Current Features of Infective Endocarditis in Elderly Patients : Results of the International Collaboration on Endocarditis Prospective Cohort Study
Identifieur interne : 008E09 ( Main/Exploration ); précédent : 008E08; suivant : 008E10Current Features of Infective Endocarditis in Elderly Patients : Results of the International Collaboration on Endocarditis Prospective Cohort Study
Auteurs : Emanuele Durante-Mangoni [Italie] ; Suzanne Bradley [États-Unis] ; Christine Selton-Suty [France] ; Marie-Francoise Tripodi [Italie] ; Bruno Barsic [Croatie] ; Emilio Bouza [Espagne] ; Christopher H. Cabell [États-Unis] ; Auristela Isabel De Oliveira Ramos [Brésil] ; Vance Jr Fowler [États-Unis] ; Bruno Hoen [France] ; Pam Konecny [Australie] ; Asuncion Moreno [Espagne] ; David Murdoch [Nouvelle-Zélande] ; Paul Pappas [États-Unis] ; Daniel J. Sexton [États-Unis] ; Denis Spelman [Australie] ; Pierre Tattevin [France] ; José M. Miro [Espagne] ; Jan T. M. Van Der Meer [Pays-Bas] ; Riccardo Utili [Italie]Source :
- Archives of internal medicine : (1960) [ 0003-9926 ] ; 2008.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Personne âgée, Prospective, Santé publique, Médecine.
English descriptors
- KwdEn :
Abstract
Background: Elderly patients are emerging as a population at high risk for infective endocarditis (IE). However, adequately sized prospective studies on the features of IE in elderly patients are lacking. Methods: In this multinational, prospective, observational cohort study within the International Collaboration on Endocarditis, 2759 consecutive patients were enrolled from June 15, 2000, to December 1, 2005; 1056 patients with IE 65 years or older were compared with 1703 patients younger than 65 years. Risk factors, predisposing conditions, origin, clinical features, course, and outcome of IE were comprehensively analyzed. Results: Elderly patients reported more frequently a hospitalization or an invasive procedure before IE onset. Diabetes mellitus and genitourinary and gastrointestinal cancer were the major predisposing conditions. Blood culture yield was higher among elderly patients with IE. The leading causative organism was Staphylococcus aureus, with a higher rate of methicillin resistance. Streptococcus bovis and enterococci were also significantly more prevalent. The clinical presentation of elderly patients with IE was remarkable for lower rates of embolism, immune-mediated phenomena, or septic complications. At both echocardiography and surgery, fewer vegetations and more abscesses were found, and the gain in the diagnostic yield of transesophageal echocardiography was significantly larger. Significantly fewer elderly patients underwent cardiac surgery (38.9% vs 53.5%; P<.001). Elderly patients with IE showed a higher rate of in-hospital death (24.9% vs 12.8%; P<.001), and age older than 65 years was an independent predictor of mortality. Conclusions: In this large prospective study, increasing age emerges as a major determinant of the clinical characteristics of IE. Lower rates of surgical treatment and high mortality are the most prominent features of elderly patients with IE. Efforts should be made to prevent health care-associated acquisition and improve outcomes in this major subgroup of patients with IE.
Affiliations:
- Australie, Brésil, Croatie, Espagne, France, Italie, Nouvelle-Zélande, Pays-Bas, États-Unis
- Bourgogne-Franche-Comté, Caroline du Nord, Catalogne, Communauté de Madrid, Franche-Comté, Grand Est, Hollande-Septentrionale, Lorraine (région), Nouvelle-Galles du Sud, Région Bretagne, Victoria (État), État de São Paulo
- Amsterdam, Barcelone, Besançon, Madrid, Melbourne, Nancy, Rennes, Sydney, São Paulo
- Université d'Amsterdam
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Sexton</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Departments of Medicine, Duke University Medical Center</s1><s2>Durham</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Durham</wicri:noRegion></affiliation></author><author><name sortKey="Spelman, Denis" sort="Spelman, Denis" uniqKey="Spelman D" first="Denis" last="Spelman">Denis Spelman</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Department of Infectious Disease, Alfred Hospital</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Tattevin, Pierre" sort="Tattevin, Pierre" uniqKey="Tattevin P" first="Pierre" last="Tattevin">Pierre Tattevin</name><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>CHU de Rennes</s1><s2>Rennes</s2><s3>FRA</s3><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</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="11"><s1>Hospital Clinic-IDIBAPS (Institut d'lnvestigacions Biomèdiques August Pi I Sunyer), University of Barcelona</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>12 aut.