INTRODUCTION: Despite the recent advances in diagnosis and treatment, mortality rates due to infective endocarditis (IE) remain high if not aggressively treated with antibiotics, whether or not associated with surgery. Data on the prevalence, epidemiology and etiology of IE from developing countries remain scarce. The aim of this observational, prospective cohort study was to report a 5-year experience of IE at two teaching hospitals in Rio de Janeiro, Brazil. MATERIAL AND METHODS: Demographical, anamnestic and microbiological characteristics of 71 IE patients were evaluated during the period of January 2009 to March 2013. RESULTS: The mean age of the IE patients was 49.8 ± 2.4 years, of which 41 (57.7%) were males. The median time between the onset of symptoms and diagnosis of IE was 35.8 ± 4.8 days. A total of 31 (43.6%) cases of community-acquired infective endocarditis (CAIE) and 40 (56.3%) cases of healthcare-acquired infective endocarditis (HAIE) were observed. Staphylococcus aureus (30%) was the predominant cause of IE. Streptococcus spp. (45.1 %) was the predominant cause of the CAIE while S. aureus (32.5%) and Enterococcus spp. (27.2 %) were the main etiological agents of HAIE. For 64 (90.1 %) patients with native valve endocarditis, the mitral valve was the most commonly affected (48.3%). The main source of IE in this cohort was intravascular catheter. The tricuspid valve and renal chronic insufficiency were more frequent in patients with HAIE than CAIE (p = 0.001). The risk factors associated with in-hospital mortality rate (46.4%) in IE patients were: age over 45 (OR 3.4; 95% CI 1.03-11.24; p = 0.04) and chronic renal insufficiency (OR 38.3; 95% CI 3.2-449.4; p = 0.004). CONCLUSIONS: At two main teaching hospitals in Brazil, Streptococcus spp. was the principal pathogen of CAIE while S. aureus and Enterococcus spp. were the most frequent causes of HAIE. IE remains a serious disease associated with high in-hospital mortality rate (46.6%); especially, in individuals over 45 years of age and with renal failure. Data suggest that early surgery may improve the outcome of IE patients.
INTRODUCTION: Despite the recent advances in diagnosis and treatment, mortality rates due to infective endocarditis (IE) remain high if not aggressively treated with antibiotics, whether or not associated with surgery. Data on the prevalence, epidemiology and etiology of IE from developing countries remain scarce. The aim of this observational, prospective cohort study was to report a 5-year experience of IE at two teaching hospitals in Rio de Janeiro, Brazil. MATERIAL AND METHODS: Demographical, anamnestic and microbiological characteristics of 71 IE patients were evaluated during the period of January 2009 to March 2013. RESULTS: The mean age of the IE patients was 49.8 ± 2.4 years, of which 41 (57.7%) were males. The median time between the onset of symptoms and diagnosis of IE was 35.8 ± 4.8 days. A total of 31 (43.6%) cases of community-acquired infective endocarditis (CAIE) and 40 (56.3%) cases of healthcare-acquired infective endocarditis (HAIE) were observed. Staphylococcus aureus (30%) was the predominant cause of IE. Streptococcus spp. (45.1 %) was the predominant cause of the CAIE while S. aureus (32.5%) and Enterococcus spp. (27.2 %) were the main etiological agents of HAIE. For 64 (90.1 %) patients with native valve endocarditis, the mitral valve was the most commonly affected (48.3%). The main source of IE in this cohort was intravascular catheter. The tricuspid valve and renal chronic insufficiency were more frequent in patients with HAIE than CAIE (p = 0.001). The risk factors associated with in-hospital mortality rate (46.4%) in IE patients were: age over 45 (OR 3.4; 95% CI 1.03-11.24; p = 0.04) and chronic renal insufficiency (OR 38.3; 95% CI 3.2-449.4; p = 0.004). CONCLUSIONS: At two main teaching hospitals in Brazil, Streptococcus spp. was the principal pathogen of CAIE while S. aureus and Enterococcus spp. were the most frequent causes of HAIE. IE remains a serious disease associated with high in-hospital mortality rate (46.6%); especially, in individuals over 45 years of age and with renal failure. Data suggest that early surgery may improve the outcome of IE patients.
