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Understanding HACEK Organisms: Characteristics and Infections

A brief overview of HACEK organisms, their common traits, and potential infections they can cause, including endocarditis. Learn about specific members like H. parainfluenzae, A. actinomycetecomitans, and more.

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Understanding HACEK Organisms: Characteristics and Infections

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  1. A Brief Synopsis of “HACEK” organisms Michael Addidle

  2. HACEK ORGANISMS • H-H. parainfluenzae • A-Aggregatibacter actinomycetecomitans • - Aggregatibacter aphrophilus and paraphrophilus. • C-Cardiobacterium hominus • E-Eikenella corrodens • K-Kingella species

  3. What do HACEK organisms have in common? • Gram negative • Commensals in oropharyngeal area • Relatively fastidious • Prefer CO2 enriched atmosphere • All have a propensity to cause endocarditis, usually secondary to rotten teeth or recent dental treatment or combination of both. • Endocarditis- long interval between first symptoms and dx. • Frequent embolisation • May be large vegetations on left sided valves. • Can all cause non-endocardial infections also.

  4. Haemophilus parainfluenzae • H. aphrophilus and H. paraphrophilus have moved • Cause endocarditis more commonly than H. influenzae but all endocarditis caused by Haemophilus is rare.

  5. A-Aggregatibacter actinomycetecomitans • Common cause of periodontitis • Most endocarditis caused by this bacteria have underlying heart disease. • Star-shaped colonies

  6. Cardiobacterium hominis • In contrast to other members of the group, almost exclusively associated with endocarditis • May also be commensal of GI tract • Characteristic Gram stain: bulbous ends and irregular staining. May have a rosette pattern. .

  7. Eikenella corrodens • Oral commensal. May implicated in bite infections. • May cause infections at several different sites within the body. • Slightly yellow colonies after a few days • Bleach like odour • Pit into agar. • Beta-lactamase strains are not infrequent.

  8. Eikenella corrodens

  9. Kingella species • K. kingae, K dentrificans, K.oralis, K. potus • Square ends, uneven decolorisation on Gram stain. • May be mildly haemolytic on blood agar • Colonise pharynx of many children 6 months to 4 years. • Common cause of septic arthritis in this age group. • Infections in adults usually in immunocompromised. • Injection of aspirate into BC media improves detection rates.

  10. Kingella species

  11. Kingella species

  12. Molecular detection • In modern blood culture systems, HACEK organsims grow within 5 days. • 16s PCR • Most useful for heart valves • May also be useful for negative blood cultures where high index of suspicion.

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