Clinical Features and Outcomes of <i>Streptococcus anginosus</i> Group Infective Endocarditis: A Multicenter Matched Cohort Study.

F Escrihuela-Vidal, LE López-Cortés, L Escolà-Vergé, Alarcón González A De, G Cuervo, A Sánchez-Porto, N Fernández-Hidalgo, R Luque, M Montejo, de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) Cohort Investigators and the Barcelona Endocarditis Study Team (BEST) Grupo, Natividad Benito

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Background: Although Streptococcus anginosus group (SAG) endocarditis is considered a severe disease associated with abscess formation and embolic events, there is limited evidence to support this assumption.

Methods: We performed a retrospective analysis of prospectively collected data from consecutive patients with definite SAG endocarditis in 28 centers in Spain and Italy. A comparison between cases due to SAG endocarditis and viridans group streptococci (VGS) or Streptococcus gallolyticus group (SGG) was performed in a 1:2 matched analysis.

Results: Of 5336 consecutive cases of definite endocarditis, 72 (1.4%) were due to SAG and matched with 144 cases due to VGS/SGG. SAG endocarditis was community acquired in 64 (88.9%) cases and affected aortic native valve in 29 (40.3%). When comparing SAG and VGS/SGG endocarditis, no significant differences were found in septic shock (8.3% vs 3.5%, P  = .116); valve disorder, including perforation (22.2% vs 18.1%, P  = .584), pseudoaneurysm (16.7% vs 8.3%, P  = .108), or prosthesis dehiscence (1.4% vs 6.3%, P  = .170); paravalvular complications, including abscess (25% vs 18.8%, P  = .264) and intracardiac fistula (5.6% vs 3.5%, P  = .485); heart failure (34.7% vs 38.9%, P  = .655); or embolic events (41.7% vs 32.6%, P  = .248). Indications for surgery (70.8% vs 70.8%; P  = 1) and mortality (13.9% vs 16.7%; P  = .741) were similar between groups.

Conclusions: SAG endocarditis is an infrequent but serious condition that presents a prognosis similar to that of VGS/SGG.

Original languageEnglish
Pages (from-to)ofab163
JournalOpen Forum Infectious Diseases
Issue number6
Publication statusPublished - 29 Mar 2021


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