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Al-Makhamreh HK, Al Bakri FG, Shaf'ei M, Mokheemer E, Alqudah S, Nofal A, Matarwah H, Altarawneh TB, Toubasi AA. Epidemiology, microbiology, and outcomes of infective endocarditis in a tertiary center in Jordan. Wien Med Wochenschr 2024; 174:126-132. [PMID: 36781611 PMCID: PMC9924832 DOI: 10.1007/s10354-023-01004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/10/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Infective endocarditis (IE) is a relatively rare but serious and life-threatening disease with substantial mortality and morbidity despite progress in diagnostic and treatment techniques. The aim of this study is to investigate the epidemiology, clinical characteristics, microbiological profile, and outcomes of IE patients in a tertiary care facility in Jordan, the Jordan University Hospital (JUH). METHODS This is a retrospective case series study which was conducted at JUH. A total of 23 patients with either definite or possible IE according to the Modified Duke Criteria were included in the study. Medical records were reviewed, and relevant information was collected. Descriptive data analysis was performed. RESULTS Our study identified a total of 23 patients with infective endocarditis; 65.2% were males, with a mean age of 40.4 years. The majority of patients had an underlying cardiac disease (60.9%), with the most common being congenital heart diseases (17.4%). The most commonly affected valves were the left-side heart valves, with the mitral valve (52.2%) being the most common followed by the aortic valve (34.8%). The most common organism detected in blood culture was Streptococcus viridans (21.7%) followed by methicillin-resistant Staphylococcus aureus. The most common complications among the patients were heart failure and septic shock, and the mortality rate among the patients was 13%. CONCLUSION In patients with endocarditis, Streptococcus viridans is the most common culture-positive bacteria at JUH. One third of our patients needed surgical intervention and the mortality rate was 13%.
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Affiliation(s)
- Hanna K Al-Makhamreh
- Department of Cardiology and Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Faris G Al Bakri
- Department of Infectious Diseases and Internal Medicine, Jordan University Hospital, Amman, Jordan
- Infectious Disease and Vaccine Center, The University of Jordan, Amman, Jordan
| | - Moayad Shaf'ei
- School of Medicine, The University of Jordan, 11942, Amman, Jordan
| | | | - Shahed Alqudah
- School of Medicine, The University of Jordan, 11942, Amman, Jordan
| | - Amani Nofal
- School of Medicine, The University of Jordan, 11942, Amman, Jordan
| | - Hanna Matarwah
- School of Medicine, The University of Jordan, 11942, Amman, Jordan
| | | | - Ahmad A Toubasi
- School of Medicine, The University of Jordan, 11942, Amman, Jordan.
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Alsheikh N, Alghbewi GB, Hakami NA, Aljadaie S, Sohaibani F, Alsaif M, Alsalamah M. A Three-Year Retrospective Study Assessing the Quality of the Course of Management of Infective Endocarditis in a Tertiary Hospital in Riyadh, Saudi Arabia. Cureus 2023; 15:e37539. [PMID: 37193472 PMCID: PMC10182859 DOI: 10.7759/cureus.37539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) is one of the most misdiagnosed diseases in Saudi Arabia because of the variable treatment regimen. This study aims to assess the quality of the management of infective endocarditis in a tertiary care teaching hospital. METHODS A single-center retrospective cohort study was conducted, based on electronic medical records extracted from the BestCare electronic medical record system, of all patients who presented with infective endocarditis as a final diagnosis from 2016 to 2019. RESULTS Out of a total of 99 patients diagnosed with infective endocarditis, 75% of our patients had blood cultures ordered before initiating empirical antibiotic therapy. Positive blood cultures were reported in 60% of patients. Staphylococcus aureus was the most common organism, identified in 18% of our patients, followed by Streptococcus viridans at 5%. Empirical antibiotics were initiated in 81% of patients. Proper antibiotic coverage was initiated within a week for 53% of the patients, and 14% had proper antibiotic coverage within two weeks. On echocardiography, 62% of the patients had vegetation that was present in a single valve. The mitral valve had the highest incidence of vegetation (24%), followed by the aortic valve (21%). Follow-up echocardiography was done in 52% of patients. It showed regressed vegetation in 43% of patients, while only 9% of patients had no vegetation regression. Valve repair was done in 25% of patients. Out of 99 patients, 47 required ICU admission. The mortality rate was 18%. CONCLUSION Overall management of infective endocarditis in the study hospital was appropriate and highly compliant with guidelines, with a few areas that could be improved further.
