Clinical features and prognosis of infective endocarditis in children: Insights from a Tunisian multicentre registry

Jomaa, Walid; Ali, Imen Ben; Abid, Dorra; Ernez, S.; Abid, Leïla; Triki, Faten; Kammoun, S.; Gharbi, Anissa; Rejeb, Oussama Ben; Mahdhaoui, Abdallah; Jeridi, Gouider; Azaiez, Mohamed Ali; Hraïech, Aymen El; Hamda, Khaldoun Ben; Maatouk, Faouzi

doi:10.1016/j.acvd.2016.12.018

Cited by 21 publications

(21 citation statements)

References 17 publications

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“…Outcome data were reported in 23 (55%) of 42 studies. [21][22][23][25][26][27][28][29][31][32][33]35,[40][41][42][45][46][47][48][49][50][51][52] The pooled in-hospital mortality rate across studies was 22•6% (95% CI 19•5-25•9), which was similar in studies from north Africa (22•5%) and those from sub-Saharan Africa (22•7%; figure 4). Heart failure was the most frequent complication, occurring in 47 5 and the appendix (pp 62-66).…”

Section: Resultsmentioning

confidence: 86%

“…22,[29][30][31]36,38,43 A microorganism was detected in 48 Twelve (29%) of 42 studies reported data for surgical treatment of infective endo carditis. [21][22][23]25,26,28,29,31,40,42,45,52 The rate of surgery uptake in studies from north Africa was 49•7% (95% CI 42•5-56•9), ranging from 30•2% to 64•6%, whereas the rate of surgery uptake in two studies from sub-Saharan Africa was 46•1% (39•0-53•4). The pooled rate of surgical treatment of infective endocarditis was 49•1% (95% CI 43•2-55•1; appendix p 56).…”

Section: Resultsmentioning

confidence: 98%

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Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

Noubiap

Nkeck

Kwondom³

et al. 2022

The Lancet Global Health

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BackgroundThe epidemiology of infective endocarditis in Africa is inadequately characterised. We therefore aimed to comprehensively summarise the available data for the incidence, risk factors, clinical pattern, microbiology, and outcomes of infective endocarditis in Africa. MethodsWe did a systematic review and meta-analysis. We searched PubMed, Embase, African Index Medicus, and African Journals Online for all studies reporting primary data for the epidemiology of infective endocarditis in populations within Africa, published from inception to Jan 14, 2021, irrespective of the language. We used the search terms "endocarditis", "Africa", and the name of all African countries in the search strategy. We excluded articles that did not include primary data, primary studies with a small sample size (<30 participants), and those that report findings from before 1990. We recorded data for study characteristics, sample size, criteria used to define infective endocarditis, risk factors, potential entry site, clinical patterns, microbiology profile, outcomes including complications such as embolic events, heart failure, acute kidney injury, and death, and predictors of death. We used random-effects meta-analysis method to pool estimates. This study is registered with PROSPERO, CRD42021243842. FindingsWe retrieved 2141 records from the database and bibliographic searches, of which a total of 42 studies were included in this systematic review. Rheumatic heart disease was the most common risk factor for infective endocarditis in adults (52•0% [95% CI 42•4-61•5]), whereas congenital heart disease was the most common risk factor for infective endocarditis in children (44•7% [29•5-60•5]). Microbiological testing (mostly blood cultures) was positive in 48•6% (95% CI 42•2-51•1) of patients with infective endocarditis, with Staphylococcus species (41•3% [95% CI 36•2-46•5]) and Streptococcus species (34•0% [29•0-39•3]) the most commonly identified microorganisms. The pooled rate of surgical treatment of infective endocarditis was 49•1% (95% CI 43•2-55•1). The pooled in-hospital mortality rate was 22•6% (95% CI 19•5-25•9). Other frequent complications included heart failure (47•0% [95% CI 38•2-56•0]), acute kidney injury (22•8% [18•8-27•0]), and embolic events (31•1% [22•2-40•7]). Interpretation As the most prevalent risk factor in Africa, rheumatic heart disease should be central in interventions to reduce the burden of infective endocarditis on the continent. In tertiary hospitals with good access to cardiac surgery, the outcomes of infective endocarditis seem relatively similar to what has been reported in other parts of the world, especially in high-income countries.

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Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 98%

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

Noubiap

Nkeck

Kwondom³

et al. 2022

The Lancet Global Health

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“…In this study, they stated that 93.67% of the possible IE cases met the definite IE criteria when there was major culture-positive microbiological evidence, and if the cases were culturenegative, 32.85% of definite IE cases could be considered as possible IE; thus, they wanted to emphasize the importance of major culturepositive microbiological criteria for a clinical diagnosis. In these and many other studies, antibiotic treatments given prior to obtaining blood samples were reported as the most important cause of culture negativity (19,20). Walid Jomaa et al (20), in their study on the prognosis and epidemiological features of IE in Tunisian children, were able to detect reproductive IE-compatible microorganisms:…”

Section: Discussionmentioning

confidence: 94%

“…In these and many other studies, antibiotic treatments given prior to obtaining blood samples were reported as the most important cause of culture negativity (19,20). Walid Jomaa et al (20), in their study on the prognosis and epidemiological features of IE in Tunisian children, were able to detect reproductive IE-compatible microorganisms:…”

Section: Discussionmentioning

confidence: 94%

İnfektif Endokarditli Çocuklarda Klinik Özellikler, Tedavi Yaklaşımları ve Komplikasyonlar: Türkiye’den Tek Merkez Deneyimi

Köşger

Keskin

Kıztanır

et al. 2019

Osmangazi̇ Journal of Medicine

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In this study, we retrospectively evaluated the underlying risk factors, clinical and laboratory findings, treatment approaches, anticoagulation therapy experiences, and the complications that arose during the follow-up of patients diagnosed with infective endocarditis in our clinic between 2010-2018. Eleven patients with infective endocarditis were evaluated. The relevant features of the patients whom developed complications, given anticoagulant therapy in addition to antibiotherapy, underwent cardiac surgery, and showed a mortality course were determined. The youngest patient was 7 months old and the oldest was 14 years old (7.5 ± 4.6 years). All of the cases had congenital heart anomalies and there were no cases with rheumatic heart disease. A total of eight patients had embolic findings. Echocardiography showed vegetation in nine patients. In addition to antibiotherapy, anticoagulant treatment was applied to 2 patients. The most common microorganism in the blood culture was coagulase negative staphylococci with five cases. Five patients underwent early surgical treatment, one patient died due to multiple organ failure caused by systemic embolization, and one patient died due to sudden hemodynamic instability in the first week of follow-up. Infective endocarditis is a serious disease with life-threatening complications. In children, the main underlying risk factor is congenital heart disease unlike with adults. Once the diagnosis is made, appropriate antibiotherapy should be initiated as soon as possible to prevent septic embolism and mortality. The role of anticoagulation in the prevention of embolism and the treatment of ischemic stroke remains controversial.

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“…Aunque la endocarditis en pediatría no es una enfermedad frecuente, los informes mundiales indican una elevada mortalidad por esta causa, sobre todo cuando se aíslan cepas de S. aureus. En uno de los estudios, la mortalidad fue muy elevada y hubo una diferencia estadísticamente significativa con respecto a los pacientes sin endocarditis, lo que ya se ha evidenciado en estudios similares (6,17,18).…”

Section: Discussionunclassified

Relación entre la muerte y el ingreso a cuidados intensivos de pacientes pediátricos con bacteriemia por Staphylococcus aureus adquirido en la comunidad, 2014-2017

2021

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Introducción. La bacteriemia por Staphylococcus aureus adquirida en la comunidad (SAAC) es una condición frecuente en pediatría que, además, constituye un problema de salud pública por las altas tasas de morbimortalidad y de resistencia bacteriana.Objetivos. Analizar los factores relacionados con la muerte y el ingreso a cuidados intensivos de pacientes menores de 18 años con bacteriemia por SA-AC que ingresaron al Hospital Infantil Los Ángeles de Pasto, Colombia, entre el 2014 y el 2017.Materiales y métodos. Se hizo un estudio observacional descriptivo y transversal. Se analizaron 86 pacientes con bacteriemia por SA-AC que cumplían los criterios de inclusión en el estudio utilizando un modelo multivariado de regresión logística.Resultados. El 25,6 % de los 86 pacientes falleció y el 40,7 % ingresó a la unidad de cuidados intensivos. La resistencia a la meticilina fue de 52,3 %. Los focos principales de infección fueron los tejidos blandos, el sistema osteoarticular y el respiratorio. El 32,6 % de los pacientes provenía de la zona del Pacífico de Nariño. Las etnias predominantes fueron la mestiza y la indígena. Entre los indígenas hubo mayor mortalidad que entre mestizos y afrocolombianos. En el análisis multivariado de la variable de muerte, se registró significación de la endocarditis (odds ratio, OR ajustado=20; IC95%1,5-254; p=0,02); no se registró significación estadística en cuanto al ingreso en la unidad de cuidados intensivos.Conclusiones. La bacteriemia por SA-AC determinó altas tasas de mortalidad e ingreso a la unidad de cuidados intensivos. Las cepas resistentes representaron el 52,3 %, y la resistencia a la meticilina desembocó en una mayor mortalidad, aunque la mortalidad con cepas sensibles también fue considerable. La endocarditis fue responsable de una mortalidad bastante elevada. Se debe ajustar el tratamiento empírico cuando se sospeche bacteriemia por SA-AC.

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Clinical features and prognosis of infective endocarditis in children: Insights from a Tunisian multicentre registry

Cited by 21 publications

References 17 publications

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis

İnfektif Endokarditli Çocuklarda Klinik Özellikler, Tedavi Yaklaşımları ve Komplikasyonlar: Türkiye’den Tek Merkez Deneyimi

Relación entre la muerte y el ingreso a cuidados intensivos de pacientes pediátricos con bacteriemia por Staphylococcus aureus adquirido en la comunidad, 2014-2017

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