Infective Endocarditis: A Contemporary Study of Microbiology, Echocardiography and Associated Clinical Outcomes at a Major Tertiary Referral Centre

Holland, David J.; Simos, Peter; Yoon, Jang Won; Sivabalan, Pirathaban; Ramnarain, J.; Runnegar, Naomi

doi:10.1016/j.hlc.2019.07.006

Cited by 26 publications

(15 citation statements)

References 25 publications

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“…A large cohort study demonstrated the role of host or pathogen-specific characteristics and association with poor outcomes in patients with IE [ 37 ]. Consistent with prior studies [ 38 , 39 ], S taphylococcus was the leading causative microorganism of IE in our study. However, MRSA organisms were detected in almost half (47.3%) of female patients with IE, which was significantly higher when compared with male patients.…”

Section: Discussionsupporting

confidence: 93%

Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study

Bhandari

Tiwari

Alexander

et al. 2022

JCM

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Infectious diseases like infective endocarditis (IE) may manifest or progress differently between sexes. This study sought to identify the differences in demographic and clinical characteristics among male and female patients with IE. Data were obtained from a newly developed registry comprising all adult patients with first IE admission at the four major tertiary cardiovascular centers in West Virginia, USA during 2014–2018. Patient characteristics were compared between males and females using Chi-square test, Fisher’s exact test, and Wilcoxon rank-sum test. A secondary analysis was restricted to IE patients with drug use only. Among 780 unique patients (390 males, 390 females), significantly more women (a) were younger than males (median age 34.9 vs. 41.4, p < 0.001); (b) reported drug use (77.7% vs. 64.1%, p < 0.001); (c) had tricuspid valve endocarditis (46.4% vs. 30.8%, p < 0.001); and (d) were discharged against medical advice (20% vs. 9.5%, p < 0.001). These differences persisted even within the subgroup of patients with drug use-associated IE. In a state with one of the highest incidences of drug use and overdose deaths, the significantly higher incident IE cases in younger women and higher proportion of women leaving treatment against medical advice are striking. Differential characteristics between male and female patients are important to inform strategies for specialized treatment and care.

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Section: Discussionsupporting

confidence: 93%

Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study

Bhandari

Tiwari

Alexander

et al. 2022

JCM

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“…Overall, the use of preoperative TEE ( Table 3 ) was substantially lower than has been reported in other investigations 15 ; given the well-established benefits of TEE over TTE, the existing local practice should be evaluated. 16 , 17 The local practice in Winnipeg is limited by scarce physical space, funding, and nursing resources; thus, a system in which only patients for whom clinical utility is deemed high are referred and with a reliance on intraoperative TEE performed in surgical patients by the cardiac anesthesia group.…”

Section: Discussionmentioning

confidence: 84%

The Epidemiology of Endocarditis in Manitoba: A Retrospective Study

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…The prognostic influence of MIE is unclear. An association with poor outcomes has been described in some studies [ 3 , 4 , 5 , 12 , 13 , 14 , 15 , 26 ] but not in others [ 2 , 6 , 7 , 8 , 9 , 11 , 24 ]. Prosthetic IE is an important compounding factor when we compare MIE with SIE, as prosthetic IE is associated with a poor prognosis [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Multivalvular Endocarditis: A Rare Condition with Poor Prognosis

Álvarez-Zaballos¹,

González-Ramallo²,

Muñóz³

et al. 2022

JCM

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Background. Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008–2020). Results. From 4064 definite cases of valvular IE, 577 (14.2%) had MIE. In patients with MIE, the most common locations were mitral (552, 95.7%) and aortic (550, 95.3%), with mitral-aortic involvement present in 507 patients (87.9%). The most common etiologies were S. viridans (192, 33.3%) and S. aureus (113, 19.6%). MIE involved only native valves in 450 patients (78.0%). Compared with patients with SIE, patients with MIE had a similar age (69 vs. 67 years, respectively, p = 0.27) and similar baseline characteristics, but were more frequently men (67.1% vs. 72.9%, p = 0.005) and had a higher incidence of intracardiac complications (36.2% vs. 50.4%, p < 0.001), heart failure (42.7% vs. 52.9%, p < 0.001), surgical indication (67.7 vs. 85.1%, p < 0.001), surgery (46.3% vs. 56.3%), and in-hospital mortality (26.9% vs. 34.3%, p < 0.001). MIE was an independent predictor of in-hospital mortality (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1–1.7, p = 0.004) but did not have an independent association with 1-year mortality (OR 1.1, 95% CI 0.9–1.4, p = 0.43). Conclusions. About one-seventh of the valvular IE patients had MIE, mainly due to mitral-aortic involvement. MIE is associated with a poor in-hospital prognosis. An early diagnosis and treatment of IE might avoid its spread to a second valve.

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Infective Endocarditis: A Contemporary Study of Microbiology, Echocardiography and Associated Clinical Outcomes at a Major Tertiary Referral Centre

Cited by 26 publications

References 25 publications

Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study

Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study

The Epidemiology of Endocarditis in Manitoba: A Retrospective Study

Multivalvular Endocarditis: A Rare Condition with Poor Prognosis

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