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Staphylococcus aureus infective endocarditis: predictors and outcome.
Session:
Posters - F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Speaker:
Geraldo Faia Carvalho Dias
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.2 Infective Endocarditis – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Geraldo Dias; Inês Alves; Pedro Von Hafe; Ana Filipa Cardoso; Tamara Pereira; Mariana Tinoco; João Português; Filipa Almeida; António Lourenço
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Introduction: Staphylococcus aureus (SA) is a frequent etiologic agent of infective endocarditis (IE) and is associated with destructive forms of the disease and a worse prognosis. </span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Purpose: This study aimed to assess which are the clinical predictors associated with IE by SA (IESA) and to compare its prognosis with that of IE by other or unknown agents (IEOA).</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Methods: A retrospective study was carried out of consecutive patients diagnosed with IE in an institution between 2008 and 2018. Hospital records were consulted and clinical and laboratory variables were analyzed. Univariate and multivariate statistical analysis was performed using SPSS 20.0.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Results: Fifty eight patients with a diagnosis of IE were identified, with a mean age of 63 ± 13 years, 42 (72%) of whom were male. The aortic valve was the most frequently involved (19, 33%), followed by the mitral valve (18, 31%). Prosthetic valve involvement was found in 14 patients (24%). In 21 cases (36%) the etiologic agent identified was SA, 2 of which a methicillin-resistant variant. The demographic variables described above, as well as the laboratory variables analysed, did not differ significantly between the groups with IESA and IEOA.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">The identification of more than one vegetation (p = 0.033), the involvement of the right heart (p = 0.049), the presence of a chronic intravenous catheter (P = 0.011), and the absence of co-morbidities (arterial hypertension, diabetes mellitus , chronic lung or kidney disease and heart failure; p = 0.021) were significantly associated with IESA. However, only the last two variables were independent predictors of this entity (p = 0.019 OR: 25.5 and p = 0.005 OR: 14.5, respectively).</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">In the analysis of prognosis, there were no significant differences in terms of in-hospital mortality (29% vs 28%) or endocarditis recurrence (5% vs 9%) between IESA and IEOA.</span></span></span></p> <p style="text-align:justify"> </p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Conclusion: In this study, IESA was more prevalent in patients with fewer co-morbidities. Additionally, higher mortality has not been shown to exist in the group of patients with IESA, contrarily to what has been reported in many studies</span></span></span></p>
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