Severe endocarditis in transplant recipients - an epidemiologic study*

Abstract

Summary Infective endocarditis (IE) is reported with an incidence of 6/100 000 inhabitants in the general population. Even though immunosuppression predisposes to systemic infection, reports regarding IE after solid organ transplantation (SOT) are sparse. From 1989 to 2004, 2556 patients underwent SOT at the University Hospital Innsbruck. During this period, 27 transplant recipients were diagnosed IE. Nine patients (33.3%) were diagnosed at autopsy, eight patients (29.6%) were cured by antibiotic treatment and 10 patients (37.1%) underwent surgery. Overall mortality was 44.4% (12 patients). Staphylococcus was the predominant microorganism in 16 cases (59.3%), fungal infection was present in four patients (14.8%). Incidence of IE was 1% (95% CI: 0.67–1.49), indicating a 171‐fold risk compared with the overall population. IE after SOT constitutes a significant problem and is associated with an excessive high mortality. Alertness to this condition is indicated, as we might diagnose more cases of IE in the future.

Myasthenia, Spondylitis and Enterococcus faecalis Endocarditis

“…Immunosuppression has been identified as a predisposing factor for infective endocarditis with an increasing prevalence during the last decades (Cabell et al 2002). Compared with the overall population, patients after solid organ transplantation have a 171-fold risk to develop endocarditis (Ruttmann et al 2005).…”

Course of transplant recipients treated with Ertapenem in the prophylaxis and treatment of infections: a first experience

“…Unfortunately in the latter case monitoring with TEE for endocarditis was discontinued after the intraoperative negative result. In fact, we recently published our experience with IE in transplant recipients and were able to show that the majority of cases of IE in transplant recipients had previously been missed or were diagnosed post mortem, emphasizing the need for alertness regarding IE [16].…”

Chlamydia pneumoniae okozta infektív endocarditis májtranszplantációt követően

“…Gyakorisága az átlagpopulációban 6/100 000 lakos évente [1]. Az IE mintegy 20 éve változatlanul kedvezőtlen prognózisú [2,3,4,5,6,7,8,9,10]. Utóbbi oka rész-ben a diagnosztikus késés, részben az inadekvát kezelés.…”

“…A kórokozók gyakoriságát korábbi közle-mények foglalják össze [2,3,4,5,6,7,8,9,10]. A natív billentyűt érintő IE esetében a leggyakoribb mikroorganizmusok a Streptococcusok.…”

“…S. bovis esetén vastagbél-folyamatra kell gondolni, epe-és húgyúti beavatkozások után elsősorban Enterococcus jön szóba. Koaguláznega-tív Staphylococcusok ritkán okoznak a natív billentyűn IE-t, műbillentyűn kialakuló IE esetében azonban jelentős szerepük van [2,3,4,5,6,7,8,9,10]. Intravénás kábítószer-élvezők infektív endocarditisét elsősorban S. aureus okozza, de Pseudomonas és Candida is előfor-dul.…”