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Non-HACEK gram-negative bacilli infective endocarditis: data from a retrospective German cohort study.
Juliane Dörfler1, Herko Grubitzsch2,3, Matthias Schneider-Reigbert4,3,5
1Department of Infectious Diseases, Respiratory Medicine and Critical Care, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Infection
|September 19, 2024
Summary
Infective endocarditis caused by non-HACEK gram-negative bacilli (GNB-IE) is rare but deadly, affecting elderly patients with comorbidities. Management strategies are limited, with high complication and mortality rates observed in this study.
Area of Science:
- Infectious Diseases
- Cardiology
- Internal Medicine
Background:
- Infective endocarditis caused by non-HACEK gram-negative bacilli (GNB-IE) is uncommon but carries substantial morbidity and mortality.
- Optimal treatment and management strategies for GNB-IE remain poorly defined due to limited evidence.
Purpose of the Study:
- To characterize the clinical features and management of patients diagnosed with GNB-IE.
- To identify factors associated with disease acquisition and adverse outcomes in GNB-IE patients.
Main Methods:
- A retrospective, single-center descriptive study was conducted from 2015 to 2021.
- Adult patients with definite GNB-IE were included, with analysis of demographic, clinical, and microbiological data.
- Predisposing factors, clinical outcomes, and one-year mortality were specifically investigated.
Main Results:
- Nineteen patients with definite GNB-IE were identified, with a median age of 69 years and high comorbidity scores.
- Nosocomial acquisition was noted in 42% of cases, with Escherichia coli and Klebsiella pneumoniae being the most frequent pathogens.
- High rates of complications (74%) and mortality (21% in-hospital, 44% at one year) were observed.
Conclusions:
- GNB-IE predominantly affects elderly individuals with significant comorbidities and healthcare exposure.
- The condition is associated with a high incidence of complications and a substantial mortality rate.
- Further research is needed to establish optimal management guidelines for GNB-IE.
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