Profile of infective endocarditis at a tertiary care center in Brazil during a seven-year period: prognostic factors and in-hospital outcome

Nunes, Maria Carmo Pereira; Gelape, Cláudio Léo; Ferrari, Teresa Cristina Abreu

doi:10.1016/j.ijid.2009.06.024

Cited by 59 publications

(86 citation statements)

References 28 publications

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“…Staphylococcus accounts for 15-50% of cases with Staphylococcus aureus more common than coagulase negative Staphylococcus (CoNS). [19][20][21][22][23]25,31,32,34 Comparison with pre-millennial ranges shows an increase in Staphylococcus which was previously reported in less than 20% of cases. 11,13,28 The emergence of Staphylococcus as a leading cause of IE in LMICs, a trend that was also previously noted in HICs, may reflect medical technology advances, increased hospital contact and increasing comorbidities.…”

Section: Staphylococcusmentioning

confidence: 60%

“…[19][20][21][22][23][24] Nel et al 25 however, reported a much higher (78%) prevalence of underlying RHD in their study in South Africa, a country where RHD is endemic. 26 Overall, this range of underlying RHD in IE represents a decline from the 45-80% reported in earlier (pre-2000) LMIC studies.…”

Section: Underlying Cardiac Conditionsmentioning

confidence: 78%

“…[19][20][21][22][23]31,32 UMIC studies account for the higher figures in these ranges, which reflects advances in medical technology and higher access to cardiac surgery. 21,22 Indeed, the largest report of PVE cases from a LMIC comes from Simsek-Yavuz et al 21 who reported findings from a referral centre in Turkey (an UMIC) in which 141 patients (44%) among 325 IE cases had PVE. 52% of the total patient cohort received surgical intervention, closely approximating the rate seen in HICs.…”

Section: Underlying Cardiac Conditionsmentioning

confidence: 99%

“…9,34,35 Consistent with these factors, it is noteworthy that only UMIC studies reported Staphylococcus as the leading cause of IE, accounting for up to 50% of cases. 21,22,25,31,32,34 In lower-middle income countries however, Streptococcus still predominates. 19,20 …”

Section: Staphylococcusmentioning

confidence: 99%

“…[19][20][21][22][23]25,31,32,34 Streptococcus is common among younger patients, patients with community-acquired IE and patients with rheumatic or congenital NVE. 19,20,34 This finding was highlighted by Simsek-Yavuz et al 21 in a study in Turkey where although Staphylococcus was the leading cause of IE in the entire cohort, Streptococcus was significantly more prevalent among patients with a native valve, patients less than 40 years of age, and patients with community-acquired IE.…”

Section: Streptococcusmentioning

confidence: 99%

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Infective Endocarditis in Low- and Middle-Income Countries

et al. 2017

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Key Points Staphylococcus is an increasingly important cause of IE in LMICs, and is the leading cause of IE in UMICs  RHD remains the major underlying cardiac pathology of IE in LMICs, identified in almost half of reported cases  The rate of microorganism non-identification is high, reaching up to 60% of IE cases in LMICs, and hampering diagnosis and treatment  Rates of access to surgery in UMICs for complicated IE are as high as in HICs, but remain dismal in lower-middle income countries SynopsisInfective endocarditis (IE) is a rare, life-threatening disease with a mortality rate of upto 25% and significant debilitating morbidities. Although much has been reported on contemporary IE in high income countries, conclusions on the state of IE in low and middle income countries (LMICs) are based on studies conducted before the year 2000. Furthermore, unique challenges in the diagnosis and management of IE persist in LMICs. This article is a review of IE studies conducted in LMICs documenting clinical experiences from the year 2000 to present. We present the causes of IE, management of patients with IE and the prevailing challenges in diagnosis and treatment of IE in LMICs.

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Section: Staphylococcusmentioning

confidence: 60%

Section: Underlying Cardiac Conditionsmentioning

confidence: 78%

Section: Underlying Cardiac Conditionsmentioning

confidence: 99%

Section: Staphylococcusmentioning

confidence: 99%

Section: Streptococcusmentioning

confidence: 99%

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Infective Endocarditis in Low- and Middle-Income Countries

et al. 2017

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The causative agents in infective endocarditis: a systematic review comprising 33,214 cases

Vogkou

Vlachogiannis

Palaiodimos

et al. 2016

Eur J Clin Microbiol Infect Dis

129

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Infective endocarditis (IE) incidence remains high with considerable fatality rates; guidelines for prophylaxis against IE are currently under review in some settings which highlights the importance of maintaining up-to-date epidemiological estimates about the most common microbial causes. The objective of this systematic review, following PRISMA guidelines, was to identify the most common microbial causes of IE in recent years. Medline was searched from January 1, 2003 to March 31, 2013 for all articles containing the term "infective endocarditis". All relevant studies reporting diagnostic results were included. Special patient subpopulations were assessed separately. A total of 105 studies were included, from 36 countries, with available data on a total of 33,214 cases. Staphylococcus aureus was found to be the most common microorganism, being the most frequent in 54.3 % of studies (N = 57) (and in 55.4 % of studies using Duke's criteria for diagnosis [N = 51]). Viridans group streptococci (VGS), coagulase-negative staphylococci (CoNS), Enterococcus spp and Streptococcus bovis were among the most common causes. S. aureus was the most common pathogen in almost all population subgroups; however, this was not the case in patients with implantable devices, prosthetic valves, or immunocompromised non-HIV, as well as in the sub-group from Asia, emphasizing that a global one-size-fits-all approach to the management of suspected IE is not appropriate. This review provides an evidence-based map of the most common causative agents of IE, highlighting S. aureus as the leading cause in the 21st century. The changing epidemiology of IE in some patient sub-groups in the last decade and the very high number of microbiologically undiagnosed cases (26.6 %) suggest the need to revisit IE prophylaxis and diagnostic strategies.

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Global Trends in Infective Endocarditis Epidemiology

Yew

Murdoch

2012

Curr Infect Dis Rep

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The global epidemiology of infective endocarditis is becoming better understood with the initiation of multi-center collaborative studies and with an increasing number of case series being reported from countries outside North America and Europe. However, there are still many knowledge gaps and a lack of population-based data. For endocarditis in developed countries, the role of rheumatic heart disease as a predisposing factor is diminishing; the population is increasingly elderly, staphylococci are becoming much more important pathogens, and proportionally more are healthcare-associated. In developing countries, the epidemiology of infective endocarditis remains similar to North America and Europe from the middle of the twentieth century, affecting a younger age group, is often associated with rheumatic heart disease, and is predominantly caused by streptococci.

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Profile of infective endocarditis at a tertiary care center in Brazil during a seven-year period: prognostic factors and in-hospital outcome

Cited by 59 publications

References 28 publications

Infective Endocarditis in Low- and Middle-Income Countries

Infective Endocarditis in Low- and Middle-Income Countries

The causative agents in infective endocarditis: a systematic review comprising 33,214 cases

Global Trends in Infective Endocarditis Epidemiology

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