The relationship between causative microorganisms and cardiac lesions caused by infective endocarditis: New perspectives from the contemporary cohort of patients

Trifunović, Danijela; Vujisić-Tešić, Bosiljka; Obrenović-Kirćanski, Biljana; Ivanović, Branislava; Kalimanovska-Oštrić, Dimitra; Petrović, Milan; Boričić-Kostić, Marija; Matić, Snežana; Stevanović, Goran; Marinković, Jelena; Petrović, Olga; Draganic, G.; Tomic-Dragovic, M; Putnik, Svetozar; Marković, Dejan; Tutus, Vladimir; Jovanovic, I; Markovič, Maja; Petrović, Ivana; Petrović, Jelena; Stepanović, Jelena

doi:10.1016/j.jjcc.2017.08.010

Cited by 20 publications

(25 citation statements)

References 27 publications

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“…The secular trend analysis is presented in Table 5 and significant trends are presented in Figure 1. [11]. Those results were consistent with our findings that CoNS infections were associated with perivalvular abscesses (extension of the infective process).…”

Section: Differences Over Timesupporting

confidence: 93%

“…However, this was not the case with prosthetic aortic valves. Further, significant associations were seen between viridans group streptococci and group B streptococcal infections and mitral valve vegetations and between HACEKand CIED-associated IE.Associations between specific bacterial infections and IE manifestations detected by ECHO have been reported previously[10,11]. Trifunovic et al could not show any associations between specific IE manifestations and certain etiologies in their study of 246 patients with IE, even though their main findings were that S. aureus and gram-negative bacteria caused large vegetations, CoNS caused destructive leaflet lesions, CoNS and gram-negative bacteria caused perivalvular extension of the infective process, and that gram-negative bacteria were associated with multiple manifestations in the same patient…”

mentioning

confidence: 54%

“…Although identification of causative bacteria and IE specific cardiac manifestations are crucial for the diagnosis and treatment of IE, the studies on associations between microbiological data and ECHO findings are scarce and the published results diverging [10][11][12]. Therefore, our aim was to analyze whether there were relationships between the bacteria found in blood culture or from sites of infection found during cardiac surgery and specific IE manifestations detected by ECHO in a cohort of IE patients.…”

Section: Introductionmentioning

confidence: 99%

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Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Damlin

Westling

Maret

et al. 2019

Preprint

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Background The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. Methods In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher’s exact test was used for comparisons between categorical variables, and student’s t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.

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Section: Differences Over Timesupporting

confidence: 93%

mentioning

confidence: 54%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Damlin

Westling

Maret

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…The secular trend analysis is presented in Table 5 and significant trends are presented in Figure 1. [11]. Those results were consistent with our findings that CoNS infections were correlated with perivalvular abscesses (extension of the infective process).…”

Section: Differences Over Timesupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Damlin

Westling

Maret

et al. 2019

Preprint

View full text Add to dashboard Cite

Background The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated correlations between bacterial infections and IE manifestations diagnosed by ECHO. Methods In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher’s exact test was used for comparisons between categorical variables, and student’s t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Correlations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions Correlations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.

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Epidemiology, Microbiology, and Clinical Outcomes Among Patients With Intravenous Drug Use-Associated Infective Endocarditis in New Brunswick

2020

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Background Within the context of Canada’s opioid crisis, medical complications associated with intravenous drug use (IVDU) are increasing. Infective endocarditis (IE) is a serious complication of IVDU, and understanding the characteristics of these patients could aid health systems, clinicians, and patients in the optimization of treatment and prevention of IVDU-IE. Methods At a tertiary care hospital in southern New Brunswick, we conducted a retrospective chart review to identify patients with IVDU-IE admitted between January 1, 2013, and December 31, 2017. We collected data related to the epidemiology, microbiology, clinical manifestations, echocardiography, complications during hospital admission, and outcomes. Results Forty-two cases of IVDU-IE met inclusion criteria. The rate of IVDU-IE increased from 2.28 per 100,000 population in 2014 to 4.00 in 2017, which, although not statistically significant, reflects patterns in other jurisdictions. Most patients (72.4%) were male, and the mean age was 38.3 (±11.5) years. Most patients (79.3%) injected opioids. The most common clinical sign was fever (90.5%), and Staphylococcus aureus ( 61.9%) was the most common microorganism. The tricuspid valve was most commonly infected (58.5%), 50% of cases had heart failure as a complication during admission, and 45.2% of cases required valve replacement or repair. The 2-year survival rate after admission for initial IVDU-IE episode was 62.0% (95% confidence interval: 36.5-79.7). Conclusion IVDU-IE is common in New Brunswick and may be increasing. Despite the relatively young age of this patient population, IVDU-IE is associated with significant morbidity and mortality. Expanding effective harm reduction and addiction treatment strategies for this cohort is recommended.

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The relationship between causative microorganisms and cardiac lesions caused by infective endocarditis: New perspectives from the contemporary cohort of patients

Cited by 20 publications

References 27 publications

Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Epidemiology, Microbiology, and Clinical Outcomes Among Patients With Intravenous Drug Use-Associated Infective Endocarditis in New Brunswick

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