Trends, microbiology, and outcomes of infective endocarditis in children during 2000-2010 in the United States

Gupta, Shipra; Sakhuja, Ankit; McGrath, Eric; Asmar, Basim I.

doi:10.1111/chd.12425

Cited by 83 publications

(87 citation statements)

References 24 publications

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“…This comes in line with the overall microbiologic profile of IE in adults (staphylococci, 42%; and streptococci, 29%)59 and in pediatrics (staphylococci, 43%; and streptococci, 40%) 60. Similar patterns were also reported in prosthetic valve endocarditis (PVE; staphylococci, 40%; and streptococci, 22%)59 and in pulmonary surgical conduit IE (staphylococci, 53%; and streptococci, 43%) 47.…”

Section: Discussionsupporting

confidence: 81%

Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

Abdelghani

Nassif

Blom

et al. 2018

JAHA

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BackgroundInfective endocarditis (IE) after transcatheter pulmonary valve implantation (TPVI) in dysfunctioning right ventricular outflow tract conduits has evoked growing concerns. We aimed to investigate the incidence and the natural history of IE after TPVI with the Melody valve through a systematic review of published data.Methods and ResultsPubMed, EMBASE, and Web of Science databases were systematically searched for articles published until March 2017, reporting on IE after TPVI with the Melody valve. Nine studies (including 851 patients and 2060 patient‐years of follow‐up) were included in the analysis of the incidence of IE. The cumulative incidence of IE ranged from 3.2% to 25.0%, whereas the annualized incidence rate ranged from 1.3% to 9.1% per patient‐year. The median (interquartile range) time from TPVI to the onset of IE was 18.0 (9.0–30.4) months (range, 1.0–72.0 months). The most common findings were positive blood culture (93%), fever (89%), and new, significant, and/or progressive right ventricular outflow tract obstruction (79%); vegetations were detectable on echocardiography in only 34% of cases. Of 69 patients with IE after TPVI, 6 (8.7%) died and 35 (52%) underwent surgical and/or transcatheter reintervention. Death or reintervention was more common in patients with new/significant right ventricular outflow tract obstruction (69% versus 33%; P=0.042) and in patients with non‐streptococcal IE (73% versus 30%; P=0.001).ConclusionsThe incidence of IE after implantation of a Melody valve is significant, at least over the first 3 years after TPVI, and varies considerably between the studies. Although surgical/percutaneous reintervention is a common consequence, some patients can be managed medically, especially those with streptococcal infection and no right ventricular outflow tract obstruction.

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Section: Discussionsupporting

confidence: 81%

Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

Abdelghani

Nassif

Blom

et al. 2018

JAHA

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“…All studies were conducted in tertiary urban or teaching hospitals. Among studies conducted in highincome settings, 15 were in European countries, [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] 19 in the United States of America, [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] one in Australia, 36 three elsewhere in North America, [37][38][39] and three in Asia. [40][41][42] There were three nonrandomised interventional studies, 6,22,23 32 cohort studies, [2][3][4][5][7][8]...…”

Section: Epidemiology Of Perioperative Infections In High-income Counmentioning

confidence: 99%

“…These included acute respiratory tract infectionsupper respiratory tract infection, bronchiolitis, pneumonia, and respiratory syncytial virus infections 5,10,11,20,40 sepsis, 18 and infective endocarditis. 4,24,39,41 Among children with cardiac disease, the cumulative incidence of preoperative hospitalisation from respiratory syncytial virus (RSV) infection was 0.5% (2518/549,265) to 9.6% (58/602) in children <2 years of age with mortality of 1.9% of 8127 to 4.9% of 549,265 patients. 5,11,20,40 Risk factors for hospital admission due to acute respiratory tract infections were malnutrition, infant, male, chromosomal abnormalities, wheezing, inadequate respiratory syncytial virus prophylaxis, and sibling <11 years of age.…”

