Valve Replacement for Left-Sided Endocarditis in Drug Addicts

Mammana, Robert B.; Levitsky, Sidney; Sernaque, David; Beckman, Charles B.; Silverman, Norman A.

doi:10.1016/s0003-4975(10)61598-6

Cited by 28 publications

(3 citation statements)

References 16 publications

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“…If the disease is refractory to antibiotics, then partial tricuspid valvulectomy or "vegetectomy" 160 without valve replacement is indicated. 161 Although valve replacement often is necessary for curing left-sided IE caused by P aeruginosa, 162 results in a series of 10 patients (7 with left-sided involvement alone or in combination with tricuspid disease) suggest that medical therapy alone is occasionally curative. 149 Studies in animals with experimental Pseudomonas endocarditis 163 offer a potential explanation for these disparate results: The penetration into vegetations and the time during which antibiotic concentrations exceeded the MBC were both significantly greater with tricuspid than with aortic vegetations for both ceftazidime and tobramycin.…”

Section: Pseudomonas Speciesmentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

1,277

436

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Background-Despite advances in medical, surgical, and critical care interventions, infective endocarditis remains a disease that is associated with considerable morbidity and mortality. The continuing evolution of antimicrobial resistance among common pathogens that cause infective endocarditis creates additional therapeutic issues for physicians to manage in this potentially life-threatening illness. Methods and Results-This work represents the third iteration of an infective endocarditis "treatment" document developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It updates recommendations for diagnosis, treatment, and management of complications of infective endocarditis. A multidisciplinary committee of experts drafted this document to assist physicians in the evolving care of patients with infective endocarditis in the new millennium. This extensive document is accompanied by an executive summary that covers the key points of the diagnosis, antimicrobial therapy, and management of infective endocarditis. For the first time, an evidence-based scoring system that is used by the American College of Cardiology and the American Heart Association was applied to treatment recommendations. Tables also have been included that provide input on the use of echocardiography during diagnosis and treatment of infective endocarditis, evaluation and treatment of culture-negative endocarditis, and short-term and long-term management of patients during and after completion of antimicrobial treatment. To assist physicians who care for children, pediatric dosing was added to each treatment regimen. Conclusions-The recommendations outlined in this update should assist physicians in all aspects of patient care in the diagnosis, medical and surgical treatment, and follow-up of infective endocarditis, as well as management of associated complications. Clinical variability and complexity in infective endocarditis, however, dictate that these guidelines be used to support and not supplant physician-directed decisions in individual patient management. (Circulation. 2005; 111:e394-e433.)

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Section: Pseudomonas Speciesmentioning

confidence: 99%

Infective Endocarditis

Baddour¹,

Wilson²,

Bayer³

et al. 2005

Circulation

1,277

436

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“…Louis, USA1986–2005Yes6239 ± 937 (59.7)19.1Microbiologic data only for 31 of 62 in PWID.No28454 ± 15185 (65.1)18.8Kim [50]2016Boston, USA2002–2014Yes7835.9 ± 9.948 (61.5)10No35859.3 ± 14.1247 (69)10Levitsky [51]1982Chicago, USA1976–1981Yes3734.6 ± NA31 (83.8)5No SD reported. Age range 20–52Mammana [52]1983Chicago, USA1976–1979Yes1833.7 ± 10.3●3Reconstructed IPD from published table.Martin-Davila [53]2005Madrid, Spain1985–1999Yes2633 ± NA●12Non-PWID were excluded because they were not separated by surgical and non-surgical patients.Marks [54]2015London, England1998–2010Yes1127.8 ± 4.8●52 daysData reported together for surgical and non-surgicalMathew [55]1995Chicago, USA1982–1991Yes8037.7 ± 1058 (72.5)7.5Mestres [56]2003Barcelona, Spain1985–2002Yes2128.2 ± 6.518 (85.7)10.8Nelson [57, 58]1984Los Angeles, USA1972–1982Yes2732.9 ± NA37 (7110)10Demographic data reported together for PWID and non-PWID. Group D streptococcus counted as enterococcus.No SD reported.…”

