title: Native-valve infective endocarditis caused by Enterobacteriaceae: report on 9 cases and literature review.
abstract: Although the demographic characteristics of patients who develop infective endocarditis (IE) have changed over the last few decades, Enterobacteriaceae remain rarely responsible. We report the clinical and epidemiological characteristics of 9 patients with native-valve Enterobacteriaceae IE from 6 French medical intensive care units over a 10-y period and have identified 29 additional cases in the literature. Nearly a third of the 38 patients were immunocompromised and/or had previously known valvular heart disease. Salmonella spp. and Yersinia spp. were the most frequently isolated microorganisms reported in the literature. The overall mortality rate was 24% (9/38) and was lower for operated patients (10% (1/10)) compared to those who did not undergo valve surgery (31% (8/26)). Our results confirmed the rarity of native-valve endocarditis caused by Enterobacteriaceae, pathogens frequently responsible for nosocomial and community-acquired bacteraemias. This paradox may be explained by susceptibility to the bactericidal action of serum and the inability of these bacteria to colonize the endocardium.
authors.affiliation: Service de Réanimation Médicale et des Maladies Infectieuses, Hôpital Bichat-Claude-Bernard, AP-HP, Paris. c.aubron@free.fr
authors.forename: Cecile
authors.initials: C
authors.lastname: Aubron
authors.forename: Julien
authors.initials: J
authors.lastname: Charpentier
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Trouillet
authors.forename: Georges
authors.initials: G
authors.lastname: Offenstadt
authors.forename: Alain
authors.initials: A
authors.lastname: Mercat
authors.forename: Gilles
authors.initials: G
authors.lastname: Bernardin
authors.forename: Herve
authors.initials: H
authors.lastname: Hyvernat
authors.forename: Michel
authors.initials: M
authors.lastname: Wolff
mesh_terms: D000328:Adult; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged