Infective Endocarditis in Childhood: a SingleCenter Experience of 18 Years

Yakut, Kahraman; Ecevit, Zafer; Tokel, Kürşad; Varan, Birgül; Özkan, Murat

doi:10.21470/1678-9741-2020-0035

Cited by 15 publications

(12 citation statements)

References 44 publications

(91 reference statements)

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“…Fever was found to be the most common symptom in our cohort which was reported in more than 90% of patients which is similar to that reported by Assiri [12], as well as to that reported in most patients presenting to the emergency department with IE [17], however, fever was reported slightly less by Zaqout et al in Qatar (84%). Only one-fifth of our patients had a documented audible murmur which is much lower than a study by Yakut et al that reported a new murmur or changing murmur in 68% of patients [18]. Previous studies from KSA and Qatar did not report the number of murmurs in their cases.…”

Section: Discussioncontrasting

confidence: 81%

Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia

Barry

Bari

Akhtar

et al. 2021

J Epidemiol Glob Health

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Background Infective endocarditis (IE) is a serious disease with complex pathology and significant mortality. Little information is known regarding clinical and microbiological characteristics in Saudi Arabia. This study surveyed these characteristics at a Cardiac Center in Riyadh, Saudi Arabia over a period of 5 years. Methods This retrospective study was done on all infective endocarditis (IE) patients admitted to Prince Sultan Cardiac Center between January 1, 2015, and December 31, 2019. Clinical characteristics, microbiological results, management, and outcomes were assessed. Result A total of 340 cases of infective endocarditis were identified over the study period. Most patients (64%) were 50 years old or above, and 67% were males. Fever was the most common clinical presentation, and a murmur was audible in a fifth of patients. Blood cultures were positive in 177 (52%) cases. The most common organisms were Staphylococcus aureus, coagulase negative Staphylococcus and viridans group Streptococcus. Most common microbiological organisms causing native valve endocarditis were viridans group Streptococcus (32%) followed by methicillin-susceptible Staphylococcus aureus (21%), and for prosthetic valve endocarditis they were coagulase negative Staphylococcus (32%) followed by methicillin-susceptible Staphylococcus aureus (23%), the most common causes of culture negative endocarditis were Q-fever and brucellosis. Predisposing cardiac conditions were present in 127 (37%) patients, most commonly rheumatic heart disease and congenital heart disease. Surgical intervention was done in 26% of cases, with an overall in-hospital mortality rate of 6.76%. Conclusion We demonstrate the epidemiological, clinical, and microbiological profile of infective endocarditis in a tertiary care cardiac center in Saudi Arabia. It gives information concerning the prevalence of responsible organisms. This information will be helpful in assessing patients with suspected IE and in planning management of cases knowing the relative frequency of types of microorganisms encountered.

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Section: Discussioncontrasting

confidence: 81%

Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia

Barry

Bari

Akhtar

et al. 2021

J Epidemiol Glob Health

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“…Regarding vegetations detected by echocardiography among our patients, vegetations were present in 77 (77%) patients. A nearly equal percentage was detected in Egyptian adults 76.9% (17) , yet higher ratios were reported by other studies in Africa 84.9% and 95.5%, respectively (5,10) .…”

Section: Discussioncontrasting

confidence: 55%

“…The occurrence of IE in children is perhaps increasing partly due to the increased incidence of IE inpatients with congenitally malformed hearts who are now surviving longer and partly due to increased use of central venous catheters in intensive care units (5) .…”

Section: Discussionmentioning

confidence: 99%

Re-Rise of Infective Endocarditis in Pediatrics? A Single Center Epidemiologic Study

