Epidemiology of infective endocarditis: novel aspects in the twenty-first century

Arshad, Verda; Talha, Khawaja M.; Baddour, Larry M.

doi:10.1080/14779072.2022.2031980

Cited by 6 publications

(11 citation statements)

References 103 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several studies suggest that the global incidence of IE may have increased over the past 20 years. 3 While sex differences in patients with non-septic VTE have been reported, preliminary reports show no evidence of sex differences in septic vein thrombosis 23 which also mirrors the epidemiology of right-sided IE. Both IE and septic vein thrombosis originate from a primary intravascular focus with a strikingly similar incidence of the primary complication, peripheral abscess formation.…”

Section: Analogies Between Septic Thrombophlebitis and Iementioning

confidence: 99%

“…1 Reported cases of SPE due to septic thrombophlebitis may have increased and be related to injection drug use. 9 However, it is unclear whether this increase reflects a true epidemiologic phenomenon, as seen in IE, 3 or whether this source of SPE was underrecognized until diagnostic techniques improved or clinical data were better assessed. 1,10,11 Infected vascular catheters, especially central venous catheters, are also major sources of SPE.…”

Section: Pathophysiology and Microbiologymentioning

confidence: 99%

“…Still, the growing population of patients undergoing implantation of permanent pacemakers or implantable cardioverter-defibrillators makes it plausible that the contribution of CIED infections to the number of SPE cases is likely to continue to increase. 3 The distribution of presumed primary sources of infection in patients with SPE described in the series published over the past 20 years has differed (►Table 1). This could reflect methodological differences in patient selection, lack of a standardized definition of some conditionssuch as septic thrombophlebitisor difficulty in distinguishing the primary source of infection from a secondary embolization site or even a concomitant infection with no relationship with SPE.…”

Section: Pathophysiology and Microbiologymentioning

confidence: 99%

“…The marked increase, however, in injection drug use associated with the opioid epidemic and in cardiovascular implantable electronic devices (CIED) in an aging population in many countries have been pivotal in the escalation in SPE cases. [2][3][4][5] The complex pathophysiology of SPEa vascular complication of localized infection with bloodstream infection places it at the crossroads of several disciplines, including radiology, infectious diseases, pulmonary medicine, cardiology, cardiothoracic surgery, and critical care medicine. Over the past decade a series of observational studies has provided insights with potential implications for clinical practice.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Septic Pulmonary Embolism: A Contemporary Profile

Valerio

Baddour

2022

Semin Thromb Hemost

Self Cite

View full text Add to dashboard Cite

Septic pulmonary embolism (SPE) is a rare clinical entity that is distinct from the classic and more common non-septic thrombotic pulmonary embolism. SPE should be suspected in patients with a systemic acute inflammatory reaction or sepsis who develop signs and symptoms of pulmonary involvement. The diagnosis of SPE depends on the specific radiologic finding of multiple, peripheral, nodular, possibly cavitated lesions. SPE should prompt an immediate search for the primary source of infection; typically, right-sided infective endocarditis, cardiac implantable electronic devices, and septic thrombophlebitis as a complication of bone, skin, and soft tissue infection including Lemierre's syndrome, indwelling catheters, or direct inoculation via injection drug use. Invasive treatment of the infection source may be necessary; in thrombophlebitis, the efficacy and safety of anticoagulation remain undefined. Blood cultures may be negative, particularly among patients with recent antibiotic exposure, and broad-spectrum antimicrobial therapy should be considered. The in-hospital mortality of SPE ranges up to 20% in published case series. While trends in the incidence of SPE are unknown, the opioid epidemic, the growing use of cardiac implantable electronic devices worldwide, and the reported increase in cases of septic thrombophlebitis may be leading to an escalation in SPE cases. We provide a contemporary profile of SPE and propose a clinical management algorithm in patients with suspected or confirmed SPE.

show abstract

Section: Analogies Between Septic Thrombophlebitis and Iementioning

confidence: 99%

Section: Pathophysiology and Microbiologymentioning

confidence: 99%

Section: Pathophysiology and Microbiologymentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Septic Pulmonary Embolism: A Contemporary Profile

