HACEK infective endocarditis: Epidemiology, clinical features, and outcome: A case–control study

Ambrosioni, Juan; Martínez-García, Clara Luz; Llopis, Jaume; García-de-la-Mària, Cristina; Hernández‐Meneses, Marta; Téllez, Adrián; Falces, Carles; Almela, Manel; Vidal, Bárbara; Sandoval, Elena; Fuster, David; Tolosana, José Marı́a; Marco, Francesc; Moreno, Asunción; Miró, José M.

doi:10.1016/j.ijid.2018.08.013

Cited by 22 publications

(33 citation statements)

References 20 publications

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“…This study is the largest one to date describing IE due to HACEK, and most of the features presented here are in line with previous findings by others. Importantly, this study confirms that IE caused by HACEK has a more favourable prognosis than IE caused by most other pathogens [5,7]. The mortality, however, was lower in our cohort as compared to the international cohort study [5], possibly reflecting that the present study is based on data from an entire country and not only on patients treated in tertiary centres.…”

Section: Discussionsupporting

confidence: 72%

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Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

Bläckberg

Morenius

Olaison

et al. 2021

Eur J Clin Microbiol Infect Dis

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Infective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.

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Section: Discussionsupporting

confidence: 72%

“…In a relatively recent publication, 16 cases of IE due to HACEK, reported to a Spanish registry, were compared to cases of streptococcal IE reported to the same registry. The groups had many similarities, but the prognosis was significantly more favourable for cases of IE caused by HACEK [7].…”

Section: Introductionmentioning

confidence: 99%

Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

Bläckberg

Morenius

Olaison

et al. 2021

Eur J Clin Microbiol Infect Dis

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“…Besides risk factors, few other similarities between non-meningococcal, non-gonococcal Neisseria species and HACEK bacteria exist. HACEK-IE vegetations have been shown on average to be larger compared to vegetations caused by viridans group streptococci (11.5 mm vs 9 mm), and these vegetations have higher rates of embolization [13]. Our patient was found to have a large vegetation (21 mm) and clinical evidence of embolization, further demonstrating the similarities between HACEK organisms and non-meningococcal, non-gonococcal Neisseria.…”

Section: Discussionsupporting

confidence: 52%

“…However, in the 1970s, research studies found that N. flavescens/subflava were capable of beta-lactamase production, thus rendering penicillin antibiotics largely ineffective [10]. Of note, studies of HACEK organisms also have shown their capability to synthesize beta-lactamase, making third-generation cephalosporins the primary antibiotic choice for HACEK-IE treatment [13]. Our patient was treated with cefepime, with subsequent repeat negative blood cultures and discharged on a longer course of ceftriaxone.…”

Section: Discussionmentioning

confidence: 84%

An Unusual Case of Neisseria flavescens/subflava Group Tricuspid Valve Endocarditis in a Patient With Previously Treated Methicillin-Resistant Staphylococcus aureus Endocarditis

Solsi

Findakly

Mihyawi

et al. 2020

Cureus

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Infective endocarditis (IE) is classified as an infection of any cardiac valve or endocardial surface and is often associated with high morbidity and mortality. Certain bacteria such as gram-positive cocci and viridans group streptococci have high predilection for both naïve and damaged cardiac valvular tissues, accounting for the majority of IE cases. In very infrequent instances, gram-negative bacteria (GNB), more specifically non-meningococcal, nongonococcal GNB, have been shown to cause IE. The following is a case of a young male diagnosed with Neisseria flavescens/subflava tricuspid valve endocarditis after being previously treated for Methicillin-resistant Staphylococcus aureus (MRSA) endocarditis.

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“…However, Campylobacter also accounts for 1% of the oral microbiome in the saliva of healthy adults [ 19 ] and this proportion was identical to our control group but lower in CRS patients. Cardiobacterium is a Gram-negative bacillus bacterium of the HACEK group (represents the species of Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, and Kingella) and accounts for 5–10% of infections in endocarditis patients who do not use intravenous drugs [ 45 , 46 ]. Currently, only two species of Cardiobacterium hominis and Cardiobacterium valvarum have been identified.…”

Section: Discussionmentioning

confidence: 99%

Clinical Detection of Chronic Rhinosinusitis through Next-Generation Sequencing of the Oral Microbiota

et al. 2020

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Chronic rhinosinusitis (CRS) is the chronic inflammation of the sinus cavities of the upper respiratory tract, which can be caused by a disrupted microbiome. However, the role of the oral microbiome in CRS is not well understood. Polymicrobial and anaerobic infections of CRS frequently increased the difficulty of cultured and antibiotic therapy. This study aimed to elucidate the patterns and clinical feasibility of the oral microbiome in CRS diagnosis. Matched saliva and nasal swabs were collected from 18 CRS patients and 37 saliva specimens from normal volunteers were collected for 16S rRNA sequencing. The α-diversity of the saliva displayed no significant difference between control and CRS patients, whereas the β-diversity was significantly different (p = 0.004). Taxonomic indices demonstrated that Veillonella dispar, Rothia mucilaginosa, and Porphyromonas endodontalis were enriched, while Campylobacter and Cardiobacterium were reduced in the saliva of CRS patients. These microbial markers could significantly distinguish CRS patients from control (AUC = 0.939). It is noted that the 16S rRNA results of the nasal swab were consistent with the nasopharynx aerobic culture, and additionally detected multiple pathogens in CRS patients. In summary, these results indicated these oral microbiomes may provide a novel signal for CRS detection and that NGS may be an alternative approach for CRS diagnosis.

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HACEK infective endocarditis: Epidemiology, clinical features, and outcome: A case–control study

Abstract: HACEK-IE represented 1.3% of all IE cases. Clinical features and outcomes were comparable to those of the VGS-IE control group. Despite the trend towards a larger vegetation size, the embolic event rate was not higher and the 1-year mortality was significantly lower for HACEK-IE.

Cited by 22 publications

References 20 publications

Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

An Unusual Case of Neisseria flavescens/subflava Group Tricuspid Valve Endocarditis in a Patient With Previously Treated Methicillin-Resistant Staphylococcus aureus Endocarditis

Clinical Detection of Chronic Rhinosinusitis through Next-Generation Sequencing of the Oral Microbiota

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