Infective endocarditis in people who inject drugs: A scoping review of clinical guidelines

Selitsky, Lea; Racha, Savitha; Rastegar, Darius A.; Olsen, Yngvild

doi:10.1002/jhm.12996

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Recent research outlines new trends in the factors of contamination by infectious agents triggering endocarditis, highlighting a significant increase in the incidence of this cardiac condition in individuals who use intravenous illicit drugs [132][133][134][135][136][137][138], a considerable proportion of whom are carriers of the hepatitis C virus [132][133][134][135][136]. The investigation of case reports pertaining to endocarditis caused by Rothia spp.…”

Section: The Incidence Of Endocarditis Caused Bymentioning

confidence: 99%

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Norberg,

Manhães

et al. 2023

JAMMR

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Background and Aim: Rothia, a genus comprising pleomorphic Gram-positive bacteria found in the human oral, intestinal, and skin microbiota, is recognized as an opportunistic pathogen. Case reports of Rothia spp. endocarditis in the scientific literature are scarce, with limited knowledge of relevant data on Rothia endocarditis and clinical aspects of its treatment. The objective of this literature review is to compile clinical aspects of endocarditis caused by Rothia species, analyzing results and clinical practices to elucidate the most important risk factors, comorbidities, prognostic factors, and appropriate antibiotic treatment options. Methods: Employing the PRISMA model, a systematic review was conducted utilizing PubMed, SciELO, and Google Scholar databases, encompassing articles published from 1978 to November 2023. Pertinent aspects were systematically recorded and summarized for subsequent analysis. Results: Rothia dentocariosa (48.69%), Rothia mucilaginosa (22.37%), Rothia aeria (14.47%), and Rothia kristinae (14.47%) were recognized as the agents of endocarditis cases. Patients exhibited an average age of 48.5 years, with a notable male preponderance (71.6%). Clinical manifestations of Rothia spp. endocarditis presented similar features compared to other Gram-positive bacterial endocarditis cases. The mortality rate was notably lower than observed in other infectious endocarditis instances (11.84%). Predominant risk factors included preexisting cardiovascular diseases (50%), followed by odontological procedures, caries, and precarious oral hygiene (17.1%), immunocompromised status (14.47%), injectable illicit drug use (11.84%), and diabetes (9.21%). Embolic events were documented in 35.53% of patients, predominantly in Central Nervous System (28.95%). Mycotic aneurysms were identified in 6.58% of cases. Resistance to antibiotics was identified in only 13.16% of strains causing endocarditis, although certain strains displayed characteristics indicative of multidrug resistance. Conclusion: Despite its rarity, Rothia spp. endocarditis exhibits clinical parallels with endocarditis caused by other Gram-positive bacteria, but with a comparatively lower mortality rate. Challenges in identifying Rothia spp. species based on cultural and microscopic characteristics, associated to early resolution in antibiotic therapy, seems to contribute to the underreporting of endocarditis caused by these bacteria.

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Section: The Incidence Of Endocarditis Caused Bymentioning

confidence: 99%

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Norberg,

Manhães

et al. 2023

JAMMR

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Grayken lessons: the role of an interdisciplinary endocarditis working group in evaluating and optimizing care for a woman with opioid use disorder requiring a second tricuspid valve replacement

Rozansky

Awtry

Weinstein

et al. 2023

Addict Sci Clin Pract

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Background Injection drug use-related endocarditis is increasingly common among hospitalized patients in the United States, and associated morbidity and mortality are rising. Case presentation Here we present the case of a 34-year-old woman with severe opioid use disorder and multiple episodes of infective endocarditis requiring prosthetic tricuspid valve replacement, who developed worsening dyspnea on exertion. Her echocardiogram demonstrated severe tricuspid regurgitation with a flail prosthetic valve leaflet, without concurrent endocarditis, necessitating a repeat valve replacement. Her care was overseen by our institution’s Endocarditis Working Group, a multidisciplinary team that includes providers from addiction medicine, cardiology, infectious disease, cardiothoracic surgery, and neurocritical care. The team worked together to evaluate her, develop a treatment plan for her substance use disorder in tandem with her other medical conditions, and advocate for her candidacy for valve replacement. Conclusions Multidisciplinary endocarditis teams such as these are important emerging innovations, which have demonstrated improvements in outcomes for patients with infective endocarditis and substance use disorders, and have the potential to reduce bias by promoting standard-of-care treatment.

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Infective endocarditis in people who inject drugs: A scoping review of clinical guidelines

Cited by 2 publications

References 28 publications

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Microbiological and Epidemiological Aspects of Endocarditis Caused by Rothia spp.: A Systematic Review

Grayken lessons: the role of an interdisciplinary endocarditis working group in evaluating and optimizing care for a woman with opioid use disorder requiring a second tricuspid valve replacement

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