Recent Trends in Infective Endocarditis Among Patients with and Without Injection Drug Use: An Eight-Year Single Center Study

Balda, Javier; Alpizar-Rivas, Rodolfo; Elarabi, Salwa; Jaber, Bertrand L.; Nader, Claudia

doi:10.1016/j.amjms.2021.07.009

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…Despite the prevalence of PWID/IE in some rural areas, larger tertiary care centers in urban environments have also been impacted, in part related to the referral of IE patients for management expertise. For example, the prevalence of PWID in adult patients with IE seen recently in Boston, Massachusetts, and Lexington, Kentucky, has reached 46% and 73%, respectively [ 8 , 9 ].…”

mentioning

confidence: 99%

Temporal Trends of Infective Endocarditis in North America From 2000 to 2017—A Systematic Review

Talha

Dayer²,

Tariq

et al. 2021

Open Forum Infectious Diseases

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Objectives To examine temporal changes of infective endocarditis (IE) incidence and epidemiology in North America. Patients and Methods A systematic review was conducted at Mayo Clinic, Rochester. Ovid EBM Reviews™, Ovid Embase™, Ovid Medline™, Scopus™, and Web of Science™ were searched for studies published between January 1, 2000 and May 31, 2020. Four referees independently reviewed all studies, and those that reported a population-based incidence of IE in patients aged 18 years and older in North America were included. Results Of 8,588 articles screened, 14 were included. Overall, IE incidence remained largely unchanged throughout the study period, except for two studies that demonstrated a rise in incidence after 2014. Five studies reported temporal trends of injection drug use (IDU) prevalence among IE patients with a notable increase in prevalence observed. Staphylococcus aureus was the most common pathogen in 7 of 9 studies that included microbiologic findings. In-patient mortality ranged from 3.7-14.4%, while the percentage of patients who underwent surgery ranged from 6.4-16.0%. Conclusion Overall incidence of IE has remained stable among the 14 population-based investigations in North America identified in our systematic review. Standardization of study design for future population-based investigations have been highlighted for use in subsequent systematic reviews of IE.

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mentioning

confidence: 99%

Temporal Trends of Infective Endocarditis in North America From 2000 to 2017—A Systematic Review

Talha

Dayer²,

Tariq

et al. 2021

Open Forum Infectious Diseases

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“…Additionally, and possibly due to the opioid epidemic and injection drug use, an increasing number of MRSA bacteremia patients are younger and severely ill with endocarditis, frequently with metastatic foci of infection [ 33 , 34 ]. As discussed earlier, vancomycin is a poor antibiotic choice for these types of infections, with clear dosing strategies muddled by dynamic renal function and by potential augmented renal clearance of acute illness.…”

Section: Cost and Complexity Of Care Of Vancomycinmentioning

confidence: 99%

Approaching 65 Years: Is It Time to Consider Retirement of Vancomycin for Treating Methicillin-Resistant Staphylococcus aureus Endovascular Infections?

Rose

Volk

Dilworth

et al. 2022

Open Forum Infectious Diseases

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Vancomycin was introduced nearly 65 years ago and remains the standard antibiotic for serious methicillin-resistant Staphylococcus aureus (MRSA) infections. S. aureus remain highly susceptibility to vancomycin (>97%). Despite this, MRSA treatment failure with vancomycin is high in complicated bacteremia. Additionally, vancomycin can cause nephrotoxicity, leading to new therapeutic drug monitoring guidance. This demonstrates how difficult it is to dose vancomycin in a way that is both efficacious and safe, especially during long courses of therapy. Often underappreciated are the cost, resources, and complexity of vancomycin care at a time when alternative antibiotics are becoming cost comparable. This perspective highlights a bigger picture of how the treatment repertoires of many other diseases have changed and advanced since vancomycin’s introduction in the 1950s, yet the vancomycin MRSA treatment standard remains. While vancomycin can still have a role, 65 years may be a practical retirement age for vancomycin in highly complex endovascular infections.

