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Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century : The International Collaboration on Endocarditis-Prospective Cohort Study

Identifieur interne : 008428 ( Main/Exploration ); précédent : 008427; suivant : 008429

Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century : The International Collaboration on Endocarditis-Prospective Cohort Study

Auteurs : David R. Murdoch [Nouvelle-Zélande] ; G. Ralph Corey [États-Unis] ; Bruno Hoen [France] ; José M. Miro [Espagne] ; Vance G. Jr Fowler [États-Unis] ; Arnold S. Bayer [États-Unis] ; Adolf W. Karchmer [États-Unis] ; Lars Olaison [Suède] ; Paul A. Pappas [États-Unis] ; Philippe Moreillon [Suisse] ; Stephen T. Chambers [Nouvelle-Zélande] ; Vivian H. Chu [États-Unis] ; Vicenc Falco [Espagne] ; David J. Holland [Nouvelle-Zélande] ; Philip Jones [Australie] ; John L. Klein [Royaume-Uni] ; Nigel J. Raymond [Nouvelle-Zélande] ; Kerry M. Read [Nouvelle-Zélande] ; Marie Francoise Tripodi [Italie] ; Riccardo Utili [Italie] ; Andrew Wang [États-Unis] ; Christopher W. Woods [États-Unis] ; Christopher H. Cabell [États-Unis]

Source :

RBID : Pascal:09-0127281

Descripteurs français

English descriptors

Abstract

Background: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. Methods: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. Results: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hall-marks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. Conclusions: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.