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Affiliation(s)
- Nejood Alsheikh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Ghadah B Alghbewi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Noof A Hakami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Soad Aljadaie
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Fatmah Sohaibani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Mohammed Alsaif
- Emergency Department, Ministry of the National Guard - Health Affairs, Riyadh, SAU
| | - Majid Alsalamah
- Emergency Department, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Poorzand H, Hamidi F, Sheybani F, Ghaderi F, Fazlinezhad A, Alimi H, Bigdelu L, Khosravi Bizhaem S. Infective Endocarditis: Clinical Characteristics and Echocardiographic Findings. Front Cardiovasc Med 2022; 9:789624. [PMID: 35445085 PMCID: PMC9014855 DOI: 10.3389/fcvm.2022.789624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/08/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Infective endocarditis (IE) remains a disease with high morbidity and mortality. The aim of this study was to determine the clinical characteristics and echocardiographic features of patients with IE. Methods We analyzed patients with either definitive or probable diagnosis of IE who were hospitalized in a teaching hospital in Mashhad, Iran between June 2011 and January 2020. Patients who survived were followed up by echocardiography for at least 6-month after hospital discharge. Results A total of 82 cases with IE were included of which 62 (75.6%) received definitive diagnosis. The mean age was 39.7 ± 18.7 years and 52 (63.4%) were male. The most common preexisting structural cardiac abnormality that predispose patients to IE were congenital heart diseases (28 %) of which bicuspid aortic valve was more common (n = 12, 14.6%), followed by ventricular septal defect (n = 9, 11%) and Tetralogy of Fallot (TOF) (n = 2, 2.4%). Three (3.6 %) cases had rheumatic heart disease and 12 (14.6 %) were injecting drug users. The most common causative pathogen was Staphylococcus aureus, detected in 7 (19.4%) cases. Follow-up echocardiography revealed right or left ventricular failure in 10 (12.1%) cases. Cardiac complications occurred in 41 (50%) cases and systemic complications in 63 (76.8%). All-cause mortality was 41.5% (n = 34) and 6 (18.1%) patients died due to cardiovascular complications. Conclusions The short- and long-term prognosis in IE was poor and the predictors for in-hospital and 1-year mortality were defined as heart failure and septic shock. Congenital heart disease and intravenous illicit drug using (IVDU) were the most common predisposing condition which may necessitate a revision in the IE prophylaxis recommendations.
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Affiliation(s)
- Hoorak Poorzand
- Division of Cardiovascular Medicine, Cardiovascular Department, Vascular and Endovascular Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Hamidi
- Cardiovascular Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- *Correspondence: Fatemeh Hamidi
| | - Fereshte Sheybani
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshteh Ghaderi
- Cardiovascular Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afsoon Fazlinezhad
- Cardiovascular Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hedieh Alimi
- Division of Cardiovascular Medicine, Cardiovascular Department, Vascular and Endovascular Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Bigdelu
- Cardiovascular Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeede Khosravi Bizhaem
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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Yang YF, Si FF, Chen TT, Fan LX, Lu YH, Jin M. Early surgical intervention in culture-negative endocarditis of the aortic valve complicated by abscess in an infant: A case report. World J Clin Cases 2021; 9:11016-11023. [PMID: 35047612 PMCID: PMC8678864 DOI: 10.12998/wjcc.v9.i35.11016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/25/2021] [Accepted: 10/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Surgical therapy of infective endocarditis (IE) involving aortic valves and mitral valves is widespread. However, there are few reports concerning patients with culture-negative endocarditis complicated by the appearance of comorbid valvular perforation and abscess. Therefore, real-time surveillance of changes in cardiac structure and function is critical for timely surgical management, especially in patients who do not respond to medical therapy.
CASE SUMMARY Here, we report an atypical case in a 9-mo-old infant without congenital heart disease but with symptoms of intermittent fever and macular rashes. Physical examination, laboratory tests, and electrocardiograms suggested a diagnosis of IE, although the result of blood cultures was exactly negative. After treatment with antibiotic drugs, the patient got a transient recovery. On the 9th day, we proceeded with continuous echocardiogram due to fever again and the results revealed aortic valve abscess with perforation, regurgitation, vegetation, and pericardial effusion. Intraoperative monitoring revealed aortic valve perforation, presence of apothegmatic cystic spaces below the left coronary cusp of the aortic valve, and severe aortic valve regurgitation. Aortic valve repair was performed by autologous pericardial patch plasty. The patient was discharged after 4 wk of treatment and no complications occurred after surgery.
