Management of infective endocarditis and multidisciplinary approach

Camou, Fabrice; Dijos, Marina; Barandon, Laurent; Cornolle, Claire; Greib, C.; Laine, Mika; Lecomte, R.; Boutoille, David; Machelart, Irène; Peuchant, Olivia; Tlili, Ghoufrane; Wirth, G.; Issa, N.

doi:10.1016/j.medmal.2018.06.007

Cited by 22 publications

(28 citation statements)

References 10 publications

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“…Similarly, a French group implemented weekly multidisciplinary meetings to discuss IE cases. This allowed that facility to adequately follow current guideline recommendations, thus reducing fatality to only 12% despite the increasing complexity of IE cases over time (21). Anguita Sánchez et al performed a prospective study of IE patients over a period of 15 years.…”

Section: Rationale and Evidence For An Endocarditis Teammentioning

confidence: 99%

The value of an “Endocarditis Team”

Davierwala¹,

Marín-Cuartas²,

Misfeld³

et al. 2019

Ann. Cardiothorac. Surg.

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Establishment of the Heart Team concept in the field of cardiovascular medicine has resulted in quality improvement in the management of heart valve disease and heart failure. Similarly, the concept of an Endocarditis Team would be important in improving outcomes in patients with infective endocarditis (IE),given it is an uncommon clinical entity with general practitioners and low-volume centers lacking sufficient experience in its management. A multidisciplinary approach can substantially reduce the still unacceptably high morbidity and mortality in patients with IE, as it allows early diagnosis and appropriate comprehensive management. Decision-making within the Endocarditis Team must follow a standard protocol that is based on current clinical guidelines for the management of IE. If surgery is indicated, it is best performed sooner than later in most instances. Communication between referring hospitals and reference centers with an established Endocarditis Team must be smooth and definite protocols for transfer to experienced endocarditis centers with surgical facilities is essential. Follow-up and outpatient care following hospital discharge is crucial due to the possibility of residual infection and risk of development of recurrent endocarditis or heart failure, particularly within the first 2 years. Patient and health-care provider education is the mainstay for the accurate implementation of the Endocarditis Team concept. The following Keynote Lecture offers an overview of the current literature supporting the multidisciplinary management of IE and addresses multiple aspects related to the Endocarditis Team, highlighting its importance and necessity for the comprehensive treatment of this complex disease.

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Section: Rationale and Evidence For An Endocarditis Teammentioning

confidence: 99%

The value of an “Endocarditis Team”

Davierwala¹,

Marín-Cuartas²,

Misfeld³

et al. 2019

Ann. Cardiothorac. Surg.

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“…La endocarditis infecciosa asociada al cuidado de la salud es una complicación grave de la atención en salud, que muestra una creciente incidencia en la literatura y representa alrededor del 30% de todos los casos de endocarditis infecciosa [6][7][8] , e incluso en algunas series se ha reportado más frecuente que la endocarditis infecciosa adquirida en la comunidad 7,9 . Este aumento en la incidencia se ha relacionado en algunos trabajos con una disminución en la realización de profilaxis antibiótica [10][11][12][13][14] .…”

Section: Introductionunclassified

“…Varios estudios realizados en diferentes países durante las últimas décadas han sugerido que las características de la endocarditis han cambiado tanto en su componente microbiológico como en el perfil demográfico. Dichos cambios se han evidenciado principalmente en la endocarditis infecciosa asociada al cuidado de la salud, lo cual podría estar relacionado con procedimientos médico-quirúrgicos invasivos 7,9,14,[16][17][18][19][20] .…”

Section: Introductionunclassified

Endocarditis infecciosa asociada al cuidado de la salud. Estudio de prevalencia en un hospital de alta complejidad

