Epidemiology of Infective Endocarditis in Spain in the Last 20 Years

Fernández-Hidalgo, Núria

doi:10.1016/j.rec.2013.05.002

Cited by 33 publications

(31 citation statements)

References 54 publications

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“…Overall, the most effective antibiotics against biofilmgrowing S. aureus were fusidic acid, oxacillin and Teicoplanin, with MBEC values below breakpoints in almost all isolates, while ampicillin and ampicillin/sulbactam were the most active drugs in IE caused by both E. faecalis and S. gallolyticus, respectively. This latter data is in agreement with previous observations, confirming the effectiveness of ampicillin against ampicillin-susceptible E. faecalis, particularly in those patients with aminoglycoside resistance, or at risk of aminoglycoside-nephrotoxicity [7,8,39]. Indeed, aminoglycosides are no longer recommended in the treatment of staphylococcal and enterococcal native valve endocarditis due to their limited clinical benefits, the increasing frequency of microbial resistance and renal toxicity [34,40].…”

Section: Discussionsupporting

confidence: 89%

“…Infective endocarditis (IE) is associated with a poor prognosis and a reduced life expectancy [1][2][3][4]. The mortality rate for patients with IE is approximately 25%, with more than one-third of patients dying within a year [5][6][7][8]. The rapid identification of the specific microbial etiology and targeted antimicrobial therapy are fundamental for optimal patient treatment [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis

et al. 2019

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Background: Infective endocarditis (IE) is associated with high rates of mortality. Prolonged treatments with highdose intravenous antibiotics often fail to eradicate the infection, frequently leading to high-risk surgical intervention. By providing a mechanism of antibiotic tolerance, which escapes conventional antibiotic susceptibility profiling, microbial biofilm represents a key diagnostic and therapeutic challenge for clinicians. This study aims at assessing a rapid biofilm identification assay and a targeted antimicrobial susceptibility profile of biofilm-growing bacteria in patients with IE, which were unresponsive to antibiotic therapy. Results: Staphylococcus aureus was the most common isolate (50%), followed by Enterococcus faecalis (25%) and Streptococcus gallolyticus (25%). All microbial isolates were found to be capable of producing large, structured biofilms in vitro. As expected, antibiotic treatment either administered on the basis of antibiogram or chosen empirically among those considered first-line antibiotics for IE, including ceftriaxone, daptomycin, tigecycline and vancomycin, was not effective at eradicating biofilm-growing bacteria. Conversely, antimicrobial susceptibility profile of biofilm-growing bacteria indicated that teicoplanin, oxacillin and fusidic acid were most effective against S. aureus biofilm, while ampicillin was the most active against S. gallolyticus and E. faecalis biofilm, respectively. Conclusions: This study indicates that biofilm-producing bacteria, from surgically treated IE, display a high tolerance to antibiotics, which is undetected by conventional antibiograms. The rapid identification and antimicrobial tolerance profiling of biofilm-growing bacteria in IE can provide key information for both antimicrobial therapy and prevention strategies.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis

et al. 2019

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“…These patients make up a special IE population with a clear predisposing factor, different epidemiological profile, and higher mortality. 2,3 Use of the traditional modified Duke criteria (DC) is limited in these patients because the interpretation of the lesions seen on echocardiography is complex and many cases of suspected IE are left without a conclusive diagnosis. 4 Hence, the development of new diagnostic tools for IE is clinically important.…”

Section: September 22 2015mentioning

confidence: 99%

Improving the Diagnosis of Infective Endocarditis in Prosthetic Valves and Intracardiac Devices With ¹⁸ F-Fluordeoxyglucose Positron Emission Tomography/Computed Tomography Angiography

