Juan M Pericàs1, Jaume Llopis2, Patricia Muñoz3, Juan Gálvez-Acebal4, Martha Kestler3, Maricela Valerio3, Marta Hernández-Meneses5, Miguel Á Goenaga6, Manuel Cobo-Belaustegui7, Miguel Montejo8, Guillermo Ojeda-Burgos9, M Dolores Sousa-Regueiro10, Arístides de Alarcón11, Antonio Ramos-Martínez12, José M Miró13. 1. Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain; Clinical Direction of Infectious Diseases and Microbiology, IRBLleida, Universitat de Lleida, Lleida, Spain. 2. Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain; Department of Genetics, Microbiology and Statistics, Universitat de Barcelona, Barcelona, Spain. 3. Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Faculty of Medicine, Universidad Complutense de Madrid, Madrid, Spain. 4. Hospital Universitario Virgen de la Macarena/CSIC/Instituto de Biomedicina de Sevilla (IBiS), Departamento de Medicina, Universidad de Sevilla, Seville, Spain. 5. Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain. 6. Hospital Universitario Donostia, Donostia, Spain. 7. Hospital Universitario Marqués de Valdecilla, Santander, Spain. 8. Hospital Universitario Cruces, Barakaldo, Spain. 9. Clinical Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Hospital Universitario Virgen de la Victoria, Málaga, Spain. 10. Servicio de Enfermedades Infecciosas, Complejo Hospitalario A Coruña, A Coruña, Spain. 11. Clinical Unit of Infectious Diseases, Microbiology, and Preventive Medicine, Infectious Diseases Research Group Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC/University Hospital Virgen del Rocío, Seville, Spain. 12. Hospital Universitario Puerta de Hierro, IDIPHIM, Majadahonda, Spain. 13. Hospital Clínic de Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, Spain. Electronic address: jmmiro@ub.edu.
Abstract
BACKGROUND: Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES: The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS: This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses. RESULTS: Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse. CONCLUSIONS: Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE.
BACKGROUND:Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES: The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS: This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses. RESULTS:Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse. CONCLUSIONS: Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE.
Authors: Laura Herrera-Hidalgo; Arístides de Alarcón; Luis Eduardo López-Cortes; Rafael Luque-Márquez; Luis Fernando López-Cortes; Alicia Gutiérrez-Valencia; María Victoria Gil-Navarro Journal: Antimicrob Agents Chemother Date: 2020-12-16 Impact factor: 5.191
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Authors: Eva Romay; Juan Manuel Pericàs; María José García-País; Marta Hernández-Meneses; Blanca Ayuso; Javier García-González; Rodrigo Vicente Garcés-Durán; Ramón Rabuñal; Pilar Alonso-García; Fernando García-Garrote; Andrés Perissinotti; Bàrbara Vidal; Carles Falces; Eduard Quintana; Leticia Moreira; Manel Almela; Josep Llach; Asunción Moreno; Juan Corredoira; Jose María Miró Journal: J Clin Med Date: 2022-04-13 Impact factor: 4.241
Authors: Juan M Pericàs; Marta Hernández-Meneses; Patricia Muñoz; Ana Álvarez-Uría; Blanca Pinilla-Llorente; Arístides de Alarcón; Karlos Reviejo; M Carmen Fariñas; Carlos Falces; Josune Goikoetxea-Agirre; Juan Gálvez-Acebal; Carmen Hidalgo-Tenorio; Eloy Gómez-Nebreda; Jose M Miro Journal: Open Forum Infect Dis Date: 2021-03-25 Impact factor: 3.835