Microbiological and clinical profile of infective endocarditis patients: an observational study experience from tertiary care center Karachi Pakistan

Abstract

BackgroundThe study analyzed microbiological and antimicrobial susceptibility profile of organisms isolated from patients with infective endocarditis (2015–17) and compared disease outcomes in cohorts of endocarditis patient with history of prior invasive vascular intervention (high risk group) vs those without (native valve group). We hypothesized that high risk group would be more likely to have severe disease outcomes.MethodsThis was a prospective cohort study (2015–17). All blood and cardiac tissue samples of enrolled patients suspected of endocarditis according to modified Duke’s criteria were followed for microbiological and antimicrobial susceptibility profile. The high risk group was compared with the native valve group with 90 day follow up to determine difference in clinical course and outcome in terms of disease severity (defined as any patient with endocarditis undergoing surgical management, readmission or dying). The data was analyzed using SPSS 21.0 software and chi-square test. 90 day mortality was calculated using Kaplan Meier survival curves.ResultsTotal 104 patients with endocarditis were enrolled. Overall culture positivity rate was 71.2%. Streptococcus species were the most common isolate (36.7%), followed by S. aureus (17.3%) cases. In Streptococcus species, 14.2% showed intermediate susceptibility to penicillin. Thirty six patients were included in the cohort analysis. A poor outcome was seen in 85.7% high risk group as compared to 50% of native valve group. The overall mortality rate was 19.4%.ConclusionsWe found Streptococcus species to be the predominant pathogen for endocarditis overall. However Staphylococcus aureus predominated native valve group. High risk group showed more complicated clinical course.Electronic supplementary materialThe online version of this article (10.1186/s13019-018-0781-y) contains supplementary material, which is available to authorized users.

Correction to the article published in 2022: Epidemiologic and clinical characteristics of infective endocarditis: a single-center retrospective study in the Bronx, New York

“…MRSA accounted for about half of the S. aureus cases in our cohort. Although S. aureus has a wellknown propensity to develop resistance to methicillin and MRSA strains have been a universally recognized problem [ The overall in-hospital mortality was 18.1% in our study, which is in line with the high in-hospital death rates observed in other recent cohorts and indicates that IE remains a life-threatening condition requiring immediate and special attention [ 4,39,45,[72][73][74][75] ]. A signi cant decrease in the in-hospital mortality from 22.1-14.6% was noted comparing 2010-2015 to 2016-2020, which can be explained at least partially by the higher representation of patients with IVDU in the late cohort, who typically are of younger age and have less comorbidities [ 71,76,77 ].…”

“…Similarly, S. aureus was the most prevalent pathogen in recent cohorts of patients with IE in Australia (45-53%)[ 21,[42][43][44][45] ]. The existing literature has repeatedly demonstrated increasing prevalence of staphylococcal IE particularly in the western world [ 6, 11,34,[46][47][48][49].…”

Genome-Based Drug Target Identification in Human Pathogen Streptococcus gallolyticus

“…For the last two decades, a significant rise in incidence of infective endocarditis were observed worldwide (Tripodi et al, 2005;Marmolin et al, 2016;Shahid et al, 2018;Arregle et al, 2019;Chamat-Hedemand et al, 2020). Among 100,000 population, 2.6-7 cases of endocarditis have been reported per year, a significant proportion of which was contributed by streptococcal infections: with incidence of 17% in North America, 31% in other European countries, 39% in the South America, and 32% in rest of the world (Holland et al, 2016).…”