Influence of Staphylococcus aureus on Outcomes after Valvular Surgery for Infective Endocarditis

Han, S.; Sorabella, Robert A.; Vasan, Sowmya; Grbic, Mark; Lambert, D; Prasad, Rahul N.; Wang, Catherine; Kurlansky, Paul; Borger, Michael A.; Gordon, Rachel; George, Isaac

doi:10.1186/s13019-017-0623-3

Cited by 28 publications

(18 citation statements)

References 12 publications

(19 reference statements)

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“…Streptococcus species were protective from mortality when compared with a negative culture. Though not statistically significant in the model, Staphylococcus aureus , the next most commonly isolated species has been associated with a more severe clinical presentation and worse long‐term survival in prior literature 10,11 . Our patients with IVDU more commonly had MRSA and MSSA positive cultures.…”

Section: Discussionmentioning

confidence: 57%

“…Outcomes for patients undergoing surgery for infective endocarditis, with and without a history of IVDU; for each readmission type, the total number of readmissions for all patients, the mean number of readmissions per patient (with standard deviation), and the median time to the first readmission for each patient (with interquartile range, in years) are shown Streptococcus species were protective from mortality when compared with a negative culture. Though not statistically significant in the model, Staphylococcus aureus, the next most commonly isolated species has been associated with a more severe clinical presentation and worse long-term survival in prior literature 10,11. Our patients with IVDU more commonly had MRSA and MSSA positive cultures.…”

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confidence: 51%

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Surgical treatment of infective endocarditis: Results in 831 patients from a single center

et al. 2020

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Introduction This study evaluated surgical outcomes of infective endocarditis (IE), with particular attention to the impact of intravenous drug use (IVDU). Methods Adult patients undergoing surgery for IE between 2011 and 2018 at a single center were included and stratified by IVDU. The primary outcome was overall survival. Secondary outcomes included postoperative complications and hospital readmissions. Kaplan‐Meier and multivariable Cox regression were utilized for unadjusted and risk‐adjusted survival analyses, respectively. Cumulative incidence function curves were compared for hospital readmissions. Results A total of 831 patients (mean age 55 years, 34.4% female) were operated on for IE, including 318 (38.3%) with IVDU. Cultures were most commonly positive for streptococcus (25.2%), methicillin‐sensitive Staphylococcus aureus (17.7%), enterococcus (14.3%), or methicillin‐resistant Staphylococcus aureus (8.4%). The most common procedures included isolated aortic valve repair/replacement (18.8%), aortic root replacement (15.9%), mitral valve repair/replacement (26.7%), aortic and mitral valve replacement (8.4%), and tricuspid valve repair/replacement (7.6%). Mean follow‐up was 3.4 ± 2.4 years. Overall 5‐year survival was 64% and was similar between IVDU and non‐IVDU. Multivariable analysis demonstrated that IVDU was not associated with mortality risk. IVDU patients displayed higher rates of all‐cause readmission (61.6% vs 53.9%; P = .03), drug‐use readmission (15.4% vs 1.4%; P < .001), and recurrent endocarditis readmission (33.0% vs 13.0%; P < .001). Conclusions The majority of patients undergoing surgical treatment of IE are alive at 5‐years although readmission rates are high. IVDU is not a risk factor for longitudinal mortality although patients with IVDU are at higher overall readmission risk, driven largely by greater readmissions for drug‐use and recurrent endocarditis.

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Section: Discussionmentioning

confidence: 57%

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confidence: 51%

Surgical treatment of infective endocarditis: Results in 831 patients from a single center

et al. 2020

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“…Staphylococcus aureus infection was correlated with death in univariate cox regression analysis in our study and also in EURO ENDO registry [ 9 ]. Staphylococcus aureus patients have more severe IE compared to non- Staphylococcus aureus patients, with higher rates of preoperative vascular complications, septic shock, embolic events, stroke, and annular abscess [ 42 ]. Staphylococcus aureus IE is associated with more severe prognosis than other pathogens (excluding fungal pathogens), with a high in-hospital mortality of 30% to 46%, according to various authors [ 10 , 42 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcome of Infective Endocarditis in a University Hospital in Romania

