Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis

BMC Infectious Diseases

Bahareh Ghadaki¹  Anjali Shroff²  Dominik Mertz²  Peter Daley³  Torrance Oravec⁴  Liam Matthews⁵  Jennifer Leigh⁶  S. Annie Oravec⁷ 

[1] Division of Infectious Diseases, Department of Medicine, Halton Healthcare, Oakville, ON, Canada;Division of Infectious Diseases, Department of Medicine, McMaster University, Hamilton, ON, Canada;Division of Infectious Diseases, Department of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada;Division of Infectious Diseases, Department of Medicine, University of British Columbia, 328C Heather Pavilion E, 2733 Heather St. Vancouver, V5Z 3J5, Vancouver, BC, Canada;Division of Internal Medicine, Department of Medicine, Memorial University of Newfoundland, St. John’s, NL, Canada;Division of Internal Medicine, Department of Medicine, University of Ottawa, Ottawa, ON, Canada;Division of Respirology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada;

关键词: Streptococcus agalactiae;    Streptococcus;    Infective endocarditis;    Case control;    Retrospective;   

DOI  :  10.1186/s12879-021-06997-6

来源: Springer

【 摘 要 】

BackgroundInfective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly reported and associated with an aggressive course and high mortality rate. Existing literature on GBS IE is limited to case series; we compared the characteristics of patients with GBS IE to patients with GBS bacteremia without IE to identify risk factors for development of IE.MethodsA nested case–control study in a cohort of adult patients with GBS bacteremia over a 18-year period was conducted across seven centres in three Canadian cities. A chart review identified patients with possible or definite IE (per Modified Duke Criteria) and patients with IE were matched to those without endocarditis in a 1:3 fashion. Multivariate analyses were completed using logistic regression.ResultsOf 520 patients with GBS bacteremia, 28 cases of possible or definite IE were identified (5.4%). 68% (19/28) met criteria for definite IE, surgery was performed in 29% (8/28), and the overall in-hospital mortality rate was 29% (8/28). Multivariate analysis demonstrated that IE was associated with injection drug use (OR = 19.6, 95% CI = 3.39–111.11, p = 0.001), prosthetic valve (OR = 11.5, 95% CI = 1.73–76.92, p = 0.011) and lack of identified source of bacteremia (OR = 3.81, 95% CI = 1.24–11.65, p = 0.019).ConclusionsGBS bacteremia, especially amongst people who inject drugs, those with prosthetic valves, and those with no apparent source of infection, should increase clinical suspicion for IE.

【 授权许可】

CC BY