Etiology, Risk Factors and Clinical Outcomes in Infective Endocarditis Patients Requiring Cardiac Surgery

Abstract

Background: Infective endocarditis, which may be caused by various microbial agents, severely affects the innermost layer of the heart and often leads to poor clinical outcomes. The purpose of this study was to investigate the etiology, risk factors and short and long-term outcomes of infective endocarditis caused by various bacterial agents in patients requiring cardiac surgery. Methods: One hundred and forty-four patients aged 18 years or above with indications for cardiac surgery due to S. aureus, Streptococcus spp., E. faecalis or coagulase-negative staphylococci caused infective endocarditis were included in this study. Results: S. aureus, Streptococcus spp., E. faecalis and coagulase-negative staphylococci were the causative agents of infective endocarditis in 44 (30.6%), 35 (24.3%), 33 (22.9%) and 32 (22.2%) patients, respectively. The presence of bicuspid aortic valve was the most common predisposing factor confirmed in 19 (23.5%), whereas intravenous drug usage was the most common in 17 (11.8%) patients. No significant differences in intrahospital mortality due to infective endocarditis caused by various bacterial agents were found, however, the worsening of long-term prognosis of endocarditis caused by S. aureus when compared to E. faecalis was confirmed (p = 0.03). The presence of S. aureus was associated with significantly higher rates of embolic complications (p = 0.003). The presence of coagulase-negative staphylococci was associated with prosthetic valve endocarditis (p = 0.015) and perivalvular complications (p = 0.024). Conclusions: In contrast to E. faecalis, the presence of S. aureus determines the worsening of the long-term mortality from infective endocarditis. Perivalvular complications are associated with the presence of coagulase-negative staphylococci.

The Assessment of Antimicrobial Resistance in Gram-Negative and Gram-Positive Infective Endocarditis: A Multicentric Retrospective Analysis

“…S. aureus is a pathogen with a reputation for aggression; it is often linked with severe clinical manifestations. Although our study did not report the complications of endocarditis, in particular, other authors have reported cerebral embolism in 30% of patients with S. aureus infective endocarditis [ 50 ]. Although embolism was more frequently associated with this bacteria, there was no significant difference in the vegetation size measured between other bacterial groups.…”

The Impact of Enterococcus spp. in the Immunocompromised Host: A Comprehensive Review

“…The presence of an invasive device has previously been identified as a significant clinical risk factor for VRE invasive infections [134]. Invasive procedures such as catheter insertion, ventilation, and surgery increase the risk by providing entry routes for Enterococcus, which can form biofilms on medical devices, or merely serve as indicators of debilitation, prolonged hospital stays, and severe comorbidities [141][142][143][144]. Patients with hematological conditions and invasive devices, undergoing prolonged antibiotic therapy in the same ward, may have acted as VRE reservoirs.…”

Post-cardiac catheterization infective endocarditis with flail mitral valve leaflets: an interesting and rare case

“…Infective endocarditis (IE) is a rare and life-threatening infection of the endocardium (inner lining of the heart). In decreasing order, the most commonly affected valves are the mitral, aortic, combined mitral-and-aortic, tricuspid, and pulmonic valves (1). In the past 30 years, IE incidence and mortality have risen, especially in areas with higher socio-demographic index (SDI) regions (2).…”