Contemporary Epidemiology and Prognosis of Health Care–Associated Infective Endocarditis

Fernández-Hidalgo, Núria; Almirante, Benito; Tornos, Pilar; Pigrau, Carles; Sambola, Antonia; Igual, A; Pahissa, Albert

doi:10.1086/592576

Cited by 181 publications

(184 citation statements)

References 22 publications

Supporting

Mentioning

131

Contrasting

Unclassified

Order By: Relevance

“…The percentage of methicillin-resistant S aureus increases with age, probably as a result of the increasing proportion of nosocomial endocarditis with age. 29 The therapeutic management of our patients differed according to their age; thus, the percentage of patients who underwent urgent or elective surgery decreased with increasing age. Several reasons may account for this finding: the lower percentage of valvular impairment (insufficiency, perforation), the lower rate of endocarditis due to S aureus, and greater comorbidity among these patients that leads to rejection for surgery due to the high risk involved.…”

Section: López Et Al Age-dependent Profile Of Left-sided Endocarditismentioning

confidence: 85%

Age-Dependent Profile of Left-Sided Infective Endocarditis

et al. 2010

View full text Add to dashboard Cite

Background-The influence of age on the main epidemiological, clinical, echocardiographic, microbiological, and prognostic features of patients with infective endocarditis remains unknown. We present the series with the largest numbers and range of ages of subjects to date that analyzes the influence of age on the main characteristics of patients with isolated left-sided infective endocarditis. Furthermore, this series is the first one in which patients have been distributed according to age quartile. Methods and Results-A total of 600 episodes of left-sided endocarditis consecutively diagnosed in 3 tertiary centers were stratified into age-specific quartiles and 107 variables compared between the different groups. With increasing age, the percentage of women, previous heart disease, predisposing disease (diabetes mellitus and cancer), and infection by enterococci and Streptococcus bovis also increased. Valvular insufficiency and perforation and Staphylococcus aureus infection were more common in younger patients. The therapeutic approach differed depending on patient age because of the growing proportion of older patients who only received medical treatment. Clinical course and hospital prognosis were worse in the older patients because of increased surgical mortality among them. Conclusions-Increasing age is associated with less valvular impairment (insufficiency and perforation), a more favorable microbiological profile, and increased surgical mortality among adults with left-sided infective endocarditis. (Circulation. 2010;121:892-897.)

show abstract

Section: López Et Al Age-dependent Profile Of Left-sided Endocarditismentioning

confidence: 85%

Age-Dependent Profile of Left-Sided Infective Endocarditis

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Today, prolonged lifetime in line with the developments in field of medicine, with gradually increasing invasive procedures in diagnosis and treatment, and the patients' close contact with health care implementations because of their concomitant diseases enhances the risk of health care-associated bacteremia and IE 9 . HAIE, which accounts for 7-34% of infective endocarditis cases, appears today as a growing problem because of high mortality rate changing between 25% and 45% 10 .…”

Section: Discussionmentioning

confidence: 99%

Toplumdan Edinilmiş ve Sağlık Hizmeti İlişkili İnfektif Endokardit Olgularının Karşılaştırmalı Değerlendirilmesi

Kurşun¹,

Turunç²,

Demıroğlu³

et al. 2015

Cukurova Medical Journal

View full text Add to dashboard Cite

Purpose: The present study aimed to comparatively evaluate the cases with health care-associated infective endocarditis and the cases with community-acquired infective endocarditis. Material and Methods: Of the cases followed for infective endocarditis (IE), 21 (40 %) had health care-associated infective endocarditis and 31 (60 %) community-acquired infective endocarditis. Results: Comparing the cases with community acquired infective endocarditis and the cases with health careassociated infective endocarditis, it was determined that advanced age (58.0 ± 15.1 years vs. 41.3± 14.4 years, P= 0.000), presence of chronic renal insufficiency (P= 0.001) and diabetes mellitus (P= 0.016) as concomitant diseases, being previously hospitalized (P= 0.0001), hemodialysis in terms of diagnostic and therapeutic interventions (P= 0.022), presence of central venous catheter (P= 0.022), and undergone intervention for gastrointestinal system (P= 0.060),as well as laboratory results including positive blood culture growth for S. aureus and Enterococcus (P= 0.037), and complications such as development of embolic event (P= 0.008), spondylodiscitis (P= 0.034) and stroke (P= 0.007) were statistically significantly more common in health care-associated infective endocarditis cases. Whilst mortality was higher in health care-associated infective endocarditis cases (28.6 %), it was determined that there was no statistically significant difference between the groups. Conclusion: Health care-associated infective endocarditis is a disease that is more common in the patients at advanced age, with concomitant disease and the history of exposing invasive procedures in the past for diagnostic and therapeutic purpose, and it is a disease with high morbidity and mortality that courses with serious complications. Key words: Infective endocarditis, health care-associated infective endocarditis, community-acquired infective endocarditis Cukurova Medical JournalBulgular: Çalışmamızda sağlık bakımı ilişkili infektif endokardit ile toplumdan edinilmiş infektif endokardit olgularımızın karşılaştırılmalı olarak değerlendirilmesi amaçlanmıştır. Toplumdan edinilmiş infektif endokardit ile sağlık bakımı ilişkili infektif endokardit olguları karşılaştırıldığında; ileri yaşın (58.0 ± 15.1 yıl ve 41.3 ± 14.4 yıl, P= 0.000), eşlik eden hastalıklar açısından kronik böbrek yetmezliğinin (P= 0.001), ve diyabetes mellitus varlığının (P= 0.016), önceden hastanede yatmış olmanın (P= 0.0001), tanı ve tedavi amaçlı uygulanan girişimler açısından özellikle hemodiyaliz uygulamalarının (P= 0.022), santral kateter varlığı (P= 0.022), ile gastrointestinal sisteme girişim yapılmasının (P= 0.060), laboratuvar bulguları açısından kan kültüründe S.aureus ve Enterokok üremesinin (P= 0.037), ve son olarak komplikasyonlar açısından ise embolik olay (P= 0.008), spondilodiskit (P= 0.034) ve stroke gelişiminin (P= 0.007) sağlık bakımı ilişkili infektif endokardit olgularında istatiksel olarak da anlamlı olacak şekilde daha yüksek olduğu saptandı. Sonuç: Mortalite sağlık bak...

