Division of Infection Medicine, Department of Clinical Sciences, Lund, Lund University, BMC B14, SE-221 84, Lund, Sweden.
Department of Infectious Diseases, Skåne University Hospital, Lund, Sweden.
Eur J Clin Microbiol Infect Dis. 2021 Sep;40(9):1919-1924. doi: 10.1007/s10096-021-04240-3. Epub 2021 Apr 14.
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.
由嗜血杆菌（不包括流感嗜血杆菌）、Aggregatibacter、心杆菌、爱肯菌和金氏菌（HACEK）引起的感染性心内膜炎（IE）较为罕见。本研究旨在描述 HACEK 属引起的 IE 的临床特征，并与其他病原体引起的 IE 进行比较。通过瑞典感染性心内膜炎登记处（SRIE）确定 HACEK 引起的 IE 病例。将 HACEK 引起的 IE 病例的临床特征与同一登记处报告的其他病原体引起的 IE 病例进行比较。确定了 96 例由 HACEK 引起的 IE 患者，占所有 IE 病例的 1.8%。83 例为明确的心内膜炎，死亡率为 2%。中位年龄为 63 岁，低于其他病原体引起的 IE 患者（分别为 66、70 和 73 岁，p ≤ 0.01）。与由 Aggregatibacter 引起的 IE 患者相比，由 Haemophilus 引起的 IE 患者更年轻（47 岁比 67 岁，p ≤ 0.001）。与金黄色葡萄球菌引起的 IE 患者相比，由 HACEK 引起的 IE 患者的症状发作至住院的时间更长，且更多为人工瓣膜心内膜炎（10 天比 2 天，p ≤ 0.001，以及 35%比 14%，p ≤ 0.001）。这是迄今为止关于 HACEK 引起的 IE 的最大研究。Aggregatibacter 是该组中最常见的 IE 病因。该病呈亚急性发病，常发生于人工瓣膜患者，死亡率相对较低。
