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Bentata Y, Haloui I, Haddiya I, Benzirar A, El Mahi O, Ismailli N, Elouafi N. Infective endocarditis in hemodialysis patients: A 10-year observational single center study. J Vasc Access 2020; 23:149-153. [PMID: 33143535 DOI: 10.1177/1129729820970783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The incidence of infective endocarditis (IE) in chronic hemodialysis (CHD) patients remains high, despite the preventive measures implemented by nephrologists, especially the rigorous respect of hygiene, the use of antibiotic locks for catheters and the use of tunneled catheters instead of non-tunneled. OBJECTIVE The objective of this study was to determine the clinical, biological, and echocardiographic characteristics, and the prognosis of IE in CHD. PATIENTS AND METHODS It was a retrospective study, conducted from December 2010 to March 2020, at the Nephrology and Cardiology units of University Hospital in Oujda, Morocco. RESULTS We compiled a series of 31 CHD patients having developed IE. Eleven cases (35.4%) were collected between 2010 and 2015, and 20 cases (64.6%) between 2016 and 2020. The mean age was 47 ± 19 years, 58% were male, and 25.8% of patients had diabetes. Vascular access for hemodialysis was by arteriovenous fistula, non-tunneled catheter, and tunneled catheter in 22.5%, 32.2%, and 45.2%, of the cases, respectively. About 25.8% of patients had benefited from more than two catheters (tunneled or non-tunneled) during the 3 months preceding the occurrence of IE. The mitral, tricuspid, and aortic valves were the site of IE in 41.9%, 41.9%, and 13% of the cases, respectively. Right heart IE and left heart IE were observed in 42% (13 cases) and 58% (18 cases) of cases, respectively. Blood cultures were negative in 58.1% of the cases at the time of diagnosis of IE. Staphylococcus aureus was identified in 69.2% of the cases. Mortality occurred in 54.8% of the cases. CONCLUSION IE remains a severe condition in CHD patients with an increasing incidence. Rigorous prevention and screening strategies should be implemented at the hemodialysis centers.
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Affiliation(s)
- Y Bentata
- Nephrology, Dialysis and Kidney Transplantation Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Medical School, University Mohammed First, Oujda, Morocco
| | - I Haloui
- Nephrology, Dialysis and Kidney Transplantation Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco
| | - I Haddiya
- Nephrology, Dialysis and Kidney Transplantation Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco.,Laboratory of Epidemiology, Clinical Research and Public Health, Medical School, University Mohammed First, Oujda, Morocco
| | - A Benzirar
- Vascular Surgery Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco
| | - O El Mahi
- Vascular Surgery Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco
| | - N Ismailli
- Laboratory of Epidemiology, Clinical Research and Public Health, Medical School, University Mohammed First, Oujda, Morocco.,Cardiology Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco
| | - N Elouafi
- Laboratory of Epidemiology, Clinical Research and Public Health, Medical School, University Mohammed First, Oujda, Morocco.,Cardiology Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco
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