/10.7326/0003-4819-147-12-200712180-00002

TY - JOUR

T1 - Non-HACEK gram-negative bacillus endocarditis

AU - Morpeth, Susan

AU - Murdoch, David

AU - Cabell, Christopher H.

AU - Karchmer, Adolf W.

AU - Pappas, Paul

AU - Levine, Donald

AU - Nacinovich, Francisco

AU - Tattevin, Pierre

AU - Fernández-Hidalgo, Núria

AU - Dickerman, Stuart

AU - Bouza, Emilio

AU - Del Río, Ana

AU - Lejko-Zupanc, Tatjana

AU - De Oliveira Ramos, Auristela

AU - Iarussi, Diana

AU - Klein, John

AU - Chirouze, Catherine

AU - Bedimo, Roger

AU - Corey, G. Ralph

AU - Fowler, Vance G.

AU - International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) Investigators

AU - Gordon, David

AU - Devi, Uma

AU - Spelman, Denis

AU - Van Der Meer, Jan T.M.

AU - Kauffman, Carol

AU - Bradley, Suzanne

AU - Armstrong, William

AU - Giannitsioti, Efthymia

AU - Giamarellou, Helen

AU - Lerakis, Stamatios

AU - Moreno, Asuncion

AU - Mestres, Carlos A.

AU - Paré, Carlos

AU - Garcia De La Maria, Cristina

AU - De Lazzario, Elisa

AU - Marco, Francesc

AU - Gatell, Jose M.

AU - Miró, José M.

AU - Almela, Manel

AU - Azqueta, Manuel

AU - Jiménez-Expósito, Maria Jesús

AU - De Benito, Natividad

AU - Perez, Noel

AU - Almirante, Benito

AU - Rodriguez De Vera, Pablo

AU - Tornos, Pilar

AU - Falcó, Vicente

AU - Claramonte, Xavier

AU - Armero, Yolanda

AU - Sidani, Nisreen

AU - Kanj-Sharara, Souha

AU - Kanafani, Zeina

AU - Raglio, Annibale

AU - Goglio, Antonio

AU - Gnecchi, Fabrizio

AU - Suter, Fredy

AU - Valsecchi, Grazia

AU - Rizzi, Marco

AU - Ravasio, Veronica

AU - Hoen, Bruno

AU - Leroy, Joel

AU - Plesiat, Patrick

AU - Bernard, Yvette

AU - Casey, Anna

AU - Lambert, Peter

AU - Watkin, Richard

AU - Elliott, Tom

AU - Patel, Mukesh

AU - Dismukes, William

AU - Pan, Angelo

AU - Caros, Giampiero

AU - Tribouilloy, Amel Brahim Mathiron Christophe

AU - Goissen, Thomas

AU - Delahaye, Armelle

AU - Delahaye, Francois

AU - Vandenesch, Francois

AU - Vizzotti, Carla

AU - Nacinovich, Francisco M.

AU - Marin, Marcelo

AU - Trivi, Marcelo

AU - Lombardero, Martin

AU - Cortes, Claudia

AU - Casabé, José Horacio

AU - Altclas, Javier

AU - Kogan, Silvia

AU - Clara, Liliana

AU - Sanchez, Marisa

AU - Commerford, Anita

AU - Hansa, Cass

AU - Deetlefs, Eduan

AU - Ntsekhe, Mpiko

AU - Commerford, Patrick

AU - Wray, Dannah

AU - Steed, Lisa L.

AU - Church, Preston

AU - Cantey, Robert

AU - Morris, Arthur

AU - Chambers, Stephen

AU - Read, Kerry

AU - Raymond, Nigel

AU - Holland, David

AU - Lang, Selwyn

AU - Kotsanas, Despina

AU - Korman, Tony M.

AU - Peterson, Gail

AU - Purcell, Jon

AU - Southern, Paul M.

AU - Shah, Manisha

AU - Reddy, Arjun

AU - Dhar, Gaurav

AU - Hanlon-Feeney, Alanna

AU - Hannan, Margaret

AU - Kelly, Sinead

AU - Wang, Andrew

AU - Woods, Christopher W.

AU - Sexton, Daniel J.

AU - Benjamin, Danny

AU - McDonald, Jay R.

AU - Federspiel, Jeff

AU - Engemann, John J.

AU - Reller, L. Barth

AU - Drew, Laura

AU - Caram, L. B.

AU - Stryjewski, Martin

AU - Lalani, Tahaniyat

AU - Chu, Vivian

AU - Mazaheri, Bahram

AU - Neuerburg, Carl

AU - Naber, Christoph

AU - Athan, Eugene

AU - Henry, Margaret

AU - Harris, Owen

AU - Alestig, Eric

AU - Olaison, Lars

AU - Wikstrom, Lotta

AU - Snygg-Martin, Ulrika

AU - Francis, Johnson

AU - Venugopal, K.

AU - Nair, Lathi

AU - Thomas, Vinod

AU - Chaiworramukkun, Jaruwan

AU - Pachirat, Orathai

AU - Chetchotisakd, Ploenchan

AU - Suwanich, Tewan

AU - Kamarulzaman, Adeeba

AU - Tamin, Syahidah Syed

AU - Mueller Premru, Manica

AU - Logar, Mateja

AU - Orezzi, Christina

AU - Moreno, Mar

AU - Rodríguez-Créixems, Marta

AU - Marín, Mercedes

AU - Fernández, Miguel

AU - Muñoz, Patricia

AU - Fernández, Rocío

AU - Ramallo, Victor

AU - Raoult, Didier

AU - Thuny, Franck

AU - Habib, Gilbert

AU - Casalta, Jean Paul

AU - Fournier, Pierre Edouard

AU - Chipigina, Natalia

AU - Kirill, Ozerecky

AU - Vinogradova, Tatiana

AU - Kulichenko, Vadim P.