</sZ><sZ>18 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="Van Der Meer, Jan T M" sort="Van Der Meer, Jan T M" uniqKey="Van Der Meer J" first="Jan T. M." last="Van Der Meer">Jan T. M. Van Der Meer</name><affiliation wicri:level="4"><inist:fA14 i1="16"><s1>University of Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>19 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region><settlement type="city">Amsterdam</settlement></placeName><orgName type="university">Université d'Amsterdam</orgName></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="01"><s1>Department of Cardiothoracic and Respiratory Sciences, Università di Napoli II</s1><s2>Naples</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Naples</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">08-0537904</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 08-0537904 INIST</idno><idno type="RBID">Pascal:08-0537904</idno><idno type="wicri:Area/PascalFrancis/Corpus">003169</idno><idno type="wicri:Area/PascalFrancis/Curation">002E84</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">003330</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">003330</idno><idno type="wicri:doubleKey">0003-9926:2008:Durante Mangoni E:current:features:of</idno><idno type="wicri:Area/Main/Merge">009744</idno><idno type="wicri:Area/Main/Curation">008E09</idno><idno type="wicri:Area/Main/Exploration">008E09</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Current Features of Infective Endocarditis in Elderly Patients : Results of the International Collaboration on Endocarditis Prospective Cohort Study</title><author><name sortKey="Durante Mangoni, Emanuele" sort="Durante Mangoni, Emanuele" uniqKey="Durante Mangoni E" first="Emanuele" last="Durante-Mangoni">Emanuele Durante-Mangoni</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Cardiothoracic and Respiratory Sciences, Università di Napoli II</s1><s2>Naples</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Bradley, Suzanne" sort="Bradley, Suzanne" uniqKey="Bradley S" first="Suzanne" last="Bradley">Suzanne Bradley</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Divisions of Geriatric Medicine and Infectious Diseases, University of Michigan Medical School</s1><s2>Ann Arbor</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Ann Arbor</wicri:noRegion></affiliation></author><author><name sortKey="Selton Suty, Christine" sort="Selton Suty, Christine" uniqKey="Selton Suty C" first="Christine" last="Selton-Suty">Christine Selton-Suty</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Cardiology, Centre Hôpitalier Universitaire (CHU) Nancy-Brabois</s1><s2>Nancy</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author><author><name sortKey="Tripodi, Marie Francoise" sort="Tripodi, Marie Francoise" uniqKey="Tripodi M" first="Marie-Francoise" last="Tripodi">Marie-Francoise Tripodi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Cardiothoracic and Respiratory Sciences, Università di Napoli II</s1><s2>Naples</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Naples</wicri:noRegion></affiliation></author><author><name sortKey="Barsic, Bruno" sort="Barsic, Bruno" uniqKey="Barsic B" first="Bruno" last="Barsic">Bruno Barsic</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Intensive Care Unit, University Hospital for Infectious Diseases</s1><s2>Zagreb</s2><s3>HRV</s3><sZ>5 aut.</sZ></inist:fA14><country>Croatie</country><wicri:noRegion>Zagreb</wicri:noRegion></affiliation></author><author><name sortKey="Bouza, Emilio" sort="Bouza, Emilio" uniqKey="Bouza E" first="Emilio" last="Bouza">Emilio Bouza</name><affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Department of Medical Microbiology, Hospital General Universitario Gregorio Maranon</s1><s2>Ciberes, Madrid</s2><s3>ESP</s3><sZ>6 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</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="06"><s1>Quintiles Transnational</s1><s2>Durham, North Carolina</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="De Oliveira Ramos, Auristela Isabel" sort="De Oliveira Ramos, Auristela Isabel" uniqKey="De Oliveira Ramos A" first="Auristela Isabel" last="De Oliveira Ramos">Auristela Isabel De Oliveira Ramos</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Instituto Dante Pazzanese de Cardiologia</s1><s2>Sao Paulo</s2><s3>BRA</s3><sZ>8 aut.</sZ></inist:fA14><country>Brésil</country><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Fowler, Vance Jr" sort="Fowler, Vance Jr" uniqKey="Fowler V" first="Vance Jr" last="Fowler">Vance Jr Fowler</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Departments of Medicine, Duke University Medical Center</s1><s2>Durham</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Durham</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="09"><s1>Department of Cardiology, Departments of Infectious Diseases, University Medical Center of Besançon</s1><s2>Besancon</s2><s3>FRA</s3><sZ>10 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="Konecny, Pam" sort="Konecny, Pam" uniqKey="Konecny P" first="Pam" last="Konecny">Pam Konecny</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>St George Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>11 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="Moreno, Asuncion" sort="Moreno, Asuncion" uniqKey="Moreno A" first="Asuncion" last="Moreno">Asuncion Moreno</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Hospital Clinic-IDIBAPS (Institut d'lnvestigacions Biomèdiques August Pi I Sunyer), University of Barcelona</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>12 aut.