Infective Endocarditis Complicating Mitral Valve Prolapse: Epidemiologic, Clinical, and Microbiologic Aspects

Baddour, Larry M.; Bisno, Alan L.

doi:10.1093/clinids/8.1.117

Cited by 46 publications

(4 citation statements)

References 83 publications

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“…This is in contrast to the study of Baddour et al , 22 which summarized data of 267 cases of infective endocarditis complicating mitral valve prolapse and found that Srreprococci viridans could be isolated from only 46% of cases. A possible explanation for the high prevalence of Srreprococci viridans in our mitral valve prolapse patients may be the fact that most of these patients (15 of 19; Table 11) underwent dental procedures before admission, which could have been the portal of entry for the Sfreprococci viriduns.…”

Section: % Of Patients With Infective E N D O C a R D I T I~~~-~~~-~~contrasting

confidence: 80%

Native valve infective endocarditis in the 1970s versus the 1980s: Underlying cardiac lesions and infecting organisms

Weinberger

Rotenberg

Zacharovitch

et al. 1990

Clinical Cardiology

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Section: % Of Patients With Infective E N D O C a R D I T I~~~-~~~-~~contrasting

confidence: 80%

Native valve infective endocarditis in the 1970s versus the 1980s: Underlying cardiac lesions and infecting organisms

Weinberger

Rotenberg

Zacharovitch

et al. 1990

Clinical Cardiology

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“…In contrast to previous studies [ 13 , 26 , 35 ], deep infections in our trial occurred in over 80% in both IDUs and nonaddicts. Systemic thromboembolic events are well recognized complications in endocarditis occurring in 21% to 50% of cases, especially in patients with left-sided involvement and prosthetic heart valves, and are accompanied by high mortality rates [ 36 - 39 ]. In earlier reports, IDUs had fewer arterial emboli or strokes than nonaddicts probably due to involvement of right-sided endocarditis [ 2 , 18 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and outcome in Staphylococcus aureus endocarditis among injection drug users and nonaddicts: a prospective study of 74 patients

et al. 2006

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BackgroundEndocarditis is a common complication in Staphylococcus aureus bacteremia (SAB). We compared risk factors, clinical manifestations, and outcome in a large, prospective cohort of patients with S. aureus endocarditis in injection drug users (IDUs) and in nonaddicts.MethodsFour hundred and thirty consecutive adult patients with SAB were prospectively followed up for 3 months. Definite or possible endocarditis by modified Duke criteria was found in 74 patients: 20 patients were IDUs and 54 nonaddicts.ResultsEndocarditis was more common in SAB among drug abusers (46%) than in nonaddicts (14%) (odds ratio [OR], 5.12; 95% confidence interval [CI], 2.65–9.91; P < 0.001). IDUs were significantly younger (27 ± 15 vs 65 ± 15 years, P < 0.001), had less ultimately or rapidly fatal underlying diseases (0% vs 37%, P < 0.001) or predisposing heart diseases (20% vs 50%, P = 0.03), and their SAB was more often community-acquired (95% vs 39%, P < 0.001). Right-sided endocarditis was observed in 60% of IDUs whereas 93% of nonaddicts had left-sided involvement (P < 0.001). An extracardiac deep infection was found in 85% of IDUs and in 89% of nonaddicts (P = 0.70). Arterial thromboembolic events and severe sepsis were also equally common in both groups. There was no difference in mortality between the groups at 7 days, but at 3 months it was lower among IDUs (10%) compared with nonaddicts (39%) (OR, 5.73; 95% CI, 1.20–27.25; P = 0.02).ConclusionS. aureus endocarditis in IDUs was associated with as high complication rates including extracardiac deep infections, thromboembolic events, or severe sepsis as in nonaddicts. Injection drug abuse in accordance with younger age and lack of underlying diseases were associated with lower mortality, but after adjusting by age and underlying diseases injection drug abuse was not significantly associated with mortality.

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“…Because the majority of cases of endocarditis are due to streptococcal and staphylococcal species [3,4], work has focused on preventing experimental endocarditis due to these organisms. Both rat and rabbit models of endocardial infection have been employed over the past two decades to study the efficacy of passive and active immunization in the prevention of experimental endocarditis.…”

Section: Role Of Immunizationmentioning

confidence: 99%

Immunization for prevention of infective endocarditis

Baddour

1999

Curr Infect Dis Rep

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Immunization has been used for many years to prevent certain infectious diseases. Often it is targeted to populations at increased risk of a particular infection. Patients at increased risk of infective endocarditis can be identified and would be eligible candidates for immunization if vaccines were available to prevent common bacterial causes of infective endocarditis. The idea of using preventive therapy among patients at increased risk of infective endocarditis is not novel, and recommendations for use of antibiotics prior to performing certain invasive procedures have been in place for years. Findings from immunization experiments using animal models of experimental endocarditis support the notion that vaccine development is appropriate for study in humans, and these findings are reviewed in this paper.

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Infective Endocarditis Complicating Mitral Valve Prolapse: Epidemiologic, Clinical, and Microbiologic Aspects

Cited by 46 publications

References 83 publications

Native valve infective endocarditis in the 1970s versus the 1980s: Underlying cardiac lesions and infecting organisms

Native valve infective endocarditis in the 1970s versus the 1980s: Underlying cardiac lesions and infecting organisms

Clinical manifestations and outcome in Staphylococcus aureus endocarditis among injection drug users and nonaddicts: a prospective study of 74 patients

Immunization for prevention of infective endocarditis

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