Infective endocarditis in Africa: an urgent call for more data

Pecoraro, Alfonso; Herbst, Philip; Doubell, Anton

doi:10.1016/s2214-109x(21)00489-7

Cited by 6 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In high-income countries, the epidemiologic factors that are engaged in the incidence of IE have altered in comparison to the past few decades due to parameters such as an increased life span, a markedly increased number of nosocomial cases, and an increased number of cases of degenerative valvular disease [9,10]. However, a paucity of data is available in developing countries such as Iran [11][12][13]. In this regard, we aimed to conduct a retrospective study to determine the demographical, microbiological, clinical features, and outcomes of patients admitted to a referral hospital in Mashhad, Iran, with a diagnosis of IE between March 2012 to March 2020.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of epidemiological and microbiological characteristics, clinical features, and outcomes of adult patients with infective endocarditis in Mashhad, Iran

Shahini,

Shirazinia,

Jafari

et al. 2023

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: Infective endocarditis (IE) is a serious problem with high morbidity and mortality. However, there is a paucity of data regarding its epidemiology in non-high-income settings. Here, we described the characteristics of patients with IE. Methodology: Between March 2012 to March 2020, all adults (≥ 16 years) with a diagnosis of IE who were admitted to a university hospital in Mashhad, Iran, were included in the study. Results: We evaluated 46 cases of IE with a median age of 42 years (interquartile range 31 to 58.3 years), of whom 21 (46%) had a definite diagnosis. The presence of a prosthetic valve or intracardiac device was the leading predisposing factor (N = 14, 30%). The etiology of IE in 22 subjects (48%) remained unknown. Staphylococcus aureus (N = 12, 26%) was the most common causative pathogen. Echocardiography revealed the mitral valve as the most affected valve (N = 18, 39%). Intravenous drug users (IVDU) had a higher chance of right-sided IE, as compared to no IVDU patients (odds ratio: 35, 95% CI: 3.7 to 425.0). The most prevalent complications were lung infarction, acute heart failure, and neurologic involvement (N = 5, 11% for each), and 15 patients (33%) died because of IE. Conclusions: In our study, the median age of IE onset was relatively low. The most frequent predisposing factor was a prosthetic valve or intracardiac device. The proportion of negative blood cultures was unacceptably high. Thus, our findings emphasize promoting laboratory infrastructure, developing a national protocol for early initiation of appropriate treatment, and eliminating predisposing factors.

show abstract

Section: Introductionmentioning

confidence: 99%

Evaluation of epidemiological and microbiological characteristics, clinical features, and outcomes of adult patients with infective endocarditis in Mashhad, Iran

Shahini,

Shirazinia,

Jafari

et al. 2023

J Infect Dev Ctries

View full text Add to dashboard Cite

show abstract

“…IE in South Africa is typically associated with high rates of blood culture negative IE (BCNIE) where no organism is cultured and no cause is identified. Although incompletely studied (8), late presentation with a delay in diagnosis and a high prevalence of underlying rheumatic heart disease (RHD) are also proposed reasons for explaining the adverse outcomes reported (1,(4)(5)(6). Due to the high prevalence of underlying RHD, combined with the young age of patients with IE, the majority of patients that require surgery will receive a mechanical valve replacement rather than valvular repair surgery or a bioprosthesis (1,5,7).…”

Section: Introductionmentioning

confidence: 99%

Early surgery determines prognosis in patients with infective endocarditis: outcome in patients managed by an Endocarditis Team—a prospective cohort study

Pecoraro¹,

Herbst²,

Janson³

et al. 2022

Cardiovasc Diagn Ther

View full text Add to dashboard Cite

Background: Infective endocarditis (IE) in South Africa is associated with significant morbidity and mortality, despite occurring in younger patients with fewer co-morbidities. Possible contributors include the high rates of blood culture negative endocarditis, high rates of mechanical valve replacement and the lack of inter-disciplinary coordination during management. Methods:The Tygerberg Endocarditis Cohort (TEC) study prospectively enrolled patients with IE between November 2019 and April 2021. All patients were managed by an Endocarditis Team with a set protocol for organism detection and a strategy of early surgery limiting the use of prosthetic material.Results: Seventy-two consecutive patients with IE were included, with a causative organism identified in 86.1% of patients. The majority of patients had a guideline indication for surgery (n=58; 80.6%). The in-hospital mortality rate was 18%, with a 6-month mortality rate of 25.7%. Surgery was performed in 42 patients (58.3%), with prosthetic valve (PVE) replacement in 32 (76.2%), conventional repair surgery in 8 (19.1%) and mitral valve reconstruction in 2 (4.8%) of patients. Patients who underwent surgery had a significantly lower in-hospital (4.8% vs. 56.3%; P<0.01) and 6-month (4.9% vs. 75.0%; P<0.01) mortality rate as compared with patients with an indication for surgery who did not undergo surgery. Conclusions:We have observed a reduction in the 6-month mortality rate in patients with IE following the establishment of an Endocarditis Team, adhering to a set protocol for organism detection and favouring early repair or reconstruction surgery. Patients who underwent surgery had a significantly lower mortality rate than patients with an indication for surgery who did not undergo surgery. Preventable residual mortality was driven by surgical delay.

show abstract

“…However, only HIV and alcohol use were reported in their Table 1; current homelessness, previous homelessness, and shelter exposure were not described. Moreover, it is increasingly recognized that B quintana is endemic to many low-income countries [ 5 , 8 ]. Thus, immigration history is an important and often neglected risk factor for B quintana infection that was not described here.…”

mentioning

confidence: 99%

Schrödinger's Cat Paradox: Bartonella Serology Cannot Be Used to Speciate Bartonella Endocarditis

Boodman

Gupta

2023

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Infective endocarditis in Africa: an urgent call for more data

Cited by 6 publications

References 10 publications

Evaluation of epidemiological and microbiological characteristics, clinical features, and outcomes of adult patients with infective endocarditis in Mashhad, Iran

Evaluation of epidemiological and microbiological characteristics, clinical features, and outcomes of adult patients with infective endocarditis in Mashhad, Iran

Early surgery determines prognosis in patients with infective endocarditis: outcome in patients managed by an Endocarditis Team—a prospective cohort study

Schrödinger's Cat Paradox: Bartonella Serology Cannot Be Used to Speciate Bartonella Endocarditis

Contact Info

Product

Resources

About