show abstract

“…Despite the low rate (8%) of subsequent bloodstream infections in patients with colonized tunneled catheters (10), the severe consequences and high mortality rates associated with this infection (3,4,13,19) mean that anticipatory antibiotic therapy is necessary. This issue has been resolved for short-term CVCs using acridine orange and Gram staining, irrespective of whether the catheter was removed.…”

Section: Discussionmentioning

confidence: 99%

“…However, those authors included only patients with hematological conditions, and some CRBSI episodes were not confirmed, as in some cases, the only microbiological evidence was the differential time to positivity. Therefore, our study provides further evidence that the best methodology for the management of catheter tips from all patients with long-term tunneled CVCs is Maki's roll-plate technique.Despite the low rate (8%) of subsequent bloodstream infections in patients with colonized tunneled catheters (10), the severe consequences and high mortality rates associated with this infection (3,4,13,19) mean that anticipatory antibiotic therapy is necessary. This issue has been resolved for short-term CVCs using acridine orange and Gram staining, irrespective of whether the catheter was removed.…”

mentioning

confidence: 99%

How Should Long-Term Tunneled Central Venous Catheters Be Managed in Microbiology Laboratories in Order To Provide an Accurate Diagnosis of Colonization?

et al. 2012

View full text Add to dashboard Cite

Guidelines recommend the roll-plate technique for short-term central venous catheter (CVC) tip cultures. However, the issue of whether the roll-plate technique is better than the sonication method for long-term CVCs remains unresolved. In addition, no data are available for predicting the value of direct Gram staining in anticipating catheter colonization or catheter-related bloodstream infection (CRBSI) in these long-term CVCs. Our objectives were to compare the roll-plate technique and the sonication method and to define the validity values of Gram staining for the prediction of colonization and CRBSI in patients with longterm tunneled CVCs. During the study period, all tunneled CVCs removed at our institution were prospectively and routinely sent to the microbiology laboratory for Gram staining (first) and tip culture (the Maki technique and sonication, in a random order). We received 149 tunneled CVCs, 39 (26.2%) of which were colonized and 11 (7.4%) of which were associated with CRBSI. Overall, the roll-plate method detected 94.9% of the colonized catheters, whereas sonication detected only 43.6% (P < 0.001).The validity values of Gram staining for the detection of colonization and CRBSI were as follows: a sensitivity of 35.9% to 60.0%, a specificity of 100% to 94.2%, a positive predictive value of 100% to 42.9%, and a negative predictive value of 81.5% to 97.0%. The roll-plate technique proved to be better than sonication for the detection of bacteria in long-term tunneled CVCs. Gram staining of the tips of tunneled CVCs can anticipate a positive culture and rule out CRBSI. In our opinion, direct Gram staining should be incorporated into routine microbiological assessments of long-term catheter tips. The recently reported Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Management of Intravascular Catheter-Related Infection recommend the roll-plate technique for the routine clinical microbiological analysis of short-term catheter tips (9). However, for the analysis of long-term catheter tips, in which the endoluminal progression of microorganisms is more frequent, the best methodology for culture remains an unresolved issue (7,12,15).Although the sonication of catheter tips can better detect the microbiological colonization of the inner surface, both the inner and outer surfaces can be colonized simultaneously (6). The results of the few studies comparing the roll-plate and sonication methods are not homogenous for catheter type or the sequence order of the procedure (2,6,11,16). In the present study, it was demonstrated that the roll-plate technique was at least as efficient as sonication for the overall group of catheters received in the microbiology laboratory, although the number of long-term catheters was limited. Moreover, both techniques were compared in selected subpopulations with tunneled central venous catheters (CVCs).Acridine orange and Gram staining have been used to provide a rapid diagnosis of catheter-related bloodstream infection (CRBSI) wit...

show abstract

Contemporary Epidemiology and Prognosis of Health Care–Associated Infective Endocarditis

Abstract: HAIE is an important health problem associated with considerable mortality. New strategies to prevent HAIE should be assessed.

Cited by 181 publications

References 22 publications

Age-Dependent Profile of Left-Sided Infective Endocarditis

Age-Dependent Profile of Left-Sided Infective Endocarditis

Toplumdan Edinilmiş ve Sağlık Hizmeti İlişkili İnfektif Endokardit Olgularının Karşılaştırmalı Değerlendirilmesi

How Should Long-Term Tunneled Central Venous Catheters Be Managed in Microbiology Laboratories in Order To Provide an Accurate Diagnosis of Colonization?

Contact Info

Product

Resources

About