AU - Butkevich, O. M.

AU - Lion, Christine

AU - Selton-Suty, Christine

AU - Alla, Francois

AU - Coyard, Hélène

AU - Doco-Lecompte, Thanh

AU - Durante-Mangoni, Emanuele

AU - Ragone, Enrico

AU - Dialetto, Giovanni

AU - Tripodi, Marie Françoise

AU - Utili, Riccardo

AU - Casillo, Roberta

AU - Kumar, A. Sampath

AU - Sharma, Gautam

AU - Street, Alan

AU - Eisen, Damon Peter

AU - McBryde, Emma Sue

AU - Grigg, Leeanne

AU - Abrutyn, Elias

AU - Michelet, Christian

AU - Donnio, Pierre Yves

AU - Fortes, Claudio Querido

AU - Edathodu, Jameela

AU - Al-Hegelan, Mashael

AU - Font, Bernat

AU - Anguera, Ignasi

AU - Guma, Joan Raimon

AU - Cereceda, M.

AU - Oyonarte, Miguel J.

AU - Mella, Rodrigo Montagna

AU - Garcia, Patricia

AU - Jones, Sandra Braun

AU - Paiva, Marcelo Goulart

AU - Tranchesi, Regina Aparecida De Medeiros

AU - Woon, Lok Ley

AU - Lum, Luh Nah

AU - Tan, Ru San

AU - Rees, David

AU - Kornecny, Pam

AU - Lawrence, Richard

AU - Dever, Robyn

AU - Post, Jeffrey

AU - Jones, Phillip

AU - Ryan, Suzanne

AU - Harkness, John

AU - Feneley, Michael

AU - Rubinstein, Ethan

AU - Strahilewitz, Jacob

AU - Ionac, Adina

AU - Mornos, Cristian

AU - Dragulescu, Stefan

AU - Forno, Davide

AU - Cecchi, Enrico

AU - De Rosa, Francesco

AU - Imazio, Massimo

AU - Trinchero, Rita

AU - Wiesbauer, Franz

AU - Gattringer, Rainer

AU - Deans, Greg

AU - Andrasevic, Arjana Tambic

AU - Barsic, Bruno

AU - Klinar, Igor

AU - Vincelj, Josip

AU - Bukovski, Suzana

AU - Krajinovic, Vladimir

PY - 2007/12/18

Y1 - 2007/12/18

N2 - Background: Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. Objective: To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. Design: Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. Setting: 61 hospitals in 28 countries. Patients: Hospitalized patients with definite endocarditis. Measurements: Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. Results: Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). Limitations: Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. Conclusion: In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

AB - Background: Infective endocarditis caused by non-HACEK (species other than Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, or Kingella species) gram-negative bacilli is rare, is poorly characterized, and is commonly considered to be primarily a disease of injection drug users. Objective: To describe the clinical characteristics and outcomes of patients with non-HACEK gram-negative bacillus endocarditis in a large, international, contemporary cohort of patients. Design: Observations from the International Collaboration on Infective Endocarditis Prospective Cohort Study (ICE-PCS) database. Setting: 61 hospitals in 28 countries. Patients: Hospitalized patients with definite endocarditis. Measurements: Characteristics of non-HACEK gram-negative bacillus endocarditis cases were described and compared with those due to other pathogens. Results: Among the 2761 case-patients with definite endocarditis enrolled in ICE-PCS, 49 (1.8%) had endocarditis (20 native valve, 29 prosthetic valve or device) due to non-HACEK, gram-negative bacilli. Escherichia coli (14 patients [29%]) and Pseudomonas aeruginosa (11 patients [22%]) were the most common pathogens. Most patients (57%) with non-HACEK gram-negative bacillus endocarditis had health care-associated infection, whereas injection drug use was rare (4%). Implanted endovascular devices were frequently associated with non-HACEK gram-negative bacillus endocarditis compared with other causes of endocarditis (29% vs. 11%; P < 0.001). The in-hospital mortality rate of patients with endocarditis due to non-HACEK gram-negative bacilli was high (24%) despite high rates of cardiac surgery (51%). Limitations: Because of the small number of patients with non-HACEK gram-negative bacillus endocarditis in each treatment group and the lack of long-term follow-up, strong treatment recommendations are difficult to make. Conclusion: In this large, prospective, multinational cohort, more than one half of all cases of non-HACEK gram-negative bacillus endocarditis were associated with health care contact. Non-HACEK gram-negative bacillus endocarditis is not primarily a disease of injection drug users.

UR - http://www.scopus.com/inward/record.url?scp=38449122050&partnerID=8YFLogxK

U2 - 10.7326/0003-4819-147-12-200712180-00002

DO - 10.7326/0003-4819-147-12-200712180-00002

M3 - Article

C2 - 18087053

AN - SCOPUS:38449122050

SN - 0003-4819

VL - 147

SP - 829

EP - 835

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

IS - 12

ER -

Non-HACEK gram-negative bacillus endocarditis

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