Abstract：
Streptococcus bovis/equinus complex (SBEC) is a major cause of infective endocarditis (IE), although its incidence varies greatly depending on the geographical area. The characteristics of IE caused by Streptococcus gallolyticus susp. gallolyticus are well known; there are hardly any descriptions of IE caused by other species or biotypes.
Retrospective cohort study, from 1990 to 2019, of all SBEC IE in adults in three Spanish hospitals, Lugo (LH), Barcelona (BH) and Ferrol (FH) where the population is mainly rural, urban and mixed, respectively. The incidence of IE was analyzed in 3 areas. Clinical characteristics of IE (277 cases, 258 biotyped) were compared according to SBEC species and biotypes.
There are significant differences between the incidence of SBEC IE in HL (27.9/106) vs. HF and HB (8.8 and 7,1, respectively, p<0.001). We found significant differences (SbI vs. SbII) in mean age (68.5 vs. 73 years; p<0.01), duration of symptoms before diagnosis (46.9±46.5 vs. 30.4±40.9 days; p<0.01), presence of comorbidities: 39.1% (78) vs. 54.2% (32; p<0.04), predisposing heart illness:62.3% (124) vs. 81.3% (48; p<0.006), particularly, prosthetic or intravascular devices IE: 24.6% (49) vs. 52.4% (31; p<0.001), bi-valve involvement:23.6% (47) vs. 11.8% (7; p<0.05) and heart failure: 24.6% (49) vs. 38.9% (23; p<0.03). There were no significant differences in embolic events, need for surgery or mortality. The association with CRC was high in both groups: 77.7% vs. 66.6%.
IE due to SBEC has geographical variations in incidence and different clinical characteristics among biotypes. The association with CRC was high.
Retrospective cohort study, from 1990 to 2019, of all SBEC IE in adults in three Spanish hospitals, Lugo (LH), Barcelona (BH) and Ferrol (FH) where the population is mainly rural, urban and mixed, respectively. The incidence of IE was analyzed in 3 areas. Clinical characteristics of IE (277 cases, 258 biotyped) were compared according to SBEC species and biotypes.
There are significant differences between the incidence of SBEC IE in HL (27.9/106) vs. HF and HB (8.8 and 7,1, respectively, p<0.001). We found significant differences (SbI vs. SbII) in mean age (68.5 vs. 73 years; p<0.01), duration of symptoms before diagnosis (46.9±46.5 vs. 30.4±40.9 days; p<0.01), presence of comorbidities: 39.1% (78) vs. 54.2% (32; p<0.04), predisposing heart illness:62.3% (124) vs. 81.3% (48; p<0.006), particularly, prosthetic or intravascular devices IE: 24.6% (49) vs. 52.4% (31; p<0.001), bi-valve involvement:23.6% (47) vs. 11.8% (7; p<0.05) and heart failure: 24.6% (49) vs. 38.9% (23; p<0.03). There were no significant differences in embolic events, need for surgery or mortality. The association with CRC was high in both groups: 77.7% vs. 66.6%.
IE due to SBEC has geographical variations in incidence and different clinical characteristics among biotypes. The association with CRC was high.
摘要：
背景：牛/马链球菌复合物（SBEC）是感染性心内膜炎（IE）的主要原因，尽管其发病率因地理区域而异。溶胆链球菌引起的IE的特征。胆囊是众所周知的；几乎没有任何由其他物种或生物型引起的IE的描述。
方法：回顾性队列研究，从1990年到2019年，在西班牙三家医院的所有成人SBECIE中，Lugo(LH),人口主要是农村的巴塞罗那（BH）和费罗尔（FH），城市和混合，分别。分析3个地区IE的发病率。IE的临床特点（277例，258个生物型）根据SBEC物种和生物型进行比较。
结果：HL中SBECIE的发生率（27.9/106）与HF和HB(分别为8.8和7.1，p<0.001)。我们发现显著差异(SbI与SbII）平均年龄（68.5vs.73岁；p<0.01)，诊断前症状持续时间（46.9±46.5vs.30.4±40.9天；p<0.01)，合并症的存在：39.1%（78）与54.2%(32；p<0.04)，诱发心脏病：62.3%（124）与81.3%（48；p<0.006），特别是,假肢或血管内装置IE：24.6%（49）vs.52.4%(31；p<0.001)，双瓣膜受累：23.6%（47）与11.8%（7；p<0.05）和心力衰竭：24.6%（49）vs.38.9%（23；p<0.03）。栓塞事件没有显着差异，需要手术或死亡。与CRC的相关性在两组中都很高：77.7％vs.66.6%。
结论：由SBEC引起的IE在发病率方面存在地理差异，并且在生物型之间具有不同的临床特征。与CRC的相关性很高。
方法：回顾性队列研究，从1990年到2019年，在西班牙三家医院的所有成人SBECIE中，Lugo(LH),人口主要是农村的巴塞罗那（BH）和费罗尔（FH），城市和混合，分别。分析3个地区IE的发病率。IE的临床特点（277例，258个生物型）根据SBEC物种和生物型进行比较。
结果：HL中SBECIE的发生率（27.9/106）与HF和HB(分别为8.8和7.1，p<0.001)。我们发现显著差异(SbI与SbII）平均年龄（68.5vs.73岁；p<0.01)，诊断前症状持续时间（46.9±46.5vs.30.4±40.9天；p<0.01)，合并症的存在：39.1%（78）与54.2%(32；p<0.04)，诱发心脏病：62.3%（124）与81.3%（48；p<0.006），特别是,假肢或血管内装置IE：24.6%（49）vs.52.4%(31；p<0.001)，双瓣膜受累：23.6%（47）与11.8%（7；p<0.05）和心力衰竭：24.6%（49）vs.38.9%（23；p<0.03）。栓塞事件没有显着差异，需要手术或死亡。与CRC的相关性在两组中都很高：77.7％vs.66.6%。
结论：由SBEC引起的IE在发病率方面存在地理差异，并且在生物型之间具有不同的临床特征。与CRC的相关性很高。
