Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Damlin, Anna; Westling, Katarina; Maret, Eva; Lundborg, Cecilia Stålsby; Caidahl, Kenneth; Eriksson, Maria

doi:10.1186/s12879-019-4682-z

Cited by 14 publications

(7 citation statements)

References 31 publications

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“…This study aimed to present the clinical characteristics and outcomes among the patients with IDU and definite IE admitted to a university hospital in Stockholm between 2008 and 2017. The hospital has a special ward for drug addicts with infectious diseases, which contributes to a high prevalence of IDU among the patients with IE, which was presented in a previous study [ 14 ]. This enables good comparability between patients with IDU-IE and patients with IE without IDU, referred to as non-IDU-IE.…”

Section: Introductionmentioning

confidence: 99%

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

Damlin

Westling

2021

BMC Infect Dis

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Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P < 0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P < 0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P < 0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P < 0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P < 0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P < 0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P < 0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P < 0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P < 0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

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Section: Introductionmentioning

confidence: 99%

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

Damlin

Westling

2021

BMC Infect Dis

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“…В этиологической структуре современного ИЭ, как и в прошлом, 80-90,3 % выделенных возбудителей составляют грамположительные кокки: стафилококки (Staphylococcus aureus, коагулазонегативные стафилококки), Streptococcus viridans и Enterococcus spp. [1,2,[14][15][16], которые не только часто вызывают бактериемию у человека, но и обладают рядом изученных механизмов, облегчающих персистенцию в кровотоке и прилипание к эндокарду [17][18][19]. Грамположительные кокки являются преобладающими возбудителями во всех основных группах риска ИЭ [2] и во всех регионах мира, несмотря на определенные различия эпидемиологических ситуаций [1,2,20].…”

Section: этиологическая структура современного инфекционного эндокардитаunclassified

Infective endocarditis caused by gram-negative bacteria

Чипигина¹,

Karpova²,

Kashentseva³

et al. 2022

Klinicist

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Infective endocarditis (IE) caused by Gram-negative bacteria is a rare and insufficiently characterized form of endocarditis. The literature review presents data on the frequency, course, risk factors, diagnosis and treatment of both IE caused by the HACEK microorganisms (Haemophilus spр., Aggregatibacter spp., Cardiobacterium hominis, Eikenella corrodens, Kingella) and other Gram-negative bacteria. Gram-negative bacteria are the cause of 3.6–13.6 % IE cases (HACEK microorganisms in 0.8–3 % of IE cases in adults, non-HACEK in 1.8–3.9 %). Patients with IE caused by the HACEK microorganisms are younger, their disease is not associated with previous in-hospital treatment and is subacute with favorable prognosis (intrahospital mortality is 2–3 %). HACEK microorganisms mostly retain sensitivity to many antibiotics. Risk factors of IE caused by HACEK microorganisms are dental interventions, heart disorders, valve prostheses and other implanted cardiac devices. IE caused by non-HACEK Gram-negative bacteria is more common in elderly with concomitant disorders and usually is acute; intrahospital mortality is 13–36.5 %. Risk factors of IE caused by non-HACEK microorganisms are valve prostheses, electrical pacemakers, venous and central catheters, recent in-hospital treatment, Gram-negative bacteremia, decreased immunity, drug abuse, urinary infection, alcoholism, cirrhosis of the liver, removed spleen, consequences of dog and cat bites, working with the soil. Among Gram-negative non-HACEK bacteria causing IE, 28 % have multi-drug resistance (MDR / XDR) against antibiotics. Therefore, Gram-negative bacteria rarely cause IE but during selection of empiric therapy in patients with IE with corresponding risk factors, probability of Gram-negative causative microorganisms in IE etiology should be taken into account.

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“…The European Society of Cardiology (ESC) guidelines indicated transoesophageal echocardiography (TOE, class I evidence B) as the first instrumental approach for diagnosing suspected IE in PHV [ 5 ]. Echocardiography can identify vegetations, abscess, leaflet dehiscence, fistulas, pseudoaneurysm, and/or new aortic regurgitation [ 37 ], thus allowing for a complete evaluation according to the ESC modified criteria for the diagnosis of infective endocarditis [ 5 ].…”

Section: Instrumental Diagnosismentioning

confidence: 99%

Endocarditis in Patients with Aortic Valve Prosthesis: Comparison between Surgical and Transcatheter Prosthesis

Palo¹,

Scicchitano²,

Malvindi

et al. 2021

Antibiotics

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The interventional treatment of aortic stenosis is currently based on transcatheter aortic valve implantation/replacement (TAVI/TAVR) and surgical aortic valve replacement (SAVR). Prosthetic valve infective endocarditis (PVE) is the most worrisome complication after valve replacement, as it still carries high mortality and morbidity rate. Studies have not highlighted the differences in the occurrence of PVE in SAVR as opposed to TAVR, but the reported incidence rates are widely uneven. Literature portrays different microbiological profiles for SAVR and TAVR PVE: Staphylococcus, Enterococcus, and Streptococcus are the pathogens that are more frequently involved with differences regarding the timing from the date of the intervention. Imaging by means of transoesophageal echocardiography, and computed tomography (CT) Scan is essential in identifying vegetations, prosthesis dysfunction, dehiscence, periannular abscess, or aorto-ventricular discontinuity. In most cases, conservative medical treatment is not able to prevent fatal events and surgery represents the only viable option. The primary objectives of surgical treatment are radical debridement and the removal of infected tissues, the reconstruction of cardiac and aortic morphology, and the restoration of the aortic valve function. Different surgical options are discussed. Fast diagnosis, the adequacy of antibiotics treatment, and prompt interventions are essential in preventing the negative consequences of infective endocarditis (IE).

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Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Cited by 14 publications

References 31 publications

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

Infective endocarditis caused by gram-negative bacteria

Endocarditis in Patients with Aortic Valve Prosthesis: Comparison between Surgical and Transcatheter Prosthesis

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