Cardiac surgery for infective endocarditis in patients with intravenous drug use

Østerdal, Oda Bratland; Salminen, Pirjo-Riitta; Jordal, Stina; Sjursen, Haakon; Wendelbo, Øystein; Haaverstad, Rune

doi:10.1093/icvts/ivv397

Cited by 60 publications

(73 citation statements)

References 24 publications

(38 reference statements)

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“…The study revealed 75% of the IDUs were HCV positive. These results were in agreement with those reported by a study conducted on IE patients who were intravenous (I.V) addicts; they reported that 86% of the patients were HCV positive [32]. Our findings were in accordance with results reported by a study conducted by Ghosh et al, in which 91% of the patients had fever as the most prevalent symptom [33].…”

Section: Discussionsupporting

confidence: 93%

Prevalence of Staphylococcal Superantigens and their association among bacteremic and Infective Endocarditis patients in Egypt

Elsherif

Helal

El-Ansary

et al. 2020

Preprint

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31Aim: Infective endocarditis (IE) is a major complication of Staphylococcus (S.) aureus infection 32 in humans particularly those with bacteremia. Although Staphylococcus species are commensal 33 on or in different parts of the human body, it is also known to be a serious pathogen causing 34 bacteremia and sepsis that could lead to IE. Therefore, our aim was to assess the prevalence as 35 well as phenotypic and genotypic association of the Staphylococcal superantigens (SAgs) among 36 bacteremic and IE patients.37 Methods: This study was conducted on Staphylococcus isolates recovered from bacteremic and 38 IE patients. The isolates were screened phenotypically for the detection of SAgs including 39Staphylococcal enterotoxins (SEs) and toxic shock syndrome toxin-1 (TSST-1). Molecular 40 detection and analysis of sea, seb, sec, sed, see and tsst-1, the major SAgs coding genes were 41 performed using PCR and agarose gel electrophoresis, respectively. The obtained findings were 42 statistically analyzed using standard methods. 43Results: Detection of SAgs using ELISA revealed that 12 (46%) isolates were positive for 44 enterotoxin production. However, the PCR revealed that 19 (73%) isolates were positive for 45 enterotoxin genes with the highest prevalence of the sea gene (79%), followed by the seb (63%), 46 tsst-1 (21%). The least frequent gene was the sed (5.3%). Accordingly, phenotypic and genotypic 47 screening for prevalence of SAgs among Staphylococcal isolates showed significant difference 48 (P value =0.046703), however, no significant correlation could be observed among the coagulase 49 negative Staphylococci (CoNS) isolates (P value =0.248213). Statistical correlations between 50 bacteremic and IE isolates with respect to prevalence of SAgs, showed no significant difference 51 (P-value = 0.139, Effect size = 0.572) indicating no specific association between any of the 52 detected SAgs and IE. 3 53 Conclusion: no significant difference has been found between Staphylococcal IE and bacteremia 54 isolates regarding both phenotypic and genotypic detection of the most commonly SAgs. 55 Therefore, all Staphylococcal bacteremic patients are suspected for IE. Also, future work should 56 be conducted for analysis of SAgs gene expression. 57 58 59 Introduction 60 S. aureus is a dangerous and versatile human pathogen because of its ability to cause various 61 types of infections, including skin and soft tissue sepsis, pneumonia, bloodstream infections 62 (BSIs), osteomyelitis and infective endocarditis (IE) [1]. Higher mortality rate (15-25%) was 63 recently reported from serious S. aureus infections, particularly bacteremia and endocarditis 64 [2,3]. IE is a major devastating complications of Staphylococcal bacteremia [3,4]. In 2018, 65 Asgeirsson et al. reported that S. aureus is the foremost cause of IE where it comprises about 15-66 40% of all IE cases worldwide [3]. 67 IE is caused principally with bacteria or fungi where serious clinically relevant complications 68 including, damaging of one or more of the ...

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Section: Discussionsupporting

confidence: 93%

Prevalence of Staphylococcal Superantigens and their association among bacteremic and Infective Endocarditis patients in Egypt

Elsherif

Helal

El-Ansary

et al. 2020

Preprint

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“…20,36,45,46,47,48 These studies were limited by the small sample sizes of PWID and markedly different ages and comorbidities 20,49 of the 2 populations, which limits the conclusions that could be drawn. Notably, it has also been shown that PWID selected for surgery were more urgent cases (taken to the operating room within 24 hours) and more likely to have active infection, with the causative agent being S aureus, 50 suggesting a more unstable population.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

et al. 2018

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Key Points Question In first-episode infective endocarditis in persons who inject drugs, what are the clinical differences between patients who receive surgery vs those who are medically treated, and which factors are associated with mortality? Findings In this case series of 370 first-episode cases of infective endocarditis, the main significant differences between persons who inject drugs who received surgery and those who did not were the site of infection and cardiac complications. Decreased mortality was associated with surgery and referral to addiction treatment services, while higher mortality was associated with left-sided and bilateral infections. Meaning In selected persons who inject drugs with first-episode endocarditis, surgical management and referral to addiction treatment were associated with reduced mortality.

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“…In particular, data regarding the outcomes of cardiovascular operations in this population are restricted mainly to reports based on single-institution experiences only. 10,[17][18][19][20][21] As such, a population-based overview of surgical outcomes among patients with OUD after various cardiovascular operations has not been previously reported. Therefore, the aims of this study were to use data from a large national database to (1) characterize the population of cardiac surgery patients with OUD and (2) investigate the association of underlying OUD with outcomes and resource utilization after cardiovascular operations.…”

mentioning

confidence: 99%

Trends and Outcomes of Cardiovascular Surgery in Patients With Opioid Use Disorders

Dewan

Idrees

et al. 2019

JAMA Surg

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IMPORTANCE Persistent opioid use is currently a major health care crisis. There is a lack of knowledge regarding its prevalence and effect among patients undergoing cardiac surgery. OBJECTIVE To characterize the national population of cardiac surgery patients with opioid use disorder (OUD) and compare outcomes with the cardiac surgery population without OUD. DESIGN, SETTING, AND PARTICIPANTS In this retrospective population-based cohort study, more than 5.7 million adult patients who underwent cardiac surgery (ie, coronary artery bypass graft, valve surgery, or aortic surgery) in the United States were included. Pregnant patients were excluded. Propensity matching was performed to compare outcomes between cardiac surgery patients with OUD (n = 11 359) and without OUD (n = 5 707 193).

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Cardiac surgery for infective endocarditis in patients with intravenous drug use

Cited by 60 publications

References 24 publications

Prevalence of Staphylococcal Superantigens and their association among bacteremic and Infective Endocarditis patients in Egypt

Prevalence of Staphylococcal Superantigens and their association among bacteremic and Infective Endocarditis patients in Egypt

Clinical Characteristics and Factors Associated With Mortality in First-Episode Infective Endocarditis Among Persons Who Inject Drugs

Trends and Outcomes of Cardiovascular Surgery in Patients With Opioid Use Disorders

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