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“…While viridans group streptococcus species were historically the most common set of pathogens identified in these illnesses, staphylococcus species (specifically S. aureus), have become the predominant pathogens worldwide over the last two decades [2,5,6]. Contributing factors include a large increase in injection drug usage [7,8], an increase in implantable cardiac devices and the broadening of their use [9], an increase in other indwelling devices in healthcare (i.e., central venous catheters) [8], and ergo a resulting overall increase in healthcare-related infections [10,11]. While staphylococcal and streptococcal species comprise the majority of identified organisms, gram negative rods (GNRs), enterococcus, polymicrobial infections, fungal species, and culture-negative cases have also been regularly identified [3,[12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Microbiology of Infective Endocarditis in United States Veterans — Association Between Causative Organism and Short- and Long-Term Outcomes

Duggan,

Peters,

Halbert

et al. 2023

HSF

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Background: Previous studies have elucidated the relationship between causative organism and outcomes in infective endocarditis, however this relationship has not been studies in United States Veterans. The aim of this manuscript is to evaluate the association between causative organism and short-term and long-term outcomes in United States (US) Veterans with infective endocarditis (IE) requiring surgical management between 2010–2020. Methods: We analyzed 489 patients with surgically treated IE from the Veterans Affairs (VA) Surgical Quality Improvement Program and the VA Informatics and Computing Infrastructure databases. Patients were divided into groups using causative organism identified from blood or intraoperative cultures – Staphylococcus, Streptococcus, Gram-negative rods, Enterococcus, Polymicrobial, and Unknown/Culture Negative. Other identified organisms were excluded from analysis. Cox proportional hazard models were used to calculate risk for stroke/transient ischemic attack (TIA), myocardial infarction (MI), and death based on group. The models were adjusted for covariates using backward elimination. Continuous variables were compared using ANOVA or Kruskal-Wallis H tests, and categorical variables were compared using Chi square tests. Results: Mean follow-up was 4.0 ± 6.3 years. Gram negative rods (GNRs) were associated with greater risk of long-term mortality (adjusted hazard ratios (aHR) 2.15, 95% CI: 1.20–3.86, p = 0.01). Enterococcus was associated with long-term risk of MI (aHR 2.05, 95% CI: 1.07–3.94, p = 0.03). Resistant organisms, such as methicillin-resistant staphylococcus aureus, were associated with long-term risk of MI (aHR 2.51, 95% CI: 1.14–5.45, p = 0.02). Polymicrobial infections were associated with greater risk of perioperative complications, including prolonged mechanical ventilation (48 hrs) (aHR 1.76, 95% CI: 1.05–2.97, p = 0.034), tracheostomy (aHR 5.64, 95% CI: 2.35–13.55, p < 0.001), and prolonged ICU stay (5 days) (aHR 1.39, 95% CI: 1.01–1.91, p = 0.043). Conclusions: In US Veterans, polymicrobial infections had notably worse perioperative outcomes but similar long-term outcomes in comparison to monomicrobial infections. GNR infections were associated with increased long-term mortality. Enterococcus and resistant organisms were associated with increased long-term risk of MI. Polymicrobial infections were associated with greater risk of perioperative complications, including prolonged mechanical ventilation, tracheostomy, and prolonged ICU stay.

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Recent Trends in Infective Endocarditis Among Patients with and Without Injection Drug Use: An Eight-Year Single Center Study

Cited by 6 publications

References 25 publications

Temporal Trends of Infective Endocarditis in North America From 2000 to 2017—A Systematic Review

Temporal Trends of Infective Endocarditis in North America From 2000 to 2017—A Systematic Review

Approaching 65 Years: Is It Time to Consider Retirement of Vancomycin for Treating Methicillin-Resistant Staphylococcus aureus Endovascular Infections?

Microbiology of Infective Endocarditis in United States Veterans — Association Between Causative Organism and Short- and Long-Term Outcomes

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