Endocarditis in children and adolescents with congenital heart defects: a Norwegian nationwide register-based cohort study

Jortveit, Jarle; Klcovansky, Jakob; Eskedal, Leif; Birkeland, S.; Døhlen, Gaute; Holmstrøm, Henrik

doi:10.1136/archdischild-2017-313917

Cited by 21 publications

(33 citation statements)

References 31 publications

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“…Informasjon om fødselsår og kjønn samt årstall for innleggelse og diagnosekoder for medfødte hjertefeil (Q20-Q26) ved samtlige sykehusopphold i perioden var tilgjengelig fra Norsk pasientregister. Befolkningsgrunnlaget i Norge for aldersgruppen 0-17 år i perioden ble hentet fra Statistisk sentralbyrås statistikkbank (7), og antall barn med hjertefeil født i samme periode ble estimert basert på vår tidligere studie av barn med medfødt hjertefeil (5). ingen statistisk signifikant endring over tid (årlig endring = −1,1 % (KI −31,9 til 43,4), p = 0,9).…”

Section: Materiale Og Metodeunclassified

“…Estimert forekomst i denne studien samsvarer med funnene i en nylig publisert studie fra USA (8). Både i den amerikanske studien og i vår tidligere studie av endokarditt hos barn med medfødt hjertefeil i Norge i 1994-2016 var forekomsten stabil over tid (5).…”

Section: Type Hjertefeil Antall Pasienterunclassified

“…Medfødte hjertefeil er også tidligere vist å representere en viktig risikofaktor for endokarditt, spesielt alvorlige hjertefeil som ofte består av flere feil i hjertet og som ofte krever omfattende hjertekirurgi inkludert bruk av kunstig materiale (4,5,9,10). Vi har tidligere vist at omtrent tre fjerdedeler av endokarditt-tilfellene hos barn med medfødt hjertefeil oppstod innen et år etter en hjerteoperasjon eller kateterbehandling i hjertet (5).…”

Section: Type Hjertefeil Antall Pasienterunclassified

“…I vår tidligere studie var feber vanligste symptom. De fleste hadde positiv blodkultur og mange hadde synlige vegetasjoner ved ekkokardiografi (5).…”

Section: Type Hjertefeil Antall Pasienterunclassified

“…Endokarditt er en alvorlig tilstand forbundet med alvorlige komplikasjoner og høy dødelighet også hos barn (5). Komplikasjonsraten er høyere hos pasienter med hjertefeil enn hos pasienter uten slike feil (5,9).…”

Section: Type Hjertefeil Antall Pasienterunclassified

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Forekomst av infeksiøs endokarditt hos barn

Jortveit¹,

Eskedal²,

Klcovansky³

et al. 2019

Tidsskriftet

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Section: Materiale Og Metodeunclassified

Section: Type Hjertefeil Antall Pasienterunclassified

“…I vår tidligere studie var feber vanligste symptom. De fleste hadde positiv blodkultur og mange hadde synlige vegetasjoner ved ekkokardiografi (5).…”

Section: Type Hjertefeil Antall Pasienterunclassified

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Forekomst av infeksiøs endokarditt hos barn

Jortveit¹,

Eskedal²,

Klcovansky³

et al. 2019

Tidsskriftet

Self Cite

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ESC guidelines 2023 on the management of endocarditis

de Waha,

Desch,

Tilz

et al. 2023

Herz

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Infective endocarditis in pediatric patients: a decade of insights from a leading Spanish heart surgery reference center

Marín-Cruz,

Pedrero-Tomé,

Toral

et al. 2024

Eur J Pediatr

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Infective endocarditis (IE) is a rare disease in children and is associated with significant morbidity and mortality. In recent years, significant changes have occurred in pediatric care that could have influenced the microbiology and presentation of IE. The aim of this work was to study epidemiological, microbiological, and clinical features of IE treated at a Pediatric Cardiac Surgery Reference Center located in Madrid (Spain) in a 10-years’ period. A descriptive observational retrospective study was performed, including pediatric patients < 16 years old with definite or possible IE admitted to a reference center between January 2012 and December 2021. Thirty-two IE episodes were identified. Twenty-eight (87.5%) had congenital heart disease (CHD), 8 (25.0%) were preterm infants, 1 (3.1%) was immunocompromised and 6 (18.8%) had other chronic conditions; in 11 (34.4%) episodes more than one underlying condition was associated. In 20 (62.5%) episodes there was an indwelling central venous catheter (CVC); children with other comorbidities (preterm, immunocompromised, other chronic conditions) were more likely to have a CVC at diagnosis compared with patients with isolated CHD (p < 0.001). Thirty-six microbiological isolates were obtained in the 32 episodes; 4 (12.5%) episodes had 2 isolated microorganisms. Microbiological isolates were 20 (55.6%) Gram-positive bacteria (GPB), 10 (27.8%) non-HACEK Gram-negative bacteria (GNB), 1 (2.8%) HACEK-group bacterium, 4 (11.1%) fungi and 1 (2.8%) Coxiella burnetii. In 10 (31.3%) episodes, patients were colonized by multidrug-resistant bacteria (MDRB) and the etiology of IE in 3 (30.0%) of those episodes was the colonizing MDRB. MDRB colonization was associated with MDRB IE (p = 0.007). The most common complication was septic embolism: 11 (34.4%) episodes (9 pulmonary and 2 cerebral). In-hospital mortality was 6.3% (n = 2), all of them due to underlying conditions and not to IE or its complications. Clinical features and complications of IE episodes caused by non-HACEK GNB and those caused by GPB were compared, finding no statistically significant differences. Conclusion: Risk factors for developing IE, the proportion of embolic complications, and mortality rate were consistent with previously published findings. Proportion of IE cases attributed to non-HACEK GNB was higher than previously reported, suggesting an evolving epidemiology of IE. One-third of children colonized with MDRB subsequently developed IE caused by the same MDRB strains, so empirical coverage of MDRB organisms must be considered when IE is suspected in MDRB colonized patients. No significant differences in clinical features and complications were observed when comparing IE episodes caused by non-HACEK GNB and those caused by GPB, however larger cohort studies are needed. What is Known:• Infective endocarditis (IE) is a rare disease in children, associated with significant morbidity and mortality.• The main risk factor for developing IE in children is an underlying congenital heart disease. What is New:• With current changing epidemiology in pediatric IE, a higher proportion of IE caused by non-HACEK Gram-negative bacteria should be expected.• A significant percentage of children colonized by multidrug-resistant bacteria can develop an IE due to those bacteria.

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Endocarditis in children and adolescents with congenital heart defects: a Norwegian nationwide register-based cohort study

Abstract: The incidence of IE among children and adolescents with CHDs was higher than the reported incidence in the general population. IE was associated with severe CHDs and recent complex cardiac interventions, and had significant mortality.

Cited by 21 publications

References 31 publications

Forekomst av infeksiøs endokarditt hos barn

Forekomst av infeksiøs endokarditt hos barn

ESC guidelines 2023 on the management of endocarditis

Infective endocarditis in pediatric patients: a decade of insights from a leading Spanish heart surgery reference center

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