Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis. - Archive ouverte HAL Access content directly
Journal Articles Clinical Infectious Diseases Year : 2008

Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis.

Vivian H Chu
  • Function : Author
Christopher W Woods
  • Function : Author
Jose M Miro
  • Function : Author
Christopher H Cabell
  • Function : Author
Paul A Pappas
  • Function : Author
Jerome Federspiel
  • Function : Author
Eugene Athan
  • Function : Author
Martin E Stryjewski
  • Function : Author
Francisco Nacinovich
  • Function : Author
Francesc Marco
  • Function : Author
Donald P Levine
  • Function : Author
Tom S Elliott
  • Function : Author
Claudio Q Fortes
  • Function : Author
Pilar Tornos
  • Function : Author
David L Gordon
  • Function : Author
Riccardo Utili
  • Function : Author
François Delahaye
  • Function : Author
  • PersonId : 962120
G Ralph Corey
  • Function : Author
Vance G Fowler
  • Function : Author
Non Renseigné
  • Function : Author

Abstract

BACKGROUND: Coagulase-negative staphylococci (CoNS) are an infrequent cause of native valve endocarditis (NVE), and our understanding of NVE caused by CoNS is incomplete. METHOD: The International Collaboration on Endocarditis-Prospective Cohort Study includes patients with endocarditis from 61 centers in 28 countries. Patients with definite cases of NVE caused by CoNS who were enrolled during the period June 2000-August 2006 were compared with patients with definite cases of NVE caused by Staphylococcus aureus and patients with NVE caused by viridans group streptococci. Multivariable logistic regression was used to determine factors associated with death in patients with NVE caused by CoNS. RESULTS: Of 1635 patients with definite NVE and no history of injection drug use, 128 (7.8%) had NVE due to CoNS. Health care-associated infection occurred in 63 patients (49%) with NVE caused by CoNS. Comorbidities, long-term intravascular catheter use, and history of recent invasive procedures were similar among patients with NVE caused by CoNS and among patients with NVE caused by S. aureus. Surgical treatment for endocarditis occurred more frequently in patients with NVE due to CoNS (76 patients [60%]) than in patients with NVE due to S. aureus (150 [33%]; P=.01) or in patients with NVE due to viridans group streptococci (149 [44%]; P=.01). Despite the high rate of surgical procedures among patients with NVE due to CoNS, the mortality rates among patients with NVE due to CoNS and among patients with NVE due to S. aureus were similar (32 patients [25%] and 124 patients [27%], respectively; P=.44); the mortality rate among patients with NVE due to CoNS was higher than that among patients with NVE due to viridans group streptococci (24 [7.0%]; P=.01). Persistent bacteremia (odds ratio, 2.65; 95% confidence interval, 1.08-6.51), congestive heart failure (odds ratio, 3.35; 95% confidence interval, 1.57-7.12), and chronic illness (odds ratio, 2.86; 95% confidence interval, 1.34-6.06) were independently associated with death in patients with NVE due to CoNS (c index, 0.73). CONCLUSIONS: CoNS have emerged as an important cause of NVE in both community and health care settings. Despite high rates of surgical therapy, NVE caused by CoNS is associated with poor outcomes.

Dates and versions

hal-00465362 , version 1 (19-03-2010)

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Vivian H Chu, Christopher W Woods, Jose M Miro, Bruno Hoen, Christopher H Cabell, et al.. Emergence of coagulase-negative staphylococci as a cause of native valve endocarditis.. Clinical Infectious Diseases, 2008, 46 (2), pp.232-42. ⟨10.1086/524666⟩. ⟨hal-00465362⟩
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