Department of Infectious Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
Department of Microbiology, Zhongshan Hospital, Fudan University, Shanghai, China.
BMC Infect Dis. 2024 Sep 20;24(1):1022. doi: 10.1186/s12879-024-09943-4.
Abiotrophia (ABI) and Granulicatella (GRA) are rare causative pathogens in infective endocarditis (IE). This study aims to describe the epidemiology, clinical characteristics, and outcome of ABI/GRA-IE. The main features of ABI/GRA-IE were compared with Viridans group streptococci (VGS) IE.
From January 2015 to December 2023, a total of 1531 definite IE in Zhongshan Hospital, Fudan University, Shanghai, China were retrospectively enrolled in this study. Clinical and laboratory data were collected.
Forty-five ABI/GRA-IE cases were identified, representing 2.9% of all IE cases in Zhongshan Hospital between 2015 and 2023, compared to 20.1% of VGS-IE. ABI and GRA IE shared similar clinical characteristics. Congenital valvulopathy was reported in 21 (46.7%) ABI/GRA-IE and 85 (28.8%) VGS-IE (P = 0.025). Pulmonary valve was more frequently affected in ABI/GRA-IE (6 [13.3%]) than VGS-IE (7 [2.4%]) (P = 0.002). Congestive heart failure was observed in 30 (66.7%) ABI/GRA-IE and 103 (34.9%) VGS-IE (P < 0.001). Systemic embolization excluding central nervous system (CNS) occurred in 13 (28.9%) ABI/GRA-IE and 39 (13.2%) VGS-IE (P = 0.012). In-hospital mortality was reported as 4.4% in ABI/GRA-IE and 3.7% in VGS-IE (P = 0.854).
GRA/ABI-IE was approximately one-seventh as prevalent as VGS-IE. Congestive heart failure and systemic embolization (excluding CNS) were more frequent in GRA/ABI-IE compared to VGS-IE. Mortality of ABI/GRA-IE in this study was comparable to that of VGS-IE and lower than previously reported results.
嗜养颗粒菌（ABI）和金氏菌属（GRA）是感染性心内膜炎（IE）少见的致病病原体。本研究旨在描述 ABI/GRA-IE 的流行病学、临床特征和结局。比较 ABI/GRA-IE 的主要特征与草绿色链球菌（VGS）IE。
2015 年 1 月至 2023 年 12 月，回顾性纳入复旦大学附属中山医院的 1531 例明确诊断的 IE。收集临床和实验室数据。
共发现 45 例 ABI/GRA-IE，占 2015 年至 2023 年中山医院 IE 病例的 2.9%，而 VGS-IE 占 20.1%。ABI 和 GRA IE 具有相似的临床特征。21 例（46.7%）ABI/GRA-IE 和 85 例（28.8%）VGS-IE 存在先天性瓣膜病（P=0.025）。ABI/GRA-IE 中更常累及肺动脉瓣（6[13.3%]）而非 VGS-IE（7[2.4%]）（P=0.002）。30 例（66.7%）ABI/GRA-IE 和 103 例（34.9%）VGS-IE 存在充血性心力衰竭（P<0.001）。13 例（28.9%）ABI/GRA-IE 和 39 例（13.2%）VGS-IE 发生除中枢神经系统（CNS）以外的全身栓塞（P=0.012）。ABI/GRA-IE 住院死亡率为 4.4%，VGS-IE 为 3.7%（P=0.854）。
GRA/ABI-IE 约为 VGS-IE 的七分之一。与 VGS-IE 相比，GRA/ABI-IE 更常出现充血性心力衰竭和全身栓塞（不包括 CNS）。本研究中 ABI/GRA-IE 的死亡率与 VGS-IE 相当，且低于既往报道结果。
