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Portraying infective endocarditis: results of multinational ID-IRI study

  • Hakan ErdemEmail author
  • Edmond Puca
  • Yvon Ruch
  • Lurdes Santos
  • Nesrin Ghanem-Zoubi
  • Xavier Argemi
  • Yves Hansmann
  • Rahmet Guner
  • Gilda Tonziello
  • Jean-Philippe Mazzucotelli
  • Najada Como
  • Sukran Kose
  • Ayse Batirel
  • Asuman Inan
  • Necla Tulek
  • Abdullah Umut Pekok
  • Ejaz Ahmed Khan
  • Atilla Iyisoy
  • Meliha Meric-Koc
  • Ayse Kaya-Kalem
  • Pedro Palma Martins
  • Imran Hasanoglu
  • André Silva-Pinto
  • Nefise Oztoprak
  • Raquel Duro
  • Fahad Almajid
  • Mustafa Dogan
  • Nicolas Dauby
  • Jesper Damsgaard Gunst
  • Recep Tekin
  • Deborah Konopnicki
  • Nicola Petrosillo
  • Ilkay Bozkurt
  • Jamal Wadi
  • Corneliu Popescu
  • Ilker Inanc Balkan
  • Safak Ozer-Balin
  • Tatjana Lejko Zupanc
  • Antonio Cascio
  • Irina Magdalena Dumitru
  • Aysegul Erdem
  • Gulden Ersoz
  • Meltem Tasbakan
  • Oday Abu Ajamieh
  • Fatma Sirmatel
  • Simin Florescu
  • Serda Gulsun
  • Hacer Deniz Ozkaya
  • Sema Sari
  • Selma Tosun
  • Meltem Avci
  • Yasemin Cag
  • Guven Celebi
  • Ayse Sagmak-Tartar
  • Sumeyra Karakus
  • Alper Sener
  • Arjeta Dedej
  • Serkan Oncu
  • Rosa Fontana Del Vecchio
  • Derya Ozturk-Engin
  • Canan Agalar
Original Article
  • 59 Downloads

Abstract

Infective endocarditis is a growing problem with many shifts due to ever-increasing comorbid illnesses, invasive procedures, and increase in the elderly. We performed this multinational study to depict definite infective endocarditis. Adult patients with definite endocarditis hospitalized between January 1, 2015, and October 1, 2018, were included from 41 hospitals in 13 countries. We included microbiological features, types and severity of the disease, complications, but excluded therapeutic parameters. A total of 867 patients were included. A total of 631 (72.8%) patients had native valve endocarditis (NVE), 214 (24.7%) patients had prosthetic valve endocarditis (PVE), 21 (2.4%) patients had pacemaker lead endocarditis, and 1 patient had catheter port endocarditis. Eighteen percent of NVE patients were hospital-acquired. PVE patients were classified as early-onset in 24.9%. A total of 385 (44.4%) patients had major embolic events, most frequently to the brain (n = 227, 26.3%). Blood cultures yielded pathogens in 766 (88.4%). In 101 (11.6%) patients, blood cultures were negative. Molecular testing of vegetations disclosed pathogens in 65 cases. Overall, 795 (91.7%) endocarditis patients had any identified pathogen. Leading pathogens (Staphylococcus aureus (n = 267, 33.6%), Streptococcus viridans (n = 149, 18.7%), enterococci (n = 128, 16.1%), coagulase-negative staphylococci (n = 92, 11.6%)) displayed substantial resistance profiles. A total of 132 (15.2%) patients had cardiac abscesses; 693 (79.9%) patients had left-sided endocarditis. Aortic (n = 394, 45.4%) and mitral valves (n = 369, 42.5%) were most frequently involved. Mortality was more common in PVE than NVE (NVE (n = 101, 16%), PVE (n = 49, 22.9%), p = 0.042).

Keywords

Infective endocarditis Prosthetic Native S. aureus Blood culture 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval is obtained from the Fatih Sultan Mehmet Training and Research Hospital’s Review Board.

