Characteristics and prognosis of pneumococcal endocarditis: a case-control study

Magalie Daudin (1, 2) , Pierre Tattevin (3, 4, 5) , Bernard Lelong (2) , Erwan Flécher (1, 2) , Sylvain Lavoué (6) , Caroline Piau (6) , Anne Ingels (2) , Anthony Chapron (6) , Jean-Claude Daubert (7, 8) , Matthieu Revest (5, 3, 6)

1 CIC-IT Rennes
2 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
3 CIC - Centre d'Investigation Clinique [Rennes]
4 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
5 Fonction, structure et inactivation d'ARN bactériens
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
8 LTSI - Laboratoire Traitement du Signal et de l'Image

Case series have suggested that pneumococcal endocarditis is a rare disease, mostly reported in patients with comorbidities but no underlying valve disease, with a rapid progression to heart failure, and high mortality. We performed a case-control study of 28 patients with pneumococal endocarditis (cases), and 56 patients with non-pneumococcal endocarditis (controls), not matched on sex and age, during years 1991-2013, in one referral center. Alcoholism (39.3% vs. 10.7%; P<.01), smoking (60.7% vs. 21.4%%; P<.01), the absence of previously known valve disease (82.1% vs. 60.7%; P=0.047), heart failure (64.3% vs. 23.2%; P<.01), and shock (53.6% vs. 23.2%; P<.01) were more common in pneumococcal than in non-pneumococcal endocarditis. Cardiac surgery was required in 64.3% of patients with pneumococcal endocarditis, much earlier than in patients with non-pneumococcal endocarditis (mean time from symptoms onset, 14.1 ± 18.2 vs. 69.0 ± 61.1 days). In-hospital mortality rates were similar (7.1% vs. 12.5%). Streptococcus pneumoniae causes rapidly progressive endocarditis requiring life-saving early cardiac surgery in most cases

Mots clés: Streptococcus pneumoniae; Cardiac surgery; Heart failure; Case-control study

Domaines: Cardiologie et système cardiovasculaire; Maladies infectieuses

Magalie Daudin, Pierre Tattevin, Bernard Lelong, Erwan Flécher, Sylvain Lavoué, et al.. Characteristics and prognosis of pneumococcal endocarditis: a case-control study. Clinical Microbiology and Infection, 2016, 22 (6), pp.572.e5-572.e8. ⟨10.1016/j.cmi.2016.03.011⟩. ⟨hal-01295663⟩