Ibrahim

Emam²,

Fattouh³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: Infective endocarditis (IE) is a rare disease yet with numerous health hazards. Currently no data is available about IE in Egyptian children. This work aimed to study the epidemiological pattern, mode of presentation, microbiology, and the outcome of IE at Cairo University Children's Hospitals. Patients and methods: A cross-sectional study was conducted over a period of 6 months and included 100 patients diagnosed with IE. All patients were subjected to 1) Full medical history and examination to study their demographic date, detect risk factors, pattern of presentations, and type of treatment. 2) Laboratory investigations including blood cultures. 3) Complete echocardiography, and 4) Close follow up of the patients to determine the outcomes and fate of IE. Results: The age of included patients ranged from 1-168 months, with a mean 59.37 (SD 41.91). They were 63 (63%) males and 37 (37%) females. Most of patients (68%) were from rural areas, and 32% were from urban areas. Most important risk factors are type of congenital heart disease (CHD) (75%), central venous pressure (CVP) insertion (29%), and dental problems (24%). Vegetations were found in 77% of our patients, significantly in the neonatal intensive care units (NICU) (p=0.02). IE was caused mainly by gram positive organisms (85%). Conclusion CHD, CVP, dental problems were the most frequent risk factors of IE in our patients. CHD was associated with significantly prolonged hospital stay and delayed response to treatment. Early and prompt management of CHD is highly recommended to reduce impact of IE in pediatric patients.

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“…The studies conducted in Turkey have reported that the most common risk factor is CHDs, and 43-91% of children with IE have underlying CHDs. Various rates between 0% and 43% have been reported for rheumatic heart disease [ 14 - 18 ]. Our results support that CHDs are the first predisposing factor; however, rheumatic heart disease is still an important risk factor in our country.…”

Section: Discussionmentioning

confidence: 99%

The Incidence and Clinical Characteristics of Infective Endocarditis in Children: A Five-Year, Single-Centre Retrospective Evaluation

Yılmaz¹,

Gürses²,

Kahraman³

2022

Cureus

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Introduction: Infective endocarditis (IE) is a rare disease with high mortality and morbidity. In recent years, an increase in the frequency of infective endocarditis has been observed due to the increase in the survival of cases with congenital heart diseases (CHDs) and the use of central catheters. In addition to revealing the incidence of IE in our clinic, this study aimed to evaluate the demographic characteristics, predisposing factors, clinical, laboratory, microbiological, and echocardiographic findings, and the complications of follow-up of our patients diagnosed with IE in light of the literature.Material and methods: Thirteen patients with IE who were hospitalized in Pediatric Cardiology Clinic, Pamukkale University Medical Faculty Hospital between January 2016 and August 2021 were retrospectively reviewed. The patients included in the study were evaluated in terms of demographic characteristics, predisposing factors, clinical, laboratory and microbiological findings, echocardiography data, surgical intervention needs, and complications. The incidence of IE in our clinic was defined as the rate of IE among patients admitted to the hospital and reported as the number of patients with IE per 100,000 hospital admissions.Results: The median age of these 13 patients was 11 (7-14) years, and the male/female ratio was 6/7. The five-year IE incidence in Pediatric Cardiology Clinic, Pamukkale University Medical Faculty Hospital, was found to be 2.5 in approximately 100,000 hospital admissions. A predisposing factor was detected in all patients. Six patients (46%) had CHDs, and four patients (31%) had acquired heart disease. The other three (23%) patients were receiving immunosuppressive therapy, and these patients had long-term port catheters. Eight (62%) patients had positive blood cultures. Streptococcus viridans, Streptococcus gordonii, Staphylococcus aureus, coagulase-negative Staphylococcus, Brucella spp, and Candida albicans were isolated in the blood cultures of these patients. IE-related complications developed in seven (54%) patients. Five (38%) had heart failure, three patients (23%) had thromboembolic events, two (15%) had glomerulonephritis, and one (8%) had thrombophlebitis. Four patients were referred to early surgery. Two patients with recurrent IE attacks were referred to surgery after their treatment was completed. Conclusion:The incidence of IE has shown an increase recently with increased rates of survival attributable to corrective surgeries performed for congenital heart diseases, increased prosthetic materials used in cardiac surgeries, and increased use of permanent catheters. In our study, the incidence of IE was found to be 2.5 in 100,000 hospital admissions. Our results have shown that rheumatic heart diseases, besides CHDs, are still an important risk factor for Turkey. Due to the low number of cases in IE studies in the pediatric population, there is a need for further studies to be conducted in large series in this field.

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Infective Endocarditis in Childhood: a SingleCenter Experience of 18 Years

Cited by 15 publications

References 44 publications

Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia

Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia

Re-Rise of Infective Endocarditis in Pediatrics? A Single Center Epidemiologic Study

The Incidence and Clinical Characteristics of Infective Endocarditis in Children: A Five-Year, Single-Centre Retrospective Evaluation

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