CONCLUSION Our case demonstrated the necessity of serial echocardiography monitoring for possible adverse symptoms of IE in pediatric patients.
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Affiliation(s)
- Yan-Feng Yang
- Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Fei-Fei Si
- Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Ting-Ting Chen
- Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Ling-Xia Fan
- Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Ya-Heng Lu
- Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Mei Jin
- Department of Pediatric Cardiology, Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
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Barry M, Bari SA, Akhtar MY, Al Nahdi F, Erlandez R, Al Khushail A, Al Hebaishi Y. Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia. J Epidemiol Glob Health 2021; 11:435-443. [PMID: 34735715 PMCID: PMC8664328 DOI: 10.1007/s44197-021-00013-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/21/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a serious disease with complex pathology and significant mortality. Little information is known regarding clinical and microbiological characteristics in Saudi Arabia. This study surveyed these characteristics at a Cardiac Center in Riyadh, Saudi Arabia over a period of 5 years. METHODS This retrospective study was done on all infective endocarditis (IE) patients admitted to Prince Sultan Cardiac Center between January 1, 2015, and December 31, 2019. Clinical characteristics, microbiological results, management, and outcomes were assessed. RESULT A total of 340 cases of infective endocarditis were identified over the study period. Most patients (64%) were 50 years old or above, and 67% were males. Fever was the most common clinical presentation, and a murmur was audible in a fifth of patients. Blood cultures were positive in 177 (52%) cases. The most common organisms were Staphylococcus aureus, coagulase negative Staphylococcus and viridans group Streptococcus. Most common microbiological organisms causing native valve endocarditis were viridans group Streptococcus (32%) followed by methicillin-susceptible Staphylococcus aureus (21%), and for prosthetic valve endocarditis they were coagulase negative Staphylococcus (32%) followed by methicillin-susceptible Staphylococcus aureus (23%), the most common causes of culture negative endocarditis were Q-fever and brucellosis. Predisposing cardiac conditions were present in 127 (37%) patients, most commonly rheumatic heart disease and congenital heart disease. Surgical intervention was done in 26% of cases, with an overall in-hospital mortality rate of 6.76%. CONCLUSION We demonstrate the epidemiological, clinical, and microbiological profile of infective endocarditis in a tertiary care cardiac center in Saudi Arabia. It gives information concerning the prevalence of responsible organisms. This information will be helpful in assessing patients with suspected IE and in planning management of cases knowing the relative frequency of types of microorganisms encountered.
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Affiliation(s)
- Mazin Barry
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, PO Box 2925, Riyadh, 11461, Saudi Arabia.
| | - Syed Abdul Bari
- Department of Infection Control, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | | | - Faizah Al Nahdi
- Department of Infection Control, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Richilda Erlandez
- Department of Infection Control, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Abdullah Al Khushail
- Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Yahya Al Hebaishi
- Department of Adult Cardiology, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
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Microbiological and Clinicoepidemiological Profile of a Series of Patients with Infective Endocarditis at a Center in Eastern Nepal. ACTA ACUST UNITED AC 2021; 2021:9980465. [PMID: 34336067 PMCID: PMC8324388 DOI: 10.1155/2021/9980465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/02/2021] [Accepted: 07/06/2021] [Indexed: 11/25/2022]
Abstract
Background The microbiological and clinicoepidemiological profile of infective endocarditis (IE) has undergone significant change over time. The pattern of IE studied at local level provides broader vision in understanding the current scenario of this disease. This study aimed to depict the overall picture of IE and its changing profile by evaluating the microbiological and clinicoepidemiological features in the context of a tertiary care center of eastern Nepal. Methods The descriptive study was conducted from September 2017 to August 2018 among IE patients presenting to B. P. Koirala Institute of Health Sciences, Nepal. Detailed history and clinical manifestations of patients were noted. Microorganisms isolated from the blood culture were processed for identification by standard microbiological methods, and susceptibility testings were done. Each patient was assessed daily during hospital stay. Results Ten definite and 7 possible endocarditis cases were studied. The mean age was 41.4 ± 15.85 (17–70) years with predominance of male (4.7 : 1). Rheumatic heart disease (41.1%) was the most common underlying heart disease observed followed by injection drug user endocarditis (23.5%). All the cases had native valve endocarditis. Aortic valve was the most common valve involved (35.3%) followed by mitral, tricuspid, and pulmonary valves. Blood culture positivity was 53%. Staphylococcus aureus was the major causative agent responsible for 23.5% of the cases followed by Enterococcus faecium, Enterococcus faecalis, and Pseudomonas aeruginosa. Mortality of 2 cases (11.8%) was associated with S. aureus and P. aeruginosa. Majority of patients developed acute kidney injury (35.3%) and congestive cardiac failure (23.5%). Conclusion IE patients in our center exhibited differences from the west in terms of age at presentation and predisposing factors but held similarity in terms of commonly isolated microorganisms. The changing patterns of IE, etiological agents, and their antimicrobial susceptibility observed in this study may be helpful for clinicians in formulating a new empirical antibiotic treatment protocol.
