Portraying infective endocarditis: results of multinational ID-IRI study

Hakan Erdem, Edmond Puca, Yvon Ruch, Lurdes Santos, Nesrin Ghanem-Zoubi, Xavier Argemi, Yves Hansmann, Rahmet Guner, Gilda Tonziello, Jean Philippe Mazzucotelli, Najada Como, Sukran Kose, Ayse Batirel, Asuman Inan, Necla Tulek, Abdullah Umut Pekok, Ejaz Ahmed Khan, Atilla Iyisoy, Meliha Meric-Koc, Ayse Kaya-KalemPedro Palma Martins, Imran Hasanoglu, André Silva-Pinto, Nefise Oztoprak, Raquel Duro, Fahad Almajid, Mustafa Dogan, Nicolas Dauby, Jesper Damsgaard Gunst, Recep Tekin, Deborah Konopnicki, Nicola Petrosillo, Ilkay Bozkurt, Jamal Wadi, Corneliu Popescu, Ilker Inanc Balkan, Safak Ozer-Balin, Tatjana Lejko Zupanc, Antonio Cascio, Irina Magdalena Dumitru, Aysegul Erdem, Gulden Ersoz, Meltem Tasbakan, Oday Abu Ajamieh, Fatma Sirmatel, Simin Florescu, Serda Gulsun, Hacer Deniz Ozkaya, Sema Sari, Selma Tosun, Meltem Avci, Yasemin Cag, Guven Celebi, Ayse Sagmak-Tartar, Sumeyra Karakus, Alper Sener, Arjeta Dedej, Serkan Oncu, Rosa Fontana Del Vecchio, Derya Ozturk-Engin, Canan Agalar

Research output: Contribution to journalArticlepeer-review

Abstract

Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042).

Original languageEnglish
Pages (from-to)1753-1763
Number of pages11
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
DOIs
Publication statusPublished - Jan 1 2019

Keywords

  • Blood culture
  • Infective endocarditis
  • Native
  • Prosthetic
  • S. aureus

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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