Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia

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.

Staphylococcus aureus adaptive evolution: Recent insights on how immune evasion, immunometabolic subversion and host genetics impact vaccine development

“…Likewise, studies by Kaasch et al (Kaasch et al, 2014), Lessa et al (Lessa et al, 2010), Gasch et al (Gasch et al, 2013) and others have observed higher incidence of SAB in males than females. In contrast, human females have been suggested to have a somewhat higher mortality rate than males as a result of SAB (Lamagni et al, 2011;Barry et al, 2021). Similarly, Bansal et al (Bansal et al, 2021) and Barry et al recently reported that males have a higher incidence of infective endocarditis (Barry et al, 2021).…”

“…In contrast, human females have been suggested to have a somewhat higher mortality rate than males as a result of SAB (Lamagni et al, 2011;Barry et al, 2021). Similarly, Bansal et al (Bansal et al, 2021) and Barry et al recently reported that males have a higher incidence of infective endocarditis (Barry et al, 2021). However, this is a common theme of sepsis (Sunden-Cullberg et al, 2020) where sepsis in females is associated with higher mortality, is recognized later and females receive treatment later than males.…”

Exebacase: A Novel Approach to the Treatment of Staphylococcal Infections

“…Staphylococcus is among the most common causes of endovascular infections, including infective endocarditis (IE), which may occur in the setting of a bloodstream infection [ 12 – 14 ]. In an experimental aortic valve MRSA IE rabbit model, transthoracic echocardiography was utilized to evaluate the in vivo effect of exebacase on vegetation progression when combined with daptomycin (versus daptomycin alone) [ 8 ].…”

Infectious endocarditis – current profile

“…В развиващите се страни обаче ревматичното сърдечно заболяване остава най-честият предразполагащ рисков фактор за ИЕ [24]. Например метаанализ за Африка, публикуван 2022 г., съобщава за 52% случаи на РСП, Индия -20%, Саудитска Арабия -15%, Латинска Америка -13% [20,[26][27][28]. За сравнение в International Collaboration on Endocarditis -Prospective Cohort Study (ICE-PCS) [2] случаите с РСП са 3%, а по данни на нашия център -2,6%.…”

“…However, in developing countries, rheumatic heart disease remains the most common predisposing risk factor for IE. For example, a meta-analysis for Africa published in 2022 reported 52% cases of RHD, India -19%, Saudi Arabia -15%, Latin America -13% [20,[26][27][28]. In comparison, in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) [2] cases of RHD were 3%.…”