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Zaqout A, Mohammed S, Thapur M, Al-Soub H, Al-Maslamani MA, Al-Khal A, Omrani AS. Clinical characteristics, microbiology, and outcomes of infective endocarditis in Qatar. Qatar Med J 2020; 2020:24. [PMID: 33282709 PMCID: PMC7684547 DOI: 10.5339/qmj.2020.24] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/03/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Infective endocarditis (IE) is a serious and potentially life-threatening disease. The epidemiology, treatment options, and outcomes have changed considerably over the last two decades. The aim of the study was to describe the epidemiology, clinical characteristics, and outcomes of patients with IE in Qatar. Methods: Patients were identified from Hamad Medical Corporation hospitals’ electronic records, the national referral center for the State of Qatar. We included those aged ≥ 18 years with Duke Criteria-based diagnosis of IE during the period from January 2015 to September 2017. Demographic and clinical data were retrieved. Descriptive statistics were performed, and logistic regression analysis was used to describe the relationship between patient characteristics and all-cause in-hospital mortality. All potentially relevant variables were included in the univariate analysis, while those with p < 0.1 in the univariate logistic regression model were included in the multivariate analysis. For the final model, we calculated odds ratios (OR) adjusted for each of the variables included, along with their 95% confidence intervals (95% CI). Data were analyzed using STATA software version 15 (StataCorp, College Station, Texas, USA). The study was approved by the Institutional Research Board with a waiver for informed consent. Results: Fifty-seven cases were included, of which 70% were males. The mean age was 51 years ( ± 16.8 years). Eleven (19%) were associated with prosthetic valves, and 6 (11%) with implantable cardiac devices. Fever (84%), dyspnea (46%), and heart failure (37%) were the most common presentations. Only 58% of patients had known preexisting valvular heart disease or an intracardiac device. Skin infections (10 patients, 18%) were the most prevalent portals of infection, followed by venous catheters, recent valve surgery, and implantable cardiac devices. Staphylococci were implicated in 19 (34%) and Streptococcaceae in 9 (16%) patients, whereas 21 (37%) patients were culture negative. Left-side IE (49 patients, 86%) was predominant. Acute kidney injury (AKI) (17 patients, 30%) and heart failure (11 patients, 19%) were common complications. The majority of patients received targeted antimicrobial therapy with at least two active agents. Only 9 (16%) patients underwent surgical intervention. Fourteen (25%) patients died of any cause before hospital discharge. Logistic regression analysis identified septic shock [OR 57.8, 95% CI 2.6–1360.2; p < 0.01] and AKI OR 33.9, 95% CI 2.9–398.1; p < 0.01) as the only risk factors independently associated with in-hospital mortality. Conclusion: Staphylococci are the most common microbiological cause of IE in Qatar. Surgical intervention is uncommon, and mortality is relatively high. Our findings suggest that efforts should be directed toward improving IE prevention strategies in high-risk patients, encouraging early microbiological investigations and improving medical and surgical management.
