Biomedical papers, 2016 (vol. 160), issue 2

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2016, 160(2):298-304 | 10.5507/bp.2015.062

Clinical manifestations of infective endocarditis in relation to infectious agents: An 8-year retrospective study

Michal Pazdernika, Josef Kautznera, Jan Sochmana, Jiri Kettnera, Jan Vojacekb, Radek Pelouchb
a Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
b 1st Department of Internal Medicine - Cardioangiology, Faculty Hospital in Hradec Kralove, Czech Republic

Aim: To compare clinical complications and outcomes of infective endocarditis (IE) episodes caused by Staphylococcus aureus (S. aureus) and other most frequent aetiological agents (streptococci, enterococci, coagulase-negative staphylococci, and culture-negative IE).

Methods: A total of 117 IE episodes assessed by all internal medicine services of a major teaching institution in the Czech Republic over an eight-year period were identified.

Results: We found that S. aureus IE episodes (n = 36) were significantly more associated with systemic embolism (41.7% vs 18.5%, P = 0.01), severe sepsis/septic shock (33.3% vs 3.7%, P < 0.0001), and in-hospital mortality (33% vs 12.3%, P = 0.01). No differences in local, structural, and/or functional complications (cardiac abscess formation, impaired integrity of the valvular apparatus, conduction disturbances, or incidence of heart failure) were observed between studied groups. Long-term survival estimates were significantly improved in patients with IE caused by agents other than S. aureus (13.78 median years vs 5.48 median years, P=0.03).

Conclusions: IE episodes caused by S. aureus are associated with both increased short-term and long-term mortality. Of all the studied parameters, only systemic embolism and severe sepsis/septic shock predicted in-hospital mortality.

Keywords: infective endocarditis, Staphylococcus aureus, systemic embolism, complications of infective endocarditis, septic shock, mortality

Received: June 18, 2015; Accepted: December 1, 2015; Prepublished online: January 5, 2016; Published: June 24, 2016


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