et al. 2015

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Background— The diagnosis of infective endocarditis (IE) in prosthetic valves and intracardiac devices is challenging because both the modified Duke criteria (DC) and echocardiography have limitations in this population. The added value of 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) and 18 F-FDG PET/CT angiography (PET/CTA) was evaluated in this complex scenario at a referral center with a multidisciplinary IE unit. Methods and Results— Ninety-two patients admitted to our hospital with suspected prosthetic valve or cardiac device IE between November 2012 and November 2014 were prospectively included. All patients underwent echocardiography and PET/CT, and 76 had cardiac CTA. PET/CT and echocardiography findings were evaluated and compared, with concordant results in 54% of cases (κ=0.23). Initial diagnoses with DC at admission, PET/CT, and DC+PET/CT were compared with the final diagnostic consensus reached by the IE Unit. DC+PET/CT enabled reclassification of 90% of cases initially classified as possible IE with DC and provided a conclusive diagnosis (definite/rejected) in 95% of cases. Sensitivity, specificity, and positive and negative predictive values were 52%, 94.7%, 92.9%, and 59.7% for DC; 87%, 92.1%, 93.6%, and 84.3% for PET/CT; and 90.7%, 89.5%, 92%, and 87.9% for DC+PET/CT. Use of PET/CTA yielded even better diagnostic performance values than PET/nonenhanced CT (91%, 90.6%, 92.8%, and 88.3% versus 86.4%, 87.5%, 90.2%, and 82.9%) and substantially reduced the rate of doubtful cases from 20% to 8% ( P <0.001). DC+PET/CTA reclassified an additional 20% of cases classified as possible IE with DC+PET/nonenhanced CT. In addition, PET/CTA enabled detection of a significantly larger number of anatomic lesions associated with active endocarditis than PET/nonenhanced CT ( P =0.006) or echocardiography ( P <0.001). Conclusions— 18 F-FDG PET/CT improves the diagnostic accuracy of the modified DC in patients with suspected IE and prosthetic valves or cardiac devices. PET/CTA yielded the highest diagnostic performance and provided additional diagnostic benefits.

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“…Mediana starosti naših bolnikov je bila 65 let, kar se ujema s staranjem populacije, ki preboleva IE. Podobne podatke najdemo tudi v novejši literaturi (3-5), v primerjavi s starejšimi podatki pa je starost nekoliko višja (6)(7)(8)(9). Razmerje med moškimi in ženskami se približa 2:1 in je podobno tipičnemu razmerju v ostalih raziskavah (7,10,11).…”

Section: Razpravljanjeunclassified

Infekcijski endokarditis v regionalni bolnišnici – Analiza primerov v letih 2005–2014

2017

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Introduction: Infective endocarditis (IE) is a serious disease with a high mortality rate and is defned as an inﬂammation of the endocardium, caused by microorganisms. Most data about IE originate from referral hospitals, therefore we aimed to analyse the demographics, presentation, diagnostics, treatment and outcome of IE at a regional hospital (Izola General Hospital–SBI) in a 10-year period.Methods: We analysed 51 episodes of IE and compared patients who were treated at a regional hospital alone, to those transferred to a referral centre. We also included data about all IE patients in a large referral hospital (University Medical Centre Ljubljana–UMCL).Results: Gender and age of the patients in SBI were similar to UMCL patients, however, there was a slightly higher share of IE in drug users and lower of prosthetic valve endocarditis. Our patients more often had streptococcal and less often staphylococcal endocarditis. Fewer patients needed surgery and time to operation was 17 days (median). Twenty-six percent of the patients died in the hospital. Approximately a half of the patients were transferred to a referral hospital, more often younger patients and women. The transferred patients often underwent surgery.Conclusions: Good cooperation with a referral hospital ensures that the outcome and other data of IE patients treated at a regional hospital are comparable to those in the literature. Some diﬀerences between patients treated in the regional hospital and the referral centre were observed. Time from admission to surgery could be shortened.

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Epidemiology of Infective Endocarditis in Spain in the Last 20 Years

Cited by 33 publications

References 54 publications

Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis

Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis

Improving the Diagnosis of Infective Endocarditis in Prosthetic Valves and Intracardiac Devices With ¹⁸ F-Fluordeoxyglucose Positron Emission Tomography/Computed Tomography Angiography

Infekcijski endokarditis v regionalni bolnišnici – Analiza primerov v letih 2005–2014

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Epidemiology of Infective Endocarditis in Spain in the Last 20 Years

Cited by 33 publications

References 54 publications

Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis

Microbial biofilm correlates with an increased antibiotic tolerance and poor therapeutic outcome in infective endocarditis

Improving the Diagnosis of Infective Endocarditis in Prosthetic Valves and Intracardiac Devices With 18 F-Fluordeoxyglucose Positron Emission Tomography/Computed Tomography Angiography

Infekcijski endokarditis v regionalni bolnišnici – Analiza primerov v letih 2005–2014

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Improving the Diagnosis of Infective Endocarditis in Prosthetic Valves and Intracardiac Devices With ¹⁸ F-Fluordeoxyglucose Positron Emission Tomography/Computed Tomography Angiography