Valerio

Baddour

2022

Semin Thromb Hemost

Self Cite

View full text Add to dashboard Cite

show abstract

“…In the current era, the landscape of infective endocarditis has dramatically changed. Implanted cardiovascular devices have increased exponentially, as well as the clinical complexity of patients [ 1 , 18 ]. The presence of an intravascular foreign material is the most important predisposing factor for early or late microorganism colonization, an issue that can be only partially controlled by improved implantation techniques and device technologies.…”

Section: Discussionmentioning

confidence: 99%

Vacuum-Implemented Removal of Lead Vegetations in Cardiac Device-Related Infective Endocarditis

Tarzia

Ponzoni

Evangelista

et al. 2022

JCM

View full text Add to dashboard Cite

When approaching infected lead removal in cardiac device-related infective endocarditis (CDRIE), a surgical consideration for large (>20 mm) vegetations is recommended. We report our experience with the removal of large CDRIE vegetations using the AngioVac system, as an alternative to conventional surgery. We retrospectively reviewed all infected lead extractions performed with a prior debulking using the AngioVac system, between October 2016 and April 2022 at our institution. A total of 13 patients presented a mean of 2(1) infected leads after a mean of 5.7(5.7) years from implantation (seven implantable cardioverter-defibrillators, four cardiac resynchronization therapy-defibrillators, and two pacemakers). The AngioVac system was used as a venous–venous bypass in six cases (46.2%), venous–venous ECMO-like circuit (with an oxygenator) in five (38.5%), and venous–arterial ECMO-like circuit in two cases (15.4%). Successful (>70%) aspiration of the vegetations was achieved in 12 patients (92.3%) and an intraoperative complication (cardiac perforation) only occurred in 1 case (7.7%). Subsequent lead extraction was successful in all cases, either manually (38.5%) or using mechanical tools (61.5%). The AngioVac system is a promising effective and safe option for large vegetation debulking in CDRIE. Planning the extracorporeal circuit design may represent the optimal strategy to enhance the tolerability of the procedure and minimize adverse events.

show abstract

Healthcare exposures and associated risk of endocarditis after open-heart cardiac valve surgery

Kwan,

Brieger,

Chow

et al. 2024

BMC Med

View full text Add to dashboard Cite

Background Infective endocarditis (IE) following cardiac valve surgery is associated with high morbidity and mortality. Data on the impact of iatrogenic healthcare exposures on this risk are sparse. This study aimed to investigate risk factors including healthcare exposures for post open-heart cardiac valve surgery endocarditis (PVE). Methods In this population-linkage cohort study, 23,720 patients who had their first cardiac valve surgery between 2001 and 2017 were identified from an Australian state-wide hospital-admission database and followed-up to 31 December 2018. Risk factors for PVE were identified from multivariable Cox regression analysis and verified using a case-crossover design sensitivity analysis. Results In 23,720 study participants (median age 73, 63% male), the cumulative incidence of PVE 15 years after cardiac valve surgery was 7.8% (95% CI 7.3–8.3%). Thirty-seven percent of PVE was healthcare-associated, which included red cell transfusions (16% of healthcare exposures) and coronary angiograms (7%). The risk of PVE was elevated for 90 days after red cell transfusion (HR = 3.4, 95% CI 2.1–5.4), coronary angiogram (HR = 4.0, 95% CI 2.3–7.0), and healthcare exposures in general (HR = 4.0, 95% CI 3.3–4.8) (all p < 0.001). Sensitivity analysis confirmed red cell transfusion (odds ratio [OR] = 3.9, 95% CI 1.8–8.1) and coronary angiogram (OR = 2.6, 95% CI 1.5–4.6) (both p < 0.001) were associated with PVE. Six-month mortality after PVE was 24% and was higher for healthcare-associated PVE than for non-healthcare-associated PVE (HR = 1.3, 95% CI 1.1–1.5, p = 0.002). Conclusions The risk of PVE is significantly higher for 90 days after healthcare exposures and associated with high mortality.

show abstract

Epidemiology of infective endocarditis: novel aspects in the twenty-first century

Cited by 6 publications

References 103 publications

Septic Pulmonary Embolism: A Contemporary Profile

Septic Pulmonary Embolism: A Contemporary Profile

Vacuum-Implemented Removal of Lead Vegetations in Cardiac Device-Related Infective Endocarditis

Healthcare exposures and associated risk of endocarditis after open-heart cardiac valve surgery

Contact Info

Product

Resources

About