</sZ><sZ>18 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="Murdoch, David" sort="Murdoch, David" uniqKey="Murdoch D" first="David" last="Murdoch">David Murdoch</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>University of Otago</s1><s2>Christchurch</s2><s3>NZL</s3><sZ>13 aut.</sZ></inist:fA14><country>Nouvelle-Zélande</country><wicri:noRegion>University of Otago</wicri:noRegion></affiliation></author><author><name sortKey="Pappas, Paul" sort="Pappas, Paul" uniqKey="Pappas P" first="Paul" last="Pappas">Paul Pappas</name><affiliation wicri:level="2"><inist:fA14 i1="13"><s1>INC Research</s1><s2>Raleigh, North Carolina</s2><s3>USA</s3><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Caroline du Nord</region></placeName></affiliation></author><author><name sortKey="Sexton, Daniel J" sort="Sexton, Daniel J" uniqKey="Sexton D" first="Daniel J." last="Sexton">Daniel J. Sexton</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Departments of Medicine, Duke University Medical Center</s1><s2>Durham</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Durham</wicri:noRegion></affiliation></author><author><name sortKey="Spelman, Denis" sort="Spelman, Denis" uniqKey="Spelman D" first="Denis" last="Spelman">Denis Spelman</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Department of Infectious Disease, Alfred Hospital</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>16 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Tattevin, Pierre" sort="Tattevin, Pierre" uniqKey="Tattevin P" first="Pierre" last="Tattevin">Pierre Tattevin</name><affiliation wicri:level="3"><inist:fA14 i1="15"><s1>CHU de Rennes</s1><s2>Rennes</s2><s3>FRA</s3><sZ>17 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</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="11"><s1>Hospital Clinic-IDIBAPS (Institut d'lnvestigacions Biomèdiques August Pi I Sunyer), University of Barcelona</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>12 aut.</sZ><sZ>18 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="Van Der Meer, Jan T M" sort="Van Der Meer, Jan T M" uniqKey="Van Der Meer J" first="Jan T. M." last="Van Der Meer">Jan T. M. Van Der Meer</name><affiliation wicri:level="4"><inist:fA14 i1="16"><s1>University of Amsterdam</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>19 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region><settlement type="city">Amsterdam</settlement></placeName><orgName type="university">Université d'Amsterdam</orgName></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="01"><s1>Department of Cardiothoracic and Respiratory Sciences, Università di Napoli II</s1><s2>Naples</s2><s3>ITA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>20 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Naples</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="2008">2008</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>Cohort study</term><term>Elderly</term><term>Endocarditis</term><term>International</term><term>Medicine</term><term>Patient</term><term>Prospective</term><term>Public health</term><term>Result</term><term>World</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Endocardite</term><term>Personne âgée</term><term>Malade</term><term>Résultat</term><term>International</term><term>Monde</term><term>Prospective</term><term>Etude cohorte</term><term>Santé publique</term><term>Médecine</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Personne âgée</term><term>Prospective</term><term>Santé publique</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Elderly patients are emerging as a population at high risk for infective endocarditis (IE). However, adequately sized prospective studies on the features of IE in elderly patients are lacking. Methods: In this multinational, prospective, observational cohort study within the International Collaboration on Endocarditis, 2759 consecutive patients were enrolled from June 15, 2000, to December 1, 2005; 1056 patients with IE 65 years or older were compared with 1703 patients younger than 65 years. Risk factors, predisposing conditions, origin, clinical features, course, and outcome of IE were comprehensively analyzed. Results: Elderly patients reported more frequently a hospitalization or an invasive procedure before IE onset. Diabetes mellitus and genitourinary and gastrointestinal cancer were the major predisposing conditions. Blood culture yield was higher among elderly patients with IE. The leading causative organism was Staphylococcus aureus, with a higher rate of methicillin resistance. Streptococcus bovis and enterococci were also significantly more