Authors: Walter Geissdörfer; Verena Moos; Annette Moter; Christoph Loddenkemper; Andreas Jansen; René Tandler; Andreas J Morguet; Florence Fenollar; Didier Raoult; Christian Bogdan; Thomas Schneider Journal: J Clin Microbiol Date: 2011-11-30 Impact factor: 5.948
Authors: Vance G Fowler; Jose M Miro; Bruno Hoen; Christopher H Cabell; Elias Abrutyn; Ethan Rubinstein; G Ralph Corey; Denis Spelman; Suzanne F Bradley; Bruno Barsic; Paul A Pappas; Kevin J Anstrom; Dannah Wray; Claudio Q Fortes; Ignasi Anguera; Eugene Athan; Philip Jones; Jan T M van der Meer; Tom S J Elliott; Donald P Levine; Arnold S Bayer Journal: JAMA Date: 2005-06-22 Impact factor: 56.272
Authors: P V Damasco; F S Cavalcante; R C Chamon; D C Ferreira; S S Rioja; M V Potsch; M P Pastura; V D Marques; M B Castier; E A Marques; K R N Santos Journal: Infection Date: 2013-03-02 Impact factor: 3.553
Authors: David R Murdoch; G Ralph Corey; Bruno Hoen; José M Miró; Vance G Fowler; Arnold S Bayer; Adolf W Karchmer; Lars Olaison; Paul A Pappas; Philippe Moreillon; Stephen T Chambers; Vivian H Chu; Vicenç Falcó; David J Holland; Philip Jones; John L Klein; Nigel J Raymond; Kerry M Read; Marie Francoise Tripodi; Riccardo Utili; Andrew Wang; Christopher W Woods; Christopher H Cabell Journal: Arch Intern Med Date: 2009-03-09
Authors: R Hirata; G A Pereira; A A Filardy; D L R Gomes; P V Damasco; A C P Rosa; P E Nagao; F P Pimenta; A L Mattos-Guaraldi Journal: Braz J Med Biol Res Date: 2008-11 Impact factor: 2.590
Authors: J Ambrosioni; M Hernandez-Meneses; A Téllez; J Pericàs; C Falces; J M Tolosana; B Vidal; M Almela; E Quintana; J Llopis; A Moreno; José M Miro Journal: Curr Infect Dis Rep Date: 2017-05 Impact factor: 3.725
Authors: Daniel C DeSimone; Imad M Tleyjeh; Daniel D Correa de Sa; Nandan S Anavekar; Brian D Lahr; Muhammad R Sohail; James M Steckelberg; Walter R Wilson; Larry M Baddour Journal: Am Heart J Date: 2015-07-17 Impact factor: 4.749
Authors: Andrea Maria Cabral; Suzimar da Siveira Rioja; Fabio Brito-Santos; Juliana Ribeiro Peres da Silva; Maria Luíza MacDowell; Marcia S C Melhem; Ana Luíza Mattos-Guaraldi; Raphael Hirata Junior; Paulo Vieira Damasco Journal: JMM Case Rep Date: 2017-11-02
Authors: Thomas Lafon; Ana Catalina Hernandez Padilla; Arthur Baisse; Lucie Lavaud; Marine Goudelin; Olivier Barraud; Thomas Daix; Bruno Francois; Philippe Vignon Journal: BMC Infect Dis Date: 2019-06-07 Impact factor: 3.090
Authors: Nathália L Andrade; Ana Carolina da Cruz Campos; Andrea Maria Cabral; Paula Hesselberg Damasco; Jerome Lo-Ten-Foe; Ana Cláudia P Rosa; Paulo V Damasco Journal: Braz J Microbiol Date: 2021-09-22 Impact factor: 2.476
Authors: Reuben K Mutagaywa; Josephine C Vroon; Lulu Fundikira; Anna Maria Wind; Peter Kunambi; Joel Manyahi; Apollinary Kamuhabwa; Gideon Kwesigabo; Steven A J Chamuleau; Maarten J Cramer; Pilly Chillo Journal: Front Cardiovasc Med Date: 2022-09-12