Streptococcus agalactiae infective endocarditis: analysis of 30 cases and review of the literature, 1962-1998.
We describe 30 cases (1.7%) of community-acquired penicillin-susceptible Streptococcus agalactiae endocarditis among 1771 episodes of endocarditis diagnosed in 4 Spanish hospitals from 1975 through 1998. Endocarditis affected a native valve (most often the mitral valve) in 25 cases (83%). Surgical valve replacement was performed for 12 patients (40%). Fourteen patients (47%) died. Mortality rates for patients with native and prosthetic valve endocarditis were 36% and 100%, respectively (P=.01). The mortality rate for native valve endocarditis decreased during the last 6 years of the study (from 61% in 1975-1992 to 8% in 1993-1998; P<.05). Additionally, 115 cases in the literature from 1962-1998 were reviewed. During 1980-1998, the percentage of patients who underwent cardiac surgery increased from 24% (in the previous period, 1962-1979) to 43% (P=.05) and the mortality rate decreased from 45% to 34% (P=NS). S. agalactiae is an uncommon cause of endocarditis with a high mortality rate, although the prognosis of native valve endocarditis has improved in recent years, probably because of an increased use of cardiac surgery.
Sambola
A
A
Hospital Clinic-Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, E-08036-Barcelona, Spain.
Miro
J M
JM
Tornos
M P
MP
Almirante
B
B
Moreno-Torrico
A
A
Gurgui
M
M
Martinez
E
E
Del Rio
A
A
Azqueta
M
M
Marco
F
F
Gatell
J M
JM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013292:Streptococcus agalactiae; D016019:Survival Analysis; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents