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  • Title: Reduction in incidence of Q fever endocarditis: 27 years of experience of a national reference center.
    Author: Edouard S, Million M, Royer G, Giorgi R, Grisoli D, Raoult D.
    Journal: J Infect; 2014 Feb; 68(2):141-8. PubMed ID: 24183890.
    Abstract:
    OBJECTIVES: 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. CONCLUSION: 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.
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