Clinical Features and Outcome of Infective Endocarditis in a University Hospital in Romania

Abstract

Background and Objectives: Characterization of patients with endocarditis regarding demographic, clinical, biological and imagistic data, blood culture results and possible correlation between different etiologic factors and host status characteristics. Material and methods: This is a retrospective observational descriptive study conducted on patients older than 18 years admitted in the past 10 years, in the Cardiology Clinic of the Clinical County Emergency Hospital Oradea Romania, with clinical suspicion of bacterial endocarditis. Demographic data, clinical, paraclinical investigations and outcome were registered and analyzed. Results: 92 patients with definite infective endocarditis (IE) according to modified Duke criteria were included. The mean age of patients was 63.80 ± 13.45 years. A percent of 32.6% had health care associated invasive procedure performed in the 6 months before diagnosis of endocarditis. Charlson’s comorbidity index number was 3.53 ± 2.029. Most common clinical symptoms and signs were: shortness of breath, cardiac murmur, fever. Sixty-six patients had native valve endocarditis, 26 patients had prosthetic valve endocarditis and one patient was with congenital heart disease. Blood cultures were positive in 61 patients. Among positive culture patient’s staphylococcus group was the most frequently involved: Staphylococcus aureus (19.6%) and coagulase negative Staphylococcus (18.5%). Most frequent complications were heart failure, acute renal failure and embolic events. Conclusions: Staphylococcus aureus IE was associated with the presence of large vegetations, prosthetic valve endocarditis and intracardiac abscess. Coagulase negative Staphylococcus (CoNS) infection was associated with prosthetic valve dysfunction. Streptococcus gallolyticus etiology correlated with ischemic embolic stroke and the presence of large vegetations. Cardiovascular surgery was recommended in 67.4% of patients but was performed only on half of them. In hospital death occurred in 33.7% of patients and independent predictors of mortality were congestive heart failure and septic shock.

Cardiovascular Risk Among Saudi Adults with Prediabetes: A Sub-Cohort Analysis from the Heart Health Promotion (HHP) Study

“…On the other hand, Vitamin D is connected to numerous CVDs, including infectious myocarditis, which is caused by aberrant immunological reactions as a result of vitamin D receptor inadequacy. 38,39 In the current study, we found that people with prediabetes have greater CVR scores than normal participants regardless of their (25(OH)D) levels, we also did not identify a significant link between HbA1c and (25(OH)D) levels in prediabetics or healthy participants.…”

Infective Endocarditis in High-Income Countries

“…CoNS coagulase-negative staphylococci occurred in 18.5% of infections leading to prosthetic valve dysfunction. In particular, the presence of Streptococcus gallolyticus etiology was correlated with ischemic embolic stroke and with the development of large vegetations [ 98 ].…”

Antibacterial and Antifungal Management in Relation to the Clinical Characteristics of Elderly Patients with Infective Endocarditis: A Retrospective Analysis

“…This multicentric study managed to provide a comprehensive analysis of infective endocarditis cases from western Romania during a four-year period and described in detail the antibiotic and antifungal management of the affected patients, along with the treatment complications and risk factors for mortality. Set in the global context of infective endocarditis, the data from Romania are limited to clinical monocentric studies [ 32 , 33 ], while country-wide epidemiologic data and real-world statistics are scarcely reported or lacking. Therefore, a real estimate of the recent evolution of cases over time is a difficult estimate in the country.…”

“…However, during the four-year period of the data analysis, nearly two-thirds (62.6%) of the participants in our research were older than 65. In older patients, the incidence of endocarditis was described to be about nine times greater compared to that in younger patients, although the threshold for old age is a matter of constant change and debate [ 32 , 33 , 34 ]. The age distribution of endocarditis is also changing, as endocarditis mostly impacted young individuals with rheumatic valvular disease, but it now primarily affects elderly patients, as rheumatic heart disease is widely prevented through prophylaxis methods [ 35 ].…”