prevalent. The clinical presentation of elderly patients with IE was remarkable for lower rates of embolism, immune-mediated phenomena, or septic complications. At both echocardiography and surgery, fewer vegetations and more abscesses were found, and the gain in the diagnostic yield of transesophageal echocardiography was significantly larger. Significantly fewer elderly patients underwent cardiac surgery (38.9% vs 53.5%; P<.001). Elderly patients with IE showed a higher rate of in-hospital death (24.9% vs 12.8%; P<.001), and age older than 65 years was an independent predictor of mortality. Conclusions: In this large prospective study, increasing age emerges as a major determinant of the clinical characteristics of IE. Lower rates of surgical treatment and high mortality are the most prominent features of elderly patients with IE. Efforts should be made to prevent health care-associated acquisition and improve outcomes in this major subgroup of patients with IE.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Brésil</li><li>Croatie</li><li>Espagne</li><li>France</li><li>Italie</li><li>Nouvelle-Zélande</li><li>Pays-Bas</li><li>États-Unis</li></country><region><li>Bourgogne-Franche-Comté</li><li>Caroline du Nord</li><li>Catalogne</li><li>Communauté de Madrid</li><li>Franche-Comté</li><li>Grand Est</li><li>Hollande-Septentrionale</li><li>Lorraine (région)</li><li>Nouvelle-Galles du Sud</li><li>Région Bretagne</li><li>Victoria (État)</li><li>État de São Paulo</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Besançon</li><li>Madrid</li><li>Melbourne</li><li>Nancy</li><li>Rennes</li><li>Sydney</li><li>São Paulo</li></settlement><orgName><li>Université d'Amsterdam</li></orgName></list><tree><country name="Italie"><noRegion><name sortKey="Durante Mangoni, Emanuele" sort="Durante Mangoni, Emanuele" uniqKey="Durante Mangoni E" first="Emanuele" last="Durante-Mangoni">Emanuele Durante-Mangoni</name></noRegion><name sortKey="Tripodi, Marie Francoise" sort="Tripodi, Marie Francoise" uniqKey="Tripodi M" first="Marie-Francoise" last="Tripodi">Marie-Francoise Tripodi</name><name sortKey="Utili, Riccardo" sort="Utili, Riccardo" uniqKey="Utili R" first="Riccardo" last="Utili">Riccardo Utili</name></country><country name="États-Unis"><noRegion><name sortKey="Bradley, Suzanne" sort="Bradley, Suzanne" uniqKey="Bradley S" first="Suzanne" last="Bradley">Suzanne Bradley</name></noRegion><name sortKey="Cabell, Christopher H" sort="Cabell, Christopher H" uniqKey="Cabell C" first="Christopher H." last="Cabell">Christopher H. Cabell</name><name sortKey="Fowler, Vance Jr" sort="Fowler, Vance Jr" uniqKey="Fowler V" first="Vance Jr" last="Fowler">Vance Jr Fowler</name><name sortKey="Pappas, Paul" sort="Pappas, Paul" uniqKey="Pappas P" first="Paul" last="Pappas">Paul Pappas</name><name sortKey="Sexton, Daniel J" sort="Sexton, Daniel J" uniqKey="Sexton D" first="Daniel J." last="Sexton">Daniel J. Sexton</name></country><country name="France"><region name="Grand Est"><name sortKey="Selton Suty, Christine" sort="Selton Suty, Christine" uniqKey="Selton Suty C" first="Christine" last="Selton-Suty">Christine Selton-Suty</name></region><name sortKey="Hoen, Bruno" sort="Hoen, Bruno" uniqKey="Hoen B" first="Bruno" last="Hoen">Bruno Hoen</name><name sortKey="Tattevin, Pierre" sort="Tattevin, Pierre" uniqKey="Tattevin P" first="Pierre" last="Tattevin">Pierre Tattevin</name></country><country name="Croatie"><noRegion><name sortKey="Barsic, Bruno" sort="Barsic, Bruno" uniqKey="Barsic B" first="Bruno" last="Barsic">Bruno Barsic</name></noRegion></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Bouza, Emilio" sort="Bouza, Emilio" uniqKey="Bouza E" first="Emilio" last="Bouza">Emilio Bouza</name></region><name sortKey="Miro, Jose M" sort="Miro, Jose M" uniqKey="Miro J" first="José M." last="Miro">José M. Miro</name><name sortKey="Moreno, Asuncion" sort="Moreno, Asuncion" uniqKey="Moreno A" first="Asuncion" last="Moreno">Asuncion Moreno</name></country><country name="Brésil"><region name="État de São Paulo"><name sortKey="De Oliveira Ramos, Auristela Isabel" sort="De Oliveira Ramos, Auristela Isabel" uniqKey="De Oliveira Ramos A" first="Auristela Isabel" last="De Oliveira Ramos">Auristela Isabel De Oliveira Ramos</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Konecny, Pam" sort="Konecny, Pam" uniqKey="Konecny P" first="Pam" last="Konecny">Pam Konecny</name></region><name sortKey="Spelman, Denis" sort="Spelman, Denis" uniqKey="Spelman D" first="Denis" last="Spelman">Denis Spelman</name></country><country name="Nouvelle-Zélande"><noRegion><name sortKey="Murdoch, David" sort="Murdoch, David" uniqKey="Murdoch D" first="David" last="Murdoch">David Murdoch</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Van Der Meer, Jan T M" sort="Van Der Meer, Jan T M" uniqKey="Van Der Meer J" first="Jan T. M." last="Van Der Meer">Jan T. M. Van Der Meer</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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