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<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="03">
<s1>Duke Clinical Research Institute</s1>
<s2>Durham</s2>
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<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Duke Clinical Research Institute</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Hoen, Bruno" sort="Hoen, Bruno" uniqKey="Hoen B" first="Bruno" last="Hoen">Bruno Hoen</name>
<affiliation wicri:level="3">
<inist:fA14 i1="04">
<s1>Departments of Infectious Diseases, Hôpital Saint-Jacques</s1>
<s2>Besancon</s2>
<s3>FRA</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Bourgogne-Franche-Comté</region>
<region type="old region">Franche-Comté</region>
<settlement type="city">Besançon</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Miro, Jose M" sort="Miro, Jose M" uniqKey="Miro J" first="José M." last="Miro">José M. Miro</name>
<affiliation wicri:level="3">
<inist:fA14 i1="05">
<s1>Hospital Clinic-Institut d'lnvestigacions Biomèdiques August Pi I Sunyer, University of Barcelona</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
<placeName>
<settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Fowler, Vance G Jr" sort="Fowler, Vance G Jr" uniqKey="Fowler V" first="Vance G. Jr" last="Fowler">Vance G. Jr Fowler</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Departments of Medicine, Duke University Medical Center</s1>
<s2>Durham, North Carolina</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>21 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="03">
<s1>Duke Clinical Research Institute</s1>
<s2>Durham</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Duke Clinical Research Institute</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Bayer, Arnold S" sort="Bayer, Arnold S" uniqKey="Bayer A" first="Arnold S." last="Bayer">Arnold S. Bayer</name>
<affiliation wicri:level="1">
<inist:fA14 i1="06">
<s1>Divisions of Infectious Diseases, University of California, Los Angeles, Harbor Medical Center</s1>
<s2>Torrance</s2>
<s3>USA</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Torrance</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Karchmer, Adolf W" sort="Karchmer, Adolf W" uniqKey="Karchmer A" first="Adolf W." last="Karchmer">Adolf W. Karchmer</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Departments of Medicine, Duke University Medical Center</s1>
<s2>Durham, North Carolina</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>21 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
<affiliation wicri:level="2">
<inist:fA14 i1="07">
<s1>Beth Israel-Deaconess Medical Center</s1>
<s2>Boston, Massachusetts</s2>
<s3>USA</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Massachusetts</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Olaison, Lars" sort="Olaison, Lars" uniqKey="Olaison L" first="Lars" last="Olaison">Lars Olaison</name>
<affiliation wicri:level="1">
<inist:fA14 i1="08">
<s1>Sahlgrenska University Hospital</s1>
<s2>Goteborg</s2>
<s3>SWE</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
<country>Suède</country>
<wicri:noRegion>Sahlgrenska University Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Pappas, Paul A" sort="Pappas, Paul A" uniqKey="Pappas P" first="Paul A." last="Pappas">Paul A. Pappas</name>
<affiliation wicri:level="1">
<inist:fA14 i1="03">
<s1>Duke Clinical Research Institute</s1>
<s2>Durham</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Duke Clinical Research Institute</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Moreillon, Philippe" sort="Moreillon, Philippe" uniqKey="Moreillon P" first="Philippe" last="Moreillon">Philippe Moreillon</name>
<affiliation wicri:level="3">
<inist:fA14 i1="09">
<s1>Centre Hospitalier Universitaire, University of Lausanne</s1>
<s2>Lausanne</s2>
<s3>CHE</s3>
<sZ>10 aut.</sZ>
</inist:fA14>
<country>Suisse</country>
<placeName>
<settlement type="city">Lausanne</settlement>
<region nuts="3" type="region">Canton de Vaud</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Chambers, Stephen T" sort="Chambers, Stephen T" uniqKey="Chambers S" first="Stephen T." last="Chambers">Stephen T. Chambers</name>
<affiliation wicri:level="1">
<inist:fA14 i1="01">
<s1>Department of Pathology, University of Otago</s1>
<s2>Christchurch</s2>
<s3>NZL</s3>
<sZ>1 aut.</sZ>
<sZ>11 aut.</sZ>
</inist:fA14>
<country>Nouvelle-Zélande</country>
<wicri:noRegion>Christchurch</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Chu, Vivian H" sort="Chu, Vivian H" uniqKey="Chu V" first="Vivian H." last="Chu">Vivian H. Chu</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Departments of Medicine, Duke University Medical Center</s1>
<s2>Durham, North Carolina</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>21 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Falco, Vicenc" sort="Falco, Vicenc" uniqKey="Falco V" first="Vicenc" last="Falco">Vicenc Falco</name>
<affiliation wicri:level="3">
<inist:fA14 i1="10">
<s1>Hospital Universitari Vall D'Hebron</s1>
<s2>Barcelona</s2>
<s3>ESP</s3>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
<placeName>
<settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Holland, David J" sort="Holland, David J" uniqKey="Holland D" first="David J." last="Holland">David J. Holland</name>
<affiliation wicri:level="1">
<inist:fA14 i1="11">
<s1>Middlemore Hospital</s1>
<s3>NZL</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Nouvelle-Zélande</country>
<wicri:noRegion>Middlemore Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Jones, Philip" sort="Jones, Philip" uniqKey="Jones P" first="Philip" last="Jones">Philip Jones</name>
<affiliation wicri:level="3">
<inist:fA14 i1="12">
<s1>University of New South Wales</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
