Non-HACEK gram negative bacilli endocarditis: Analysis of a national prospective cohort

•Non-HACEK endocarditis affects elderly patients with high comorbidity.•There are difference between Enterobacterales and NF-GNB cases.•Advanced age and prosthetic valve confer a worse prognosis.•Surgery may not be indicated in all cases. Infective endocarditis (IE) due to non-HACEK bacilli (Haemophilus species, Actinobacillus, Cardiobacterium, Eikenella, or Kingella) is uncommon and poorly described. The objectives of this study were to describe non-HACEK Gram-Negative Bacilli (GNB) IE cases and compare characteristic of IE produced by Enterobacterales and non-fermenting (NF) GNB. From January 2008 to December 2018, 3910 consecutive patients with definitive IE diagnosis, defined with Modified Duke criteria, either clinical or pathological criteria (e.g. demonstration of non-HACEK GNB in valve culture)were prospectively included. A total of 104 IE cases were caused by non-HACEK GNB (2.6%). Compared to IE due to other microorganisms (excluding HACEK GNB), patients with non-HACEK GNB IE presented with higher age (71 years [IQR 62–78] vs 68 years [IQR: 57–77]; p = 0.026), higher proportion of women (52% vs 31.5%, p