Infective Endocarditis in Children in Italy from 2000 to 2015

Esposito, Susanna; Mayer, Alessandra; Krzysztofiak, Andrzej; Garazzino, Silvia; Lipreri, Rita; Galli, Luisa; Osimani, Patrizia; Fossali, Emilio F.; Gangi, Maria Di; Lancella, Laura; Denina, Marco; Pattarino, Giulia; Montagnani, Carlotta; Salvini, Filippo; Villani, Alberto; Principi, Nicola

doi:10.1586/14787210.2016.1136787

Cited by 17 publications

(13 citation statements)

References 25 publications

(14 reference statements)

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“…Since an underlying CHD was known in 87% of our IE population data strongly support the observation of other reports which state that CHD became one of the major risk factors for IE after the occurrence of rheumatic fever declined (9,14,22,23). In addition we observed a high prevalence (62%) of right-sided IE in a CHD heavy population as observed in other CHD cohorts (8,22,24). Interestingly, IE in unrepaired CHD was less common in our patients.…”

Section: A C C E P T E Dsupporting

confidence: 91%

“…IE caused by viridans group streptococci was the most prevalent in our population, closely followed by coagulase-negative staphylococci and S. aureus. This is in line with an Italian pediatric IE survey from 2000-2015 where streptococci were found as the major underlying cause in CHD patients (24). In other studies and an international review of more than 30,000 children, however, S. aureus is reported as being the most frequent and important bacterial origin (19,22,32).…”

Section: A C C E P T E Dsupporting

confidence: 84%

“…IE in children with a normal structured heart remains present in a small group of our population (13%). At present, 8-20% of the IE cases are estimated to occur in children with anatomically normal hearts, in which the course of IE is essentially different if predisposing factors as indwelling central lines leading to health-care associated IE are present (24,29).…”

Section: A C C E P T E Dmentioning

confidence: 99%

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Clinical Characteristics of Infective Endocarditis in Children

Kelchtermans

Grossar

Eyskens

et al. 2019

Pediatric Infectious Disease Journal

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Background: Infective endocarditis (IE) remains a diagnostic and therapeutic challenge associated with high morbidity and mortality. We evaluated the microbial profile and clinical manifestation of IE in children. Methods: A retrospective study examining pediatric IE cases treated between 2000 and 2017 at the Department of Pediatric Cardiology, KU Leuven, was conducted. Clinical presentation, treatment, complications, outcome of IE, underlying microorganisms and congenital heart defects were reviewed. Results: 53 patients were diagnosed with IE. Overall, 19 patients (36%) required cardiac surgery. 7 patients (13%) died. 87% of patients had an underlying congenital cardiac defect. 18 (34%) children presented with prosthetic graft IE. A causative organism was found in 49 (92%) cases: viridans group streptococci were identified in 17 (32%), S. aureus in 13 (25%) and coagulase-negative staphylococci (CNS) in 11 (20%) children. Community acquired (CA) IE increased significantly from 8 (33%) cases in 2000 -2007 to 20 (74%) cases in 2008 -2017 (p<0.01). Even with viridans streptococci being significantly more prevalent in the CA group (p<0.01), we did not observe an increase of streptococcal IE from 2008 -2017. 17 (32%) patients presented with HA IE during the first year of life with 14 (82%) children after surgery and a prevalence of CNS (53%). Conclusion:The incidence of pediatric IE was similar over the investigated time period with a shift towards CA IE. Streptococci and staphylococci accounted for the majority of cases in both periods. Awareness of IE and its prevention is crucial in patients after implantation of prosthetic grafts.