<country>Australie</country>
<placeName>
<settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Klein, John L" sort="Klein, John L" uniqKey="Klein J" first="John L." last="Klein">John L. Klein</name>
<affiliation wicri:level="3">
<inist:fA14 i1="13">
<s1>Department of Infection, St Thomas' Hospital</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Raymond, Nigel J" sort="Raymond, Nigel J" uniqKey="Raymond N" first="Nigel J." last="Raymond">Nigel J. Raymond</name>
<affiliation wicri:level="1">
<inist:fA14 i1="14">
<s1>Wellington Hospital</s1>
<s2>Wellington</s2>
<s3>NZL</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Nouvelle-Zélande</country>
<wicri:noRegion>Wellington Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Read, Kerry M" sort="Read, Kerry M" uniqKey="Read K" first="Kerry M." last="Read">Kerry M. Read</name>
<affiliation wicri:level="1">
<inist:fA14 i1="15">
<s1>North Shore Hospital</s1>
<s2>Auckland</s2>
<s3>NZL</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
<country>Nouvelle-Zélande</country>
<wicri:noRegion>North Shore Hospital</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Francoise Tripodi, Marie" sort="Francoise Tripodi, Marie" uniqKey="Francoise Tripodi M" first="Marie" last="Francoise Tripodi">Marie Francoise Tripodi</name>
<affiliation wicri:level="1">
<inist:fA14 i1="16">
<s1>Department of Cardiothoracic and Respiratory Services, Second University of Naples</s1>
<s2>Naples</s2>
<s3>ITA</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<wicri:noRegion>Naples</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Utili, Riccardo" sort="Utili, Riccardo" uniqKey="Utili R" first="Riccardo" last="Utili">Riccardo Utili</name>
<affiliation wicri:level="1">
<inist:fA14 i1="16">
<s1>Department of Cardiothoracic and Respiratory Services, Second University of Naples</s1>
<s2>Naples</s2>
<s3>ITA</s3>
<sZ>19 aut.</sZ>
<sZ>20 aut.</sZ>
</inist:fA14>
<country>Italie</country>
<wicri:noRegion>Naples</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Wang, Andrew" sort="Wang, Andrew" uniqKey="Wang A" first="Andrew" last="Wang">Andrew Wang</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Departments of Medicine, Duke University Medical Center</s1>
<s2>Durham, North Carolina</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>21 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Woods, Christopher W" sort="Woods, Christopher W" uniqKey="Woods C" first="Christopher W." last="Woods">Christopher W. Woods</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Departments of Medicine, Duke University Medical Center</s1>
<s2>Durham, North Carolina</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>21 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Cabell, Christopher H" sort="Cabell, Christopher H" uniqKey="Cabell C" first="Christopher H." last="Cabell">Christopher H. Cabell</name>
<affiliation wicri:level="2">
<inist:fA14 i1="02">
<s1>Departments of Medicine, Duke University Medical Center</s1>
<s2>Durham, North Carolina</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>21 aut.</sZ>
<sZ>22 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">Caroline du Nord</region>
</placeName>
</affiliation>
<affiliation wicri:level="1">
<inist:fA14 i1="03">
<s1>Duke Clinical Research Institute</s1>
<s2>Durham</s2>
<s3>USA</s3>
<sZ>2 aut.</sZ>
<sZ>5 aut.</sZ>
<sZ>9 aut.</sZ>
<sZ>23 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<wicri:noRegion>Duke Clinical Research Institute</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">Archives of internal medicine : (1960)</title>
<title level="j" type="abbreviated">Arch. intern. med. : (1960)</title>
<idno type="ISSN">0003-9926</idno>
<imprint>
<date when="2009">2009</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Archives of internal medicine : (1960)</title>
<title level="j" type="abbreviated">Arch. intern. med. : (1960)</title>
<idno type="ISSN">0003-9926</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Century 21st</term>
<term>Cohort study</term>
<term>Endocarditis</term>
<term>Etiology</term>
<term>Evolution</term>
<term>Human</term>
<term>International</term>
<term>Medicine</term>
<term>Prognosis</term>
<term>Prospective</term>
<term>Public health</term>
<term>Symptomatology</term>
<term>World</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Endocardite</term>
<term>Symptomatologie</term>
<term>Etiologie</term>
<term>Evolution</term>
<term>Pronostic</term>
<term>Siècle 21eme</term>
<term>International</term>
<term>Monde</term>
<term>Prospective</term>
<term>Etude cohorte</term>
<term>Santé publique</term>
<term>Médecine</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Prospective</term>
<term>Santé publique</term>
<term>Médecine</term>
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Background: We sought to provide a contemporary picture of the presentation, etiology, and outcome of infective endocarditis (IE) in a large patient cohort from multiple locations worldwide. Methods: Prospective cohort study of 2781 adults with definite IE who were admitted to 58 hospitals in 25 countries from June 1, 2000, through September 1, 2005. Results: The median age of the cohort was 57.9 (interquartile range, 43.2-71.8) years, and 72.1% had native valve IE. Most patients (77.0%) presented early in the disease (<30 days) with few of the classic clinical hall-marks of IE. Recent health care exposure was found in one-quarter of patients. Staphylococcus aureus was the most common pathogen (31.2%). The mitral (41.1%) and aortic (37.6%) valves were infected most commonly. The following complications were common: stroke (16.9%), embolization other than stroke (22.6%), heart failure (32.3%), and intracardiac abscess (14.4%). Surgical therapy was common (48.2%), and in-hospital mortality remained high (17.7%). Prosthetic valve involvement (odds ratio, 1.47; 95% confidence interval, 1.13-1.90), increasing age (1.30; 1.17-1.46 per 10-year interval), pulmonary edema (1.79; 1.39-2.30), S aureus infection (1.54; 1.14-2.08), coagulase-negative staphylococcal infection (1.50; 1.07-2.10), mitral valve vegetation (1.34; 1.06-1.68), and paravalvular complications (2.25; 1.64-3.09) were associated with an increased risk of in-hospital death, whereas viridans streptococcal infection (0.52; 0.33-0.81) and surgery (0.61; 0.44-0.83) were associated with a decreased risk. Conclusions: In the early 21st century, IE is more often an acute disease, characterized by a high rate of S aureus infection. Mortality remains relatively high.