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A light at the end of the tunnel – Could Infective Endocarditis epidemiology and burden be changing for the better?
Session:
Comunicações Orais - Sessão 28 - Doença Valvular e Endocardite
Speaker:
Rafaela Fernandes
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.8 Infective Endocarditis - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Rafaela Fernandes; Mariana Simões; Ana Rita Gomes; Gustavo Campos; João Rosa; Vanessa Lopes; Eric Monteiro; Gonçalo Costa; Joana Guimarães; Diogo Fernandes; Carolina Saleiro; Ana Sofia Martinho; Luís Paiva; Joana Moura Ferreira; Lino Gonçalves
Abstract
<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background</strong>: Infective endocarditis (IE) is not a common disease but has high morbidity and mortality rates. In Portugal, the burden of IE is increasing due to the epidemiological profile changes, an aged population with severe comorbidities and a greater number of prosthetic valve and device-related infections. </span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods</strong>: Retrospective observational study that included all cases of IE in adult patients, admitted to Cardiology wards in a University Hospital Centre between 2005 and 2021. The patients were divided into two cohorts (cohort 1: patients admitted from 2005 to 2013, cohort 2: patients admitted from 2014 to 2021). Our purpose was to characterize the epidemiological profile of this disease. A revision of informatized clinical files was performed and statistical analysis was conducted using SPSS software.</span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results</strong>: A total of 230 patients were included, with 95 patients in cohort 1 and 135 in cohort 2. The median hospital stay was 41 (ID=34) days, and the median follow-up time was 607 (ID=1946) days. A male predominance was observed (cohort 1 with 73/76.8% patients and cohort 2 with 95/70.4% patients). The median age was 62(ID=22) years in cohort 1 and 67(ID=21) years in cohort 2. The in-hospital mortality rate was higher in cohort 1 (30.5% in cohort 1 versus 20% in cohort 2). Cohort 2 has a higher number of patients with prosthetic valves (11/8.1%). <em>Staphylococcus epidermidis</em> (10/10.5%) and <em>Staphylococcus aureus methicillin-susceptible</em> (MSSA) (10/10.5%) were the more frequent causative agents identified in cohort 1. In cohort 2 the most frequent microorganisms identified were <em>Staphylococcus aureus methicillin-resistant</em> (MRSA) (18/13.3%) and Enterococcus<em> faecalis </em>(15/11.1%). In 33 (24.4%) patients from cohort 2, IE was considered a nosocomial infection. </span></span></span></p> <p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusion</strong>: The slightly higher age in cohort 2 is indicative of an older population, with more comorbidities and a rapidly increasing rate of nosocomial infections. There is no doubt that nowadays, IE is even more severe. However, in our study we found that the prognosis is improving. Our in-hospital mortality rate has decreased in the last years, probably because of a better diagnosis, and improved medical and surgical treatments. </span></span></span></p>
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