Section: Epidemiology Of Perioperative Infections In High-income Counmentioning

confidence: 99%

Perioperative infections in congenital heart disease

et al. 2017

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Background: Perioperative infections have significant consequences for children with congenital heart disease (CHD), which can manifest as acute or chronic infection followed by poor growth and progressive cardiac failure. The consequences include delayed or higher-risk surgery, and increased postoperative morbidity and mortality. Methods: A systematic search for studies evaluating the burden and interventions to reduce perioperative infections in children with CHD was undertaken using PubMed. Results: Limited studies conducted in low-to middle-income countries demonstrated the large burden of perioperative infections among children with CHD. Most studies focussed on infections after surgery. Few studies evaluated strategies to prevent preoperative infection or the impact of infection on decision-making around the timing of surgery. Children with CHD have multiple risk factors for infections including delayed presentation, inadequate treatment of cardiac failure, and poor nutrition. Conclusions: The burden of perioperative infections is high among children with CHD, and studies evaluating the effectiveness of interventions to reduce these infections are lacking. As good nutrition, early corrective surgery, and measures to reduce nosocomial infection are likely to play a role, practical steps can be taken to make surgery safer.

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“…This was in contrast to American Heart Association (AHA) [2] and European Society of Cardiology (ESC) [3] guidelines issued around the same time, which continued to recommend antibiotic prophylaxis in certain high-risk cases, e.g., patients with prosthetic heart valves or who had had infective endocarditis previously. Although much research on the impact of guideline changes on the incidence of infective endocarditis has been conducted internationally [4][5][6][7][8][9][10][11][12][13][14][15], and in particular a study in England which showed an increase in cases following the NICE guideline change [6], no consensus has been reached, and in a 2016 update to their guidelines [16] NICE reaffirmed their previous position, while clarifying that doctors and dentists should still apply their clinical judgement on a case by case basis.…”

Section: Introductionmentioning

confidence: 99%

Investigation of the impact of the NICE guidelines regarding antibiotic prophylaxis during invasive dental procedures on the incidence of infective endocarditis in England: an electronic health records study

Quan

Müller‐Pebody

Fawcett

et al. 2020

BMC Med

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Background Infective endocarditis is an uncommon but serious infection, where evidence for giving antibiotic prophylaxis before invasive dental procedures is inconclusive. In England, antibiotic prophylaxis was offered routinely to patients at risk of infective endocarditis until March 2008, when new guidelines aimed at reducing unnecessary antibiotic use were issued. We investigated whether changes in infective endocarditis incidence could be detected using electronic health records, assessing the impact of inclusion criteria/statistical model choice on inferences about the timing/type of any change. Methods Using national data from Hospital Episode Statistics covering 1998–2017, we modelled trends in infective endocarditis incidence using three different sets of inclusion criteria plus a range of regression models, identifying the most likely date for a change in trends if evidence for one existed. We also modelled trends in the proportions of different organism groups identified during infection episodes, using secondary diagnosis codes and data from national laboratory records. Lastly, we applied non-parametric local smoothing to visually inspect any changes in trend around the guideline change date. Results Infective endocarditis incidence increased markedly over the study (22.2–41.3 per million population in 1998 to 42.0–67.7 in 2017 depending on inclusion criteria). The most likely dates for a change in incidence trends ranged from September 2001 (uncertainty interval August 2000–May 2003) to May 2015 (March 1999–January 2016), depending on inclusion criteria and statistical model used. For the proportion of infective endocarditis cases associated with streptococci, the most likely change points ranged from October 2008 (March 2006–April 2010) to August 2015 (September 2013–November 2015), with those associated with oral streptococci decreasing in proportion after the change point. Smoothed trends showed no notable changes in trend around the guideline date. Conclusions Infective endocarditis incidence has increased rapidly in England, though we did not detect any change in trends directly following the updated guidelines for antibiotic prophylaxis, either overall or in cases associated with oral streptococci. Estimates of when changes occurred were sensitive to inclusion criteria and statistical model choice, demonstrating the need for caution in interpreting single models when using large datasets. More research is needed to explore the factors behind this increase.

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Trends, microbiology, and outcomes of infective endocarditis in children during 2000-2010 in the United States

Cited by 83 publications

References 24 publications

Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

Infective Endocarditis After Melody Valve Implantation in the Pulmonary Position: A Systematic Review

Perioperative infections in congenital heart disease

Investigation of the impact of the NICE guidelines regarding antibiotic prophylaxis during invasive dental procedures on the incidence of infective endocarditis in England: an electronic health records study

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