Section: Resultsmentioning

confidence: 99%

Long term surgical outcomes for infective endocarditis in people who inject drugs: a systematic review and meta-analysis

Goodman‐Meza

Weiss²,

Gamboa³

et al. 2019

BMC Infect Dis

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BackgroundIn recent years, the number of infective endocarditis (IE) cases associated with injection drug use has increased. Clinical guidelines suggest deferring surgery for IE in people who inject drugs (PWID) due to a concern for worse outcomes in comparison to non-injectors (non-PWID). We performed a systematic review and meta-analysis of long-term outcomes in PWID who underwent cardiac surgery and compared these outcomes to non-PWID.MethodsWe systematically searched for studies reported between 1965 and 2018. We used an algorithm to estimate individual patient data (eIPD) from Kaplan-Meier (KM) curves and combined it with published individual patient data (IPD) to analyze long-term outcomes after cardiac surgery for IE in PWID. Our primary outcome was survival. Secondary outcomes were reoperation and mortality at 30-days, one-, five-, and 10-years. Random effects Cox regression was used for estimating survival.ResultsWe included 27 studies in the systematic review and 19 provided data (KM or IPD) for the meta-analysis. PWID were younger and more likely to have S. aureus than non-PWID. Survival at 30-days, one-, five-, and 10-years was 94.3, 81.0, 62.1, and 56.6% in PWID, respectively; and 96.4, 85.0, 70.3, and 63.4% in non-PWID. PWID had 47% greater hazard of death (HR 1.47, 95% CI, 1.05–2.05) and more than twice the hazard of reoperation (HR 2.37, 95% CI, 1.25–4.50) than non-PWID.ConclusionPWID had shorter survival that non-PWID. Implementing evidence-based interventions and testing new modalities are urgently needed to improve outcomes in PWID after cardiac surgery.

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“…In the case of GNB-IE, historically, the most critical risk factor was the intravenous injection of recreational substances associated with contaminants in the drugs used or the products used for their dilution [9,[15][16][17][18][19][20][21]. The past two decades of this century have again seen a rise in IE due to the epidemic of opioid use, particularly in the USA [22,23 && ].…”

Section: What Is the Proportion Of Gram-negative Bacilli As Causative...mentioning

confidence: 99%

Gram-negative endocarditis: disease presentation, diagnosis and treatment

Bouza

Muñóz

Burillo

2021

Current Opinion in Infectious Diseases

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Purpose of reviewGram-negative bacilli (GNB) cause between 1% and 10% of infective endocarditis (IE). Most episodes are caused by microorganisms of the Haemophilus spp., Aggregatibacter spp. Cardiobacterium spp., Eikenella spp., and Kingella spp (HACEK) group. The frequency of IE caused by non-HACEK (GNB-IE) has increased in recent years. Uncertainties persist regarding its best medical treatment and the appropriateness and timing of surgical treatment. In addition, there are new drugs with activity against multiresistant microorganisms, of which there is little experience in this disease. We review this topic by answering the most frequently asked questions that arise among our colleagues.Recent findings HACEK microorganisms cause 1.5-2% of IE with only a 2% mortality. In contrast, non-HACEK GNB-IE accounts for 2.5-3% of all IE cases and is associated with nosocomial acquisition, advanced age, solid organ transplantation and 20-30% mortality. Drug addiction is important in areas with epidemic opioid abuse.

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Valve Replacement for Left-Sided Endocarditis in Drug Addicts

Cited by 28 publications

References 16 publications

Infective Endocarditis

Infective Endocarditis

Long term surgical outcomes for infective endocarditis in people who inject drugs: a systematic review and meta-analysis

Gram-negative endocarditis: disease presentation, diagnosis and treatment

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