title: Reduction in incidence of Q fever endocarditis: 27 years of experience of a national reference center.
abstract: OBJECTIVE
  We conducted an observational study to evaluate the impact of our antibioprophylaxis protocols implemented in 2000, on the incidence of Q fever endocarditis diagnosed in our French reference center between 1985 and 2011.
  
  
  METHODS
  Endocarditis was diagnosed according to modified Duke Criteria, serological and PCR results. Our prophylaxis recommendations consist of a systematic echocardiography and an antibioprophylaxis in patients with acute Q fever and risk factors for developing endocarditis.
  
  
  RESULTS
  Over the last 27 years, we diagnosed 4231 acute Q fever and 818 endocarditis. Despite a significantly increased number of acute Q fever diagnoses and the use of systematic PCR testing of valves allowing serendipitous Q fever endocarditis diagnoses, we observed a decline of Q fever endocarditis. The number of cases has decreased from 316, which represents 18% of newly diagnosed cases of Q fever between 1998 and 2004, to 225, which corresponds to 11% of the cases diagnosed between 2005 and 2011.
  
  
  CONCLUSIONS
  We believe that this decrease was a result of our strategies for prophylaxis. If this assumption is true, we may have prevented more than 150 cases of Q fever endocarditis in France over the past 10 years.
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD198, Inserm 1095, 13005 Marseille Cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Edouard
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD198, Inserm 1095, 13005 Marseille Cedex, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Million
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD198, Inserm 1095, 13005 Marseille Cedex, France.
authors.forename: Guilhem
authors.initials: G
authors.lastname: Royer
authors.affiliation: UMR 912 SESSTIM, Inserm, IRD, Aix-Marseille Université, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille Cedex, France.
authors.forename: Roch
authors.initials: R
authors.lastname: Giorgi
authors.affiliation: Service de Chirurgie Cardiaque, Hôpital de la Timone, Marseille Cedex, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Grisoli
authors.affiliation: Aix Marseille Université, URMITE, UM63, CNRS 7278, IRD198, Inserm 1095, 13005 Marseille Cedex, France. Electronic address: didier.raoult@gmail.com.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood; D016208:Databases, Factual; D004697:Endocarditis, Bacterial / Q000453:epidemiology* / Q000276:immunology; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000276:immunology; D011778:Q Fever / Q000453:epidemiology* / Q000276:immunology; D012189:Retrospective Studies
chemical_list: D000907:Antibodies, Bacterial
keywords: Antibioprophylaxis; Coxiella burnetii; Endocarditis; Q fever; Reference center