ArticlePloS one2013
HACEK infective endocarditis: characteristics and outcomes from a large, multi-national cohort.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers, 1 of them a synthesis that pooled it.
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Who cites it
97 citing papers in PubMed, 1 synthesis or guideline pooled it, 233 citations in OpenAlex.
- Prophylactic antibiotic use for infective endocarditis: a systematic review and meta-analysis.BMJ open · 2023Pooled it
- Endocarditis Masquerading as Malignancy: Native Valve HACEK Infection.JACC. Case reports · 2026Article
- Deep Tracking Neck Abscesses, Mediastinitis, and Deep Vein Thrombosis Caused byClinical case reports · 2026Article
- Aggregatibacter aphrophilus bacteraemia with suspected infective endocarditis in a patient with bioprosthetic aortic valve replacement and atrial septal defect repair.Access microbiology · 2026Article
- Clinical Characteristics, Microbiology, and In-Hospital Outcomes of Infective Endocarditis at a Tertiary Cardiac Center in Saudi Arabia: A Retrospective Cohort Study.Journal of the Saudi Heart Association · 2026Article
- Beyond typical pathogens: pleural empyema caused byRespiratory research & clinical practice · 2026Article
- Fastidious or rarely isolated gram-negative rods with a particular focus onClinical microbiology reviews · 2025Review
- Metagenomic insights into microbial community alterations and co-occurrence networks in infective endocarditis.Genomics & informatics · 2025Article
- Article
- Advances and Prospects in the Diagnosis and Treatment of Blood Culture-Negative Infective Endocarditis.Reviews in cardiovascular medicine · 2025Review
- The Evolving Landscape of Infective Endocarditis: Difficult-to-Treat Resistance Bacteria and Novel Diagnostics at the Foreground.Journal of clinical medicine · 2025Review
- [Infective endocarditis caused byRevista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Article
- Diagnosing Prosthetic Valve Endocarditis Despite a Negative Work-Up.JACC. Case reports · 2024Article
- Infective Endocarditis in Patients with End-Stage Renal Disease on Dialysis: Epidemiology, Risk Factors, Diagnostic Challenges, and Management Approaches.Healthcare (Basel, Switzerland) · 2024Review
- Emerging and Re-Emerging Pathogens in Valvular Infective Endocarditis: A Review.Pathogens (Basel, Switzerland) · 2024Review
- Article
- The Brief Case:Journal of clinical microbiology · 2024Review
- An unusual presentation of subacute Haemophilus parainfluenzae endocarditis in a low-risk woman treated by minimally invasive mitral valve repair: a case report.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2024Article
- Article
- The Trimeric Autotransporter Adhesin EmaA and Infective Endocarditis.Pathogens (Basel, Switzerland) · 2024Review
37 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
24 authors at 18 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The HACEK organisms (Haemophilus species, Aggregatibacter species, Cardiobacterium hominis, Eikenella corrodens, and Kingella species) are rare causes of infective endocarditis (IE). The objective of this study is to describe the clinical characteristics and outcomes of patients with HACEK endocarditis (HE) in a large multi-national cohort. Patients hospitalized with definite or possible infective endocarditis by the International Collaboration on Endocarditis Prospective Cohort Study in 64 hospitals from 28 countries were included and characteristics of HE patients compared with IE due to other pathogens. Of 5591 patients enrolled, 77 (1.4%) had HE. HE was associated with a younger age (47 vs. 61 years; p<0.001), a higher prevalence of immunologic/vascular manifestations (32% vs. 20%; p<0.008) and stroke (25% vs. 17% p = 0.05) but a lower prevalence of congestive heart failure (15% vs. 30%; p = 0.004), death in-hospital (4% vs. 18%; p = 0.001) or after 1 year follow-up (6% vs. 20%; p = 0.01) than IE due to other pathogens (n = 5514). On multivariable analysis, stroke was associated with mitral valve vegetations (OR 3.60; CI 1.34-9.65; p<0.01) and younger age (OR 0.62; CI 0.49-0.90; p<0.01). The overall outcome of HE was excellent with the in-hospital mortality (4%) significantly better than for non-HE (18%; p<0.001). Prosthetic valve endocarditis was more common in HE (35%) than non-HE (24%). The outcome of prosthetic valve and native valve HE was excellent whether treated medically or with surgery. Current treatment is very successful for the management of both native valve prosthetic valve HE but further studies are needed to determine why HE has a predilection for younger people and to cause stroke. The small number of patients and observational design limit inferences on treatment strategies. Self selection of study sites limits epidemiological inferences.
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