Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 8, November, p. 1197–1205

doi: 10.17219/acem/64874

Publication type: original article

Language: English

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Patients with infective endocarditis: Five-year observation from a single reference center

Józefa Dąbek1,A,E,F, Michał Majewski1,A,B,C,D,E, Marta Michalak-Kolarz2,A,B,C,D, Zbigniew Gąsior1,E,F

1 Chair and Department of Cardiology, School of Health Sciences, Medical University of Silesia in Katowice, Poland

2 Chair and Department of Cardiology, Students’ Scientific Society, School of Health Sciences, Medical University of Silesia in Katowice, Poland

Abstract

Background. Infective endocarditis (IE) is a serious and, if untreated, usually fatal disease. Diagnosing IE is often considered to be one of the most difficult medical conditions because of the heterogeneous and ambiguous clinical presentation.
Objectives. The purpose of this study was to investigate diagnostic and therapeutic management in a non-selected group of patients with IE.
Material and Methods. A total of 45 patients consecutively admitted to the Department of Cardiology, Medical University of Silesia in Katowice (mean age 53.6 ±18 years; 13 females) with IE between 2009 and 2013 were evaluated. Echocardiography, blood cultures and laboratory tests were performed on every patient upon admission. An analysis of the diagnostic and therapeutic management was performed.
Results. Most frequent predisposing factors were: a history of heart valve replacement and/or repair (40%), dental caries (17.8%) and bicuspid aortic valve (17.8%). The majority of patients were admitted from another hospital (91.1%). Fever (92%) and symptoms of heart failure (80%) were the most common manifestations. Abnormalities in ECG occured in 91.2% of patients. Echocardiography was highly sensitive (>90%) in detecting endocardial changes. Staphylococcal etiology was the most common (33.3%). Surgery procedures were necessary in 62.2% of patients. Arrhythmias (91.1%) and acute heart failure (57.8%) were the most commonly observed complications, although 24.4% of subjects had neurological disorders. The patients studied were burdened with a number of factors predisposing to IE.
Conclusion. The diagnosis of IE can be a difficult challenge. Particular attention should be paid to the care of oral hygiene and treatment of dental diseases in order to reduce the risk of IE developing.

Key words

etiology, complication, infective endocarditis, treatment

References (20)

  1. Habib G, Lancellotti P, Antunes MJ, et al. 2015 ESC Guidelines for the management of infective endocarditis. Eur Heart J. 2015;36(44):3075–3128. doi: 10.1093/eurheartj/ehv319.
  2. Hoen B, Alla F, Selton-Suty C, et al. Association pour l’Etude et la Prévention de l’Endocardite Infectieuse (AEPEI) Study Group. Changing profile of infective endocarditis: Results of a 1-year survey in France. JAMA. 2002;288:75–81.
  3. Hogevik H, Olaison L, Andersson R, Lindberg J, Alestig K. Epidemiologic aspects of infective endocarditis in an urban population. A 5-year prospective study. Medicine (Baltimore). 1995;74:324–339.
  4. Moreillon P, Que YA. Infective endocarditis. Lancet. 2004;363:139–149.
  5. Cabell CH, Heidenreich PA, Chu VH, Moore CM, Stryjewski ME, Corey GR, Fowler VG Jr. Increasing rates of cardiac device infections among Medicare beneficiaries: 1990–1999. Am Heart J. 2004;147:582–586.
  6. Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med. 2004;350(14):1422–1429.
  7. McCarthy JT, Steckelberg JM. Infective endocarditis in patients receiving long-term hemodialysis. Mayo Clin Proc. 2000;75:1008–1014.
  8. Wisplinghoff H, Bischoff T, Tallent SM, Seifert H, Wenzel RP, Edmond MB. Nosocomial bloodstream infections in US hospitals: Analysis of 24 179 cases from a prospective nationwide surveillance study. Clin Infect Dis. 2004;39:309–317.
  9. Fluit AC, Jones ME, Schmitz FJ, Acar J, Gupta R, Verhoef J. Antimicrobial susceptibility and frequency of occurrence of clinical blood isolates in Europe from the SENTRY antimicrobial surveillance program, 1997 and 1998. Clin Infect Dis. 2000;30:454–460.
  10. Slipczuk L, Codolosa JN, Davila CD, et al. Infective endocarditis epidemiology over five decades: A systematic review. PLoS One. 2013;9;8:e82665. doi: 10.1371/journal.pone. 0082665.
  11. Munita JM, Arias CA, Murray BE. Enterococcal endocarditis: Can we win the war? Curr Infect Dis Rep. 2012;14:339–349.
  12. Perez de Isla L, Zamorano J, Lennie V, Vazquez J, Ribera JM, Macaya C. Negative blood culture infective endocarditis in the elderly: Long-term follow-up. Gerontology. 2007;53:245–249.
  13. Evangelista A, Gonzalez-Alujas MT. Echocardiography in infective endocarditis. Heart. 2004;90:614–617.
  14. Bertagna F, Bisleri G, Motta F, et al. Possible role of F18-FDG-PET/CT in the diagnosis of endocarditis: Preliminary evidence from a review of the literature. Int J Cardiovasc Imaging. 2012;28(6):1417–1425.
  15. Wang A, Athan E, Pappas PA, et al. International collaboration on endocarditis-prospective cohort study investigators. Contemporary clinical profile and outcome of prosthetic valve endocarditis. JAMA. 2007;297(12):1354–1361.
  16. Thuny F, Avierinos JF, Tribouilloy C, et al. Impact of cerebrovascular complications on mortality and neurologic outcome during infective endocarditis: A prospective multicentre study. Eur Heart J. 2007;28:1155–1161.
  17. Anderson DJ, Goldstein LB, Wilkinson WE, et al. Stroke location, characterization, severity and outcome in mitral vs aortic valve endocarditis. Neurology. 2003;61:1341–1346.
  18. Heiro M, Nikoskelainen J, Engblom E, Kotilainen E, Marttila R, Kotilainen P. Neurologic manifestations of infective endocarditis: A 17-year experience in a teaching hospital in Finland. Arch Intern Med. 2000;160:2781–2787.
  19. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: Guidelines from the American Heart Association: A guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2007;116:1736–1754.
  20. NICE Short Clinical Guidelines Technical Team. Prophylaxis against infective endocarditis: Antimicrobial prophylaxis against infective endocarditis in adults and children undergoing interventional procedures. London: National Institute for Health and Clinical Excellence; 2008.