Arango¹,

Camacho-Mackenzie²,

Cruz-Cuevas³

et al. 2022

RCCAR

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Introducción: Los procedimientos vasculares invasivos ocasionan infecciones sanguíneas asociadas a cuidados de la salud, entre ellas endocarditis infecciosa. Este evento adverso conlleva mayor morbimortalidad que la endocarditis infecciosa adquirida en la comunidad. Objetivo: Evaluar la prevalencia de endocarditis infecciosa asociada al cuidado de la salud y describir las características demográficas de esta población, así como los agentes etiológicos. Método: Estudio de corte transversal, en el que se incluyó población mayor de 18 años con endocarditis infecciosa asociada al cuidado de la salud, documentada entre enero de 2013 y junio de 2018 en la Fundación Cardioinfantil. Se realizó un análisis estadístico con distribución de variables de edad, sexo, procedimientos invasivos asociados, mortalidad y microorganismo aislado. Resultados: Se incluyeron 41 pacientes con una edad promedio de 60,6 años. No hubo distinción entre hombres (22, 53.6%) y mujeres (19, 46.3%). Los pacientes se agruparon, según el procedimiento realizado, en implantación de dispositivos intravasculares de alto flujo (16, 39.02%), catéter venoso central (12, 29.26%) y dispositivos intracardiacos (11, 26.82%). La prevalencia general en los procedimientos evaluados fue del 0.21%, siendo del 1.42% en dispositivos intravasculares de alto flujo, del 0.72% en dispositivos intracardiacos y del 0.08% en catéteres centrales. La mortalidad registrada fue del 4.9% (2 pacientes). En el 78.05% de los pacientes se obtuvo aislamiento microbiológico. Conclusiones: Los pacientes sometidos a procedimientos invasivos pueden tener un riesgo elevado de endocarditis infecciosa, conferido por el procedimiento. La baja tasa de mortalidad intrahospitalaria puede estar relacionada con la notable tasa de aislamiento positivo en hemocultivos, lo cual facilitó la terapia antibiótica dirigida.

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“…The implementation of an ID team for the early management of sepsis in the Emergency Department improved the adherence to Surviving Sepsis Campaign recommendations, appropriateness of initial antibiotic therapy and patient survival (Viale et al, 2017). Nowadays, management of IE typically requires a multidisciplinary team, including, at least, an infectious disease specialist, a cardiologist and a cardiac surgeon, with proven benefit (Nishimura et al, 2014;Holland et al, 2016;Camou et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Risk factors and outcomes of early acute kidney injury in infective endocarditis: A retrospective cohort study

Tokarski

Lemaignen

Portais

et al. 2020

International Journal of Infectious Diseases

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The incidence of acute kidney injury (AKI) in infective endocarditis (IE), its risk factors and consequences on patient and renal survival remain debated. Methods: Patients hospitalized for a first episode of IE (possible or definite according to modified Duke criteria) between 2013 and 2016 were included. The primary endpoint was to determine risk factors for early AKI (E-AKI) during the first week of management of IE. Results: A total of 276 patients were included: 220 (79.7%) had definite IE and 56 (20.3%) had possible IE. E-AKI occurred in 150 patients (53%). IE due to Staphylococcus aureus (OR 3.41; 95% CI 1.83-6.39; p < 0.01), history of diabetes (OR 2.34; 95% CI 1.25-4.37; p < 0.01), peripheral arterial disease (OR 2.59; 95% CI 1.07-6.23; p < 0.05), immunological manifestations (OR 3.11; 95% CI 1.31-7.39; p = 0.01), and use of norepinephrine (OR 3.44; 95% CI 1.72-7.02; p < 0.01) were associated with E-AKI. In subgroup analysis, infectious disease consultation was associated with a lower risk of AKI at day 7 (OR 0.41; 95% CI 0.16-0.88; p = 0.04). E-AKI was associated with 1-year mortality (OR 1.65; 95% CI 1.03-2.64; p = 0.04) and chronic kidney disease progression (OR 2.23; 95% CI 1.30-3.82; p < 0.01).Conclusions: E-AKI is common in IE and often associated with non-modifiable variables. Multidisciplinary management should be mandatory, and awareness of AKI diagnosis and etiological explorations should be raised.

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Management of infective endocarditis and multidisciplinary approach

Cited by 22 publications

References 10 publications

The value of an “Endocarditis Team”

The value of an “Endocarditis Team”

Endocarditis infecciosa asociada al cuidado de la salud. Estudio de prevalencia en un hospital de alta complejidad

Risk factors and outcomes of early acute kidney injury in infective endocarditis: A retrospective cohort study

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