Babeş

Lucuța²,

Petcheşi

et al. 2021

Medicina

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Background and Objectives: Characterization of patients with endocarditis regarding demographic, clinical, biological and imagistic data, blood culture results and possible correlation between different etiologic factors and host status characteristics. Material and methods: This is a retrospective observational descriptive study conducted on patients older than 18 years admitted in the past 10 years, in the Cardiology Clinic of the Clinical County Emergency Hospital Oradea Romania, with clinical suspicion of bacterial endocarditis. Demographic data, clinical, paraclinical investigations and outcome were registered and analyzed. Results: 92 patients with definite infective endocarditis (IE) according to modified Duke criteria were included. The mean age of patients was 63.80 ± 13.45 years. A percent of 32.6% had health care associated invasive procedure performed in the 6 months before diagnosis of endocarditis. Charlson’s comorbidity index number was 3.53 ± 2.029. Most common clinical symptoms and signs were: shortness of breath, cardiac murmur, fever. Sixty-six patients had native valve endocarditis, 26 patients had prosthetic valve endocarditis and one patient was with congenital heart disease. Blood cultures were positive in 61 patients. Among positive culture patient’s staphylococcus group was the most frequently involved: Staphylococcus aureus (19.6%) and coagulase negative Staphylococcus (18.5%). Most frequent complications were heart failure, acute renal failure and embolic events. Conclusions: Staphylococcus aureus IE was associated with the presence of large vegetations, prosthetic valve endocarditis and intracardiac abscess. Coagulase negative Staphylococcus (CoNS) infection was associated with prosthetic valve dysfunction. Streptococcus gallolyticus etiology correlated with ischemic embolic stroke and the presence of large vegetations. Cardiovascular surgery was recommended in 67.4% of patients but was performed only on half of them. In hospital death occurred in 33.7% of patients and independent predictors of mortality were congestive heart failure and septic shock.

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“…Second, several studies have found that Staphylococcus aureus infection is associated with higher mortality rates in a variety of infectious diseases [40,41,42,43]. The higher rate of Staphylococcus aureus infection in diabetic patients conveys an important message, that is, this infection is associated with higher rates of both complications and mortality in IE, and these findings have been confirmed by several studies [42,43,44,45]. Third, the ratio of receiving surgical intervention is lower in the with DM group compared to the without DM group in our study.…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

Lin

Chua

Chung

et al. 2019

IJERPH

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Infective endocarditis (IE) is a severe disease with a hospital mortality rate of 17%–25%. Early identification of IE patients with high risk of mortality may improve their clinical outcomes. Patients with diabetes mellitus (DM) who develop infective diseases are associated with worse outcomes. This study aimed to define the impact of DM on long-term mortality in IE patients. A total of 412 patients with definite IE from February 1999 to June 2012 were enrolled in this observational study and divided into 2 groups: group 1, patients with DM (n = 72) and group 2, patients without DM (n = 340). The overall in-hospital mortality rate for both groups combined was 20.2% and was higher in group 1 than in group 2 (41.7% vs. 16.5%, p < 0.01). Compared to patients without DM, patients with DM were older and associated with higher incidence of chronic diseases, less drug abuse, higher creatinine levels, and increased risk of Staphylococcus aureus infection (all p < 0.05). Moreover, they were more likely to have atypical clinical presentation and were associated with longer IE diagnosis time (all p < 0.05). In multivariable analysis, DM is an independent and significant predictor of mortality. The prognosis of IE patients with DM is still poor. Early identification and more aggressive treatment may be considered in IE patients with DM.

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Influence of Staphylococcus aureus on Outcomes after Valvular Surgery for Infective Endocarditis

Cited by 28 publications

References 12 publications

Surgical treatment of infective endocarditis: Results in 831 patients from a single center

Surgical treatment of infective endocarditis: Results in 831 patients from a single center

Clinical Features and Outcome of Infective Endocarditis in a University Hospital in Romania

Diabetes Mellitus: An Independent Risk Factor of In-Hospital Mortality in Patients with Infective Endocarditis in a New Era of Clinical Practice

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