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Section: A C C E P T E Dsupporting

confidence: 91%

Section: A C C E P T E Dsupporting

confidence: 84%

Section: A C C E P T E Dmentioning

confidence: 99%

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Clinical Characteristics of Infective Endocarditis in Children

Kelchtermans

Grossar

Eyskens

et al. 2019

Pediatric Infectious Disease Journal

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“…Staphylococci predominate in children without congenital heart disease. For example in a recent epidemiological investigation in Italy, S. aureus emerged as the leading cause of IE in children without predisposing cardiac ailments with an overwhelming majority (85.7%) of S. aureus isolates being MRSA [48].…”

Section: Special Considerations For Ie In Childrenmentioning

confidence: 99%

An update on Staphylococcus aureus infective endocarditis from the International Society of Antimicrobial Chemotherapy (ISAC)

Saeed

Bal

Gould

et al. 2019

International Journal of Antimicrobial Agents

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“…У цих підгрупах ВВС не є основною причиною розвитку ІЕ, але в них могли бути інші фактори ризику і різний спектр збудників. Так, у реанімаційних відділеннях стафілококи, стрептококи та гриби є поширеними причинними мікроорганізмами для ІЕ, тоді як грамнегативні збудники частіше трапляються у відділеннях інтенсивної терапії дитячого профілю [17,18].…”

Section: вступunclassified

Experience of surgical treatment of infective endocarditis in children

Prokopovуch¹,

Golovenko

Truba

et al. 2019

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Surgical treatment of infectious endocarditis in children, single-center experience. The paper analyzes the experience of surgical treatment of infectious endocarditis (IE) in children. In the period from January 1999 to July 2019, 69 children with IE were operated at National Amosov Institute of Cardiovascular Surgery of NAMS of Ukraine, 44 of them (63.8%) developed the disease on the background of congenital heart defects (CHD). The mean age of the patients at the time of surgery was 9.1 ± 6.1 years. The average weight is 31.5 ± 21.7 (3.6 to 85 kg). The duration of the disease at the time of hospitalization was 5.3 ± 1.1 months. The average duration of the fever before hospitalization was 10.2 ± 8.5 weeks. Among the causes of IE, we observed three groups of inflammatory diseases: infections of the skin and subcutaneous fat in 15 (21.7%) cases, pathology of ENT – organs – 14 (20.2%) and broncho-pulmonary diseases – 9 (13.1%) cases. The risk factors were: presence of CHD – 44 (63.7%) and also nosocomial factors. The microbiological spectrum of pathogens included gram-positive microorganisms – 33 (71.7%), gram-negative microorganisms 4 (8.7%) and fungal microflora 9 (19.6%). The mean values of bypass circulation were 111.5 ± 62.4 minutes, and the time of aortic clamping was 71.4 ± 43.9 minutes, respectively. Hospital mortality in the general group of patients was 4 (5.8%) cases. In the follow-up period, 59 patients were examined, representing 90.7% of those discharged at the hospital stage. The observation period lasted from one month to 19.4 years (9.6 ± 5.7 years). According to the Kaplan-Meier analysis, the cumulative survival rate of patients in the CHD group at one year after surgery was 97.1%, at 10 years – 93.5%; after 15 years – 93.5%. Survival in the non-CHD group at 5, 10, and 15 years was 100%. In the long term, two patients died (3.4%). The recurrence rate of IE in the distant period was 2 (3.4%) cases. The incidence of long-term reoperation was 8 (13.6%) cases, three were recurrent IE and five were non-recurrent. According to Kaplan-Meier analysis, the proportion of patients without recurrent surgery in the long-term follow-up at 5 years was 87.9%, at 10 years – 84.1%, after 15 years – 77.1% in the CHD group. In the group without CHD 5 years – 95.2%, 10 years – 95.2%, 15 years – 81.6%. In the long term, as a result of performed surgical interventions, the regression of clinical manifestations of heart failure was noted in the majority of patients.

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Infective Endocarditis in Children in Italy from 2000 to 2015

Abstract: In Italy, paediatric IE develops without any previous predisposing factors in a number of children, methicillin-resistant S. aureus has emerged as a common causative agent and the therapeutic approach is extremely variable.

Cited by 17 publications

References 25 publications

Clinical Characteristics of Infective Endocarditis in Children

Clinical Characteristics of Infective Endocarditis in Children

An update on Staphylococcus aureus infective endocarditis from the International Society of Antimicrobial Chemotherapy (ISAC)

Experience of surgical treatment of infective endocarditis in children

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