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Affiliation(s)
- Ahmed Zaqout
- Infectious Diseases, Department of Medicine, Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
| | - Shaban Mohammed
- Department of Pharmacy Hamad Medical Corporation, Doha, Qatar
| | - Maliha Thapur
- Infectious Diseases, Department of Medicine, Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
| | - Hussam Al-Soub
- Infectious Diseases, Department of Medicine, Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Ali S Omrani
- Infectious Diseases, Department of Medicine, Division of Infectious Diseases, Hamad Medical Corporation, Doha, Qatar
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Angsutararux T, Angkasekwinai N. Cumulative incidence and mortality of infective endocarditis in Siriraj hospital-Thailand: a 10-year retrospective study. BMC Infect Dis 2019; 19:1062. [PMID: 31852453 PMCID: PMC6921523 DOI: 10.1186/s12879-019-4689-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 12/08/2019] [Indexed: 12/14/2022] Open
Abstract
Background To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand’s largest national tertiary referral center. Methods Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed. Results Of 380 patients, 66.3% had definite IE, and 81.3% had native valve IE (NVE). Cumulative IE incidence was 5.67/1000 admissions. The most common pathogens were viridans group streptococci (VGS) (39.7%), methicillin-sensitive Staphylococcus aureus (MSSA) (13.1%), and beta-hemolytic streptococci (11.5%) in NVE; and, MSSA (20.3%), VGS (20.3%), and Enterococcus spp. (16.9%) in prosthetic valve (PVE) or device-related IE (DRIE). Overall in-hospital mortality was 18.4%. Mortality was significantly higher in PVE/DRIE than in NVE (26.8% vs. 16.5%, p = 0.047). End-stage renal disease (ESRD) (aOR: 9.43, 95% CI: 2.36–37.70), diabetes mellitus (DM) (aOR: 2.81, 95% CI: 1.06–7.49), neurological complication (aOR: 14.16, 95% CI: 5.11–39.22), congestive heart failure (aOR: 4.32, 95% CI: 1.91–9.75), hospital-acquired infection (aOR: 3.78, 95% CI: 1.66–8.57), renal complication (aOR: 3.12, 95%CI: 1.32–7.37), and other complication during admission (aOR: 3.28, 95% CI: 1.41–7.61) were independently associated with mortality. Conclusions The incidence of IE, and the mortality rate among those diagnosed with IE are both increasing in Thailand – particularly among those with PVE or DRIE. End-stage renal disease, diabetes mellitus, and development of IE-related complications during admission were found to be independent predictors of mortality.
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Affiliation(s)
- Taksaon Angsutararux
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Nasikarn Angkasekwinai
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
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Kothari SS. Interactive clinical case: to give, or not to give, infective endocarditis prophylaxis. HEART ASIA 2017; 9:27-29. [PMID: 28123458 PMCID: PMC5237718 DOI: 10.1136/heartasia-2016-010860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/18/2016] [Indexed: 11/04/2022]
Abstract
The practice of prophylactic use of antibiotics before certain procedures for preventing infective endocarditis (IE) is not based on rigorous scientific data. It seems reasonable, however, to offer prophylactic antibiotics before dental procedures to patients who would have the highest risk of adverse events if they were to develop IE. The current recommendations do not include patients with rheumatic heart disease (RHD) in such a category. In the real world, however, patients with underlying RHD suffer high morbidity and mortality with IE due to several reasons. Consequently, prophylactic antibiotics should be used judiciously in patients with RHD. Further, other patient related factors might influence the decision to use antibiotics.
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Watt G, Lacroix A, Pachirat O, Baggett HC, Raoult D, Fournier PE, Tattevin P. Prospective comparison of infective endocarditis in Khon Kaen, Thailand and Rennes, France. Am J Trop Med Hyg 2015; 92:871-4. [PMID: 25646262 DOI: 10.4269/ajtmh.14-0689] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 12/13/2014] [Indexed: 12/13/2022] Open
Abstract
Prospectively collected, contemporary data are lacking on how the features of infective endocarditis (IE) vary according to region. We, therefore, compared IE in Rennes, France and Khon Kaen, Thailand. Fifty-eight patients with confirmed IE were enrolled at each site during 2011 and 2012 using a common protocol. Compared with French patients, Thais had a lower median age (47 versus 70 years old; P < 0.001) and reported more animal contact (86% versus 21%; P < 0.001). There were more zoonotic infections among Thai than France patients (6 and 1 cases; P = 0.017) and fewer staphylococcal infections (4 versus 15 cases; P = 0.011). Underlying rheumatic heart disease was more prevalent in Thai than in French patients (31% and 4%; P = 0.001), whereas prosthetic heart valves were less prevalent (9% and 35%; P = 0.001). Our data strengthen previous observations that IE in the tropics has distinctive demographic characteristics, risk factors, and etiologies and underscore the need for improved prevention and control strategies.
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Affiliation(s)
- George Watt
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
| | - Adele Lacroix
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
| | - Orathai Pachirat
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
| | - Henry C Baggett
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
| | - Didier Raoult
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
| | - Pierre-Edouard Fournier
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
| | - Pierre Tattevin
- Global Disease Detection Center, Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France
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