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Beta-Hemolytic Streptococcal Infective Endocarditis: Characteristics and Outcomes From a Large, Multinational Cohort

Núria Fernández Hidalgo1, Amal A Gharamti2, María Luisa Aznar1

  • 1Hospital Universitari Vall d'Hebron, Barcelona, Spain.

Open Forum Infectious Diseases
|May 29, 2020
PubMed

Insights

Beta-hemolytic streptococci infective endocarditis (IE) presents acutely with a higher risk of stroke and mortality compared to viridans streptococci IE. Implantable cardiac devices are a more frequent predisposing factor in BHS IE.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Microbiology

Background:

  • Beta-hemolytic streptococci (BHS) are an infrequent cause of infective endocarditis (IE).
  • Understanding BHS IE clinical features and outcomes is crucial for patient management.

Purpose of the Study:

  • To describe the clinical characteristics and outcomes of patients with BHS IE.
  • To compare BHS IE with viridans streptococcal IE (VGS IE) in a large multinational cohort.

Main Methods:

  • Prospective cohort study using the International Collaboration on Endocarditis Prospective Cohort Study (ICE-PCS) database.
  • Inclusion of 1336 definite cases of streptococcal IE across 64 sites in 28 countries.
  • Standardized data collection using a common case report form.

Main Results:

  • 147 cases of BHS IE and 823 cases of VGS IE were identified.
  • BHS IE patients showed higher rates of native valve disease, congenital heart disease, and implantable cardiac device predisposition.
  • BHS IE was associated with acute presentation, fever, stroke, systemic emboli, and significantly higher in-hospital mortality compared to VGS IE.

Conclusions:

  • BHS IE presents acutely with increased risks of stroke, systemic emboli, and in-hospital mortality compared to VGS IE.
  • Implantable cardiac devices are a more common predisposing factor in BHS IE.
  • These findings highlight distinct clinical profiles and outcomes for BHS IE.
Abstract

Keywords:
International Collaboration on Endocarditisbeta-hemolytic streptococcicardiac devicescongestive heart failureinfective endocarditis

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