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Espagne</li>
<li>France</li>
<li>Italie</li>
<li>Nouvelle-Zélande</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>Suède</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Bourgogne-Franche-Comté</li>
<li>Canton de Vaud</li>
<li>Caroline du Nord</li>
<li>Catalogne</li>
<li>Franche-Comté</li>
<li>Grand Londres</li>
<li>Massachusetts</li>
<li>Nouvelle-Galles du Sud</li>
</region>
<settlement>
<li>Barcelone</li>
<li>Besançon</li>
<li>Lausanne</li>
<li>Londres</li>
<li>Sydney</li>
</settlement>
</list>
<tree>
<country name="Nouvelle-Zélande">
<noRegion>
<name sortKey="Murdoch, David R" sort="Murdoch, David R" uniqKey="Murdoch D" first="David R." last="Murdoch">David R. Murdoch</name>
</noRegion>
<name sortKey="Chambers, Stephen T" sort="Chambers, Stephen T" uniqKey="Chambers S" first="Stephen T." last="Chambers">Stephen T. Chambers</name>
<name sortKey="Holland, David J" sort="Holland, David J" uniqKey="Holland D" first="David J." last="Holland">David J. Holland</name>
<name sortKey="Raymond, Nigel J" sort="Raymond, Nigel J" uniqKey="Raymond N" first="Nigel J." last="Raymond">Nigel J. Raymond</name>
<name sortKey="Read, Kerry M" sort="Read, Kerry M" uniqKey="Read K" first="Kerry M." last="Read">Kerry M. Read</name>
</country>
<country name="États-Unis">
<region name="Caroline du Nord">
<name sortKey="Corey, G Ralph" sort="Corey, G Ralph" uniqKey="Corey G" first="G. Ralph" last="Corey">G. Ralph Corey</name>
</region>
<name sortKey="Bayer, Arnold S" sort="Bayer, Arnold S" uniqKey="Bayer A" first="Arnold S." last="Bayer">Arnold S. Bayer</name>
<name sortKey="Cabell, Christopher H" sort="Cabell, Christopher H" uniqKey="Cabell C" first="Christopher H." last="Cabell">Christopher H. Cabell</name>
<name sortKey="Cabell, Christopher H" sort="Cabell, Christopher H" uniqKey="Cabell C" first="Christopher H." last="Cabell">Christopher H. Cabell</name>
<name sortKey="Chu, Vivian H" sort="Chu, Vivian H" uniqKey="Chu V" first="Vivian H." last="Chu">Vivian H. Chu</name>
<name sortKey="Corey, G Ralph" sort="Corey, G Ralph" uniqKey="Corey G" first="G. Ralph" last="Corey">G. Ralph Corey</name>
<name sortKey="Fowler, Vance G Jr" sort="Fowler, Vance G Jr" uniqKey="Fowler V" first="Vance G. Jr" last="Fowler">Vance G. Jr Fowler</name>
<name sortKey="Fowler, Vance G Jr" sort="Fowler, Vance G Jr" uniqKey="Fowler V" first="Vance G. Jr" last="Fowler">Vance G. Jr Fowler</name>
<name sortKey="Karchmer, Adolf W" sort="Karchmer, Adolf W" uniqKey="Karchmer A" first="Adolf W." last="Karchmer">Adolf W. Karchmer</name>
<name sortKey="Karchmer, Adolf W" sort="Karchmer, Adolf W" uniqKey="Karchmer A" first="Adolf W." last="Karchmer">Adolf W. Karchmer</name>
<name sortKey="Pappas, Paul A" sort="Pappas, Paul A" uniqKey="Pappas P" first="Paul A." last="Pappas">Paul A. Pappas</name>
<name sortKey="Wang, Andrew" sort="Wang, Andrew" uniqKey="Wang A" first="Andrew" last="Wang">Andrew Wang</name>
<name sortKey="Woods, Christopher W" sort="Woods, Christopher W" uniqKey="Woods C" first="Christopher W." last="Woods">Christopher W. Woods</name>
</country>
<country name="France">
<region name="Bourgogne-Franche-Comté">
<name sortKey="Hoen, Bruno" sort="Hoen, Bruno" uniqKey="Hoen B" first="Bruno" last="Hoen">Bruno Hoen</name>
</region>
</country>
<country name="Espagne">
<region name="Catalogne">
<name sortKey="Miro, Jose M" sort="Miro, Jose M" uniqKey="Miro J" first="José M." last="Miro">José M. Miro</name>
</region>
<name sortKey="Falco, Vicenc" sort="Falco, Vicenc" uniqKey="Falco V" first="Vicenc" last="Falco">Vicenc Falco</name>
</country>
<country name="Suède">
<noRegion>
<name sortKey="Olaison, Lars" sort="Olaison, Lars" uniqKey="Olaison L" first="Lars" last="Olaison">Lars Olaison</name>
</noRegion>
</country>
<country name="Suisse">
<region name="Canton de Vaud">
<name sortKey="Moreillon, Philippe" sort="Moreillon, Philippe" uniqKey="Moreillon P" first="Philippe" last="Moreillon">Philippe Moreillon</name>
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</country>
<country name="Australie">
<region name="Nouvelle-Galles du Sud">
<name sortKey="Jones, Philip" sort="Jones, Philip" uniqKey="Jones P" first="Philip" last="Jones">Philip Jones</name>
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</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Klein, John L" sort="Klein, John L" uniqKey="Klein J" first="John L." last="Klein">John L. Klein</name>
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</country>
<country name="Italie">
<noRegion>
<name sortKey="Francoise Tripodi, Marie" sort="Francoise Tripodi, Marie" uniqKey="Francoise Tripodi M" first="Marie" last="Francoise Tripodi">Marie Francoise Tripodi</name>
</noRegion>
<name sortKey="Utili, Riccardo" sort="Utili, Riccardo" uniqKey="Utili R" first="Riccardo" last="Utili">Riccardo Utili</name>
</country>
</tree>
</affiliations>
</record>

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