Infective endocarditis in the 21st century

Nappi, Francesco; Spadaccio, Cristiano; Mihos, Christos G.

doi:10.21037/atm-20-4867

Cited by 11 publications

(7 citation statements)

References 22 publications

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“…In the antibiotic era, IE is no longer a disease of underdeveloped countries. Similar epidemiological phenomena have been reported in high income countries due to rising living standards and prophylactic antibiotic administration [ 36 , 37 ].…”

Section: From Pathophysiology To Multidisciplinary Assessmentsupporting

confidence: 80%

Infective Endocarditis during Pregnancy—Keep It Safe and Simple!

et al. 2023

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The diagnosis of infective endocarditis (IE) during pregnancy is accompanied by a poor prognosis for both mother and fetus in the absence of prompt management by multidisciplinary teams. We searched the electronic databases of PubMed, MEDLINE and EMBASE for clinical studies addressing the management of infective endocarditis during pregnancy, with the aim of realizing a literature review ranging from risk factors to diagnostic investigations to optimal therapeutic management for mother and fetus alike. The presence of previous cardiovascular pathologies such as rheumatic heart disease, congenital heart disease, prosthetic valves, hemodialysis, intravenous catheters or immunosuppression are the main risk factors predisposing patients to IE during pregnancy. The identification of modern risk factors such as intracardiac devices and intravenous drug administration as well as genetic diagnostic methods such as cell-free deoxyribonucleic acid (DNA) next-generation sequencing require that these cases be addressed in multidisciplinary teams. Guiding treatment to eradicate infection and protect the fetus simultaneously creates challenges for cardiologists and gynecologists alike.

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Section: From Pathophysiology To Multidisciplinary Assessmentsupporting

confidence: 80%

Infective Endocarditis during Pregnancy—Keep It Safe and Simple!

et al. 2023

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“…The major concern due to infective endocarditis is the discrepancy between the trends toward earlier diagnosis and surgical intervention with respect to the 1-year mortality that has not improved in over 2 decades. This indicates that infective endocarditis persists as a primary concern despite its change in presentation from the pre-antibiotic era, through the first generations of targeted antibiotic treatment, and finally to the present patient population who have all undergone variations in the microbiology profile [ 13 , 39 ]. In the past, IE occurred in young or middle-aged adults with underlying rheumatic heart disease or congenital heart disease (CHD).…”

Section: Special Populations Of Infectious Endocarditis In the 21st C...mentioning

confidence: 99%

Infective Endocarditis in High-Income Countries

et al. 2022

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Infective endocarditis remains an illness that carries a significant burden to healthcare resources. In recent times, there has been a shift from Streptococcus sp. to Staphylococcus sp. as the primary organism of interest. This has significant consequences, given the virulence of Staphylococcus and its propensity to form a biofilm, rendering non-surgical therapy ineffective. In addition, antibiotic resistance has affected treatment of this organism. The cohorts at most risk for Staphylococcal endocarditis are elderly patients with multiple comorbidities. The innovation of transcatheter technologies alongside other cardiac interventions such as implantable devices has contributed to the increased risk attributable to this cohort. We examined the pathophysiology of infective endocarditis carefully. Inter alia, the determinants of Staphylococcus aureus virulence, interaction with host immunity, as well as the discovery and emergence of a potential vaccine, were investigated. Furthermore, the potential role of prophylactic antibiotics during dental procedures was also evaluated. As rates of transcatheter device implantation increase, endocarditis is expected to increase, especially in this high-risk group. A high level of suspicion is needed alongside early initiation of therapy and referral to the heart team to improve outcomes.

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“…The major concern due to the infective endocarditis is the discrepancy between the trends toward earlier diagnosis and surgical intervention with respect to the 1-year mortality that has not improved in over 2 decades. This indicates that IE persists as a primary concern despite its change in presentation from the pre-antibiotic era through the first generations of targeted antibiotic treatment and finally to the present patient population who have all have undergone variations in the microbiology profile [13,39]. In the past, IE occurred in young or middle-aged adults with underlying rheumatic heart disease or congenital heart disease (CHD).…”

Section: Special Populations Of Infectious Endocarditis In the 21st C...mentioning

confidence: 99%

Pathophysiology of Infective Endocarditis in High-Income Countries

Nappi¹,

Martuscelli²,

Bellomo³

et al. 2022

Preprint

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Infective endocarditis remains an illness that carries a significant burden to healthcare resources. In recent times, there has been a shift from Streptococcus sp to Staphylococcus sp as the primary organism of interest. This has significant consequences given the virulence of Staphylococcus and its propensity to form a biofilm, rendering non-surgical therapy ineffective. In addition, antibiotic resistance has affected treatment of this organism. The cohorts at most risk for Staphylococcal endocarditis are the elderly patients with multiple comorbidities. The innovation of transcatheter technologies alongside other cardiac interventions such as implantable devices have contributed to the increased risk attributable to this cohort. We examine the role of the heart team for diagnosis and treatment of this condition. In addition, we examine the determinants of virulence of Staphylococcus aureus, the interaction with hosts immunity and the discovery and emergence of a potential vaccine. We also examine the potential role of prophylactic antibiotics during dental procedures. With increasing rates of transcatheter device implantations, there is a projected increment of endocarditis especially in this high-risk group. A high index of suspicion is needed alongside early initiation of therapy and referral to the heart time to improve outcomes.

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Infective endocarditis in the 21st century

Cited by 11 publications

References 22 publications

Infective Endocarditis during Pregnancy—Keep It Safe and Simple!

Infective Endocarditis during Pregnancy—Keep It Safe and Simple!

Infective Endocarditis in High-Income Countries

Pathophysiology of Infective Endocarditis in High-Income Countries

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