Informed consent

Not applicable. The study has a retrospective design.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hakan Erdem
    • 1
    Email author
  • Edmond Puca
    • 2
  • Yvon Ruch
    • 3
  • Lurdes Santos
    • 4
  • Nesrin Ghanem-Zoubi
    • 5
  • Xavier Argemi
    • 3
  • Yves Hansmann
    • 3
  • Rahmet Guner
    • 6
  • Gilda Tonziello
    • 7
  • Jean-Philippe Mazzucotelli
    • 8
  • Najada Como
    • 9
  • Sukran Kose
    • 10
  • Ayse Batirel
    • 11
  • Asuman Inan
    • 12
  • Necla Tulek
    • 13
  • Abdullah Umut Pekok
    • 14
  • Ejaz Ahmed Khan
    • 15
  • Atilla Iyisoy
    • 16
  • Meliha Meric-Koc
    • 17
  • Ayse Kaya-Kalem
    • 6
  • Pedro Palma Martins
    • 4
  • Imran Hasanoglu
    • 6
  • André Silva-Pinto
    • 4
  • Nefise Oztoprak
    • 18
  • Raquel Duro
    • 4
  • Fahad Almajid
    • 19
  • Mustafa Dogan
    • 20
  • Nicolas Dauby
    • 21
  • Jesper Damsgaard Gunst
    • 22
  • Recep Tekin
    • 23
  • Deborah Konopnicki
    • 21
  • Nicola Petrosillo
    • 7
  • Ilkay Bozkurt
    • 24
  • Jamal Wadi
    • 25
  • Corneliu Popescu
    • 26
  • Ilker Inanc Balkan
    • 27
  • Safak Ozer-Balin
    • 28
  • Tatjana Lejko Zupanc
    • 29
  • Antonio Cascio
    • 30
  • Irina Magdalena Dumitru
    • 31
  • Aysegul Erdem
    • 32
  • Gulden Ersoz
    • 33
  • Meltem Tasbakan
    • 34
  • Oday Abu Ajamieh
    • 25
  • Fatma Sirmatel
    • 35
  • Simin Florescu
    • 26
  • Serda Gulsun
    • 36
  • Hacer Deniz Ozkaya
    • 37
  • Sema Sari
    • 38
  • Selma Tosun
    • 39
  • Meltem Avci
    • 40
  • Yasemin Cag
    • 41
  • Guven Celebi
    • 42
  • Ayse Sagmak-Tartar
    • 28
  • Sumeyra Karakus
    • 41
  • Alper Sener
    • 43
  • Arjeta Dedej
    • 44
  • Serkan Oncu
    • 45
  • Rosa Fontana Del Vecchio
    • 46
  • Derya Ozturk-Engin
    • 47
  • Canan Agalar
    • 47
  1. 1.IDI-IRIAnkaraTurkey
  2. 2.Department of Infectious DiseasesUniversity Hospital Center “Mother Teresa”TiranaAlbania
  3. 3.Department of Infectious DiseasesStrasbourg University Hospital, Nouvel Hôpital CivilStrasbourgFrance
  4. 4.Infectious Diseases DepartmentCentro Hospitalar São João and Faculdade de Medicina da Universidade do PortoPortoPortugal
  5. 5.Institute of Infectious DiseasesRambam Health Care CampusHaifaIsrael
  6. 6.Ataturk Training and Research Hospital, Department of Infectious Diseases and Clinical MicrobiologyYildirim Beyazit UniversityAnkaraTurkey
  7. 7.Clinical & Research Department for Infectious DiseasesNational Institute for Infectious Diseases “Lazzaro Spallanzani”, IRCCS,RomeItaly
  8. 8.Department of Cardiovascular SurgeryStrasbourg University Hospital, Nouvel Hôpital CivilStrasbourgFrance
  9. 9.Service of Infectious Disease, UHCTiranaAlbania
  10. 10.Department of Infectious Diseases and Clinical MicrobiologyTepecik Training and Research HospitalIzmirTurkey
  11. 11.Department of Infectious Diseases and Clinical Microbiology, Dr. Lutfi Kirdar Training and Research HospitalHealth Sciences UniversityIstanbulTurkey
  12. 12.Department of Infectious Diseases and Clinical MicrobiologyHaydarpasa Numune Training and Research HospitalIstanbulTurkey
  13. 13.Department of MicrobiologyAtilim University, School of MedicineAnkaraTurkey
  14. 14.Department of Infectious Diseases and Clinical MicrobiologyPendik Medical Park HospitalIstanbulTurkey
  15. 15.Shifa International Hospital and Shifa Tameer-e-Millat UniversityIslamabadPakistan
  16. 16.Department of Cardiology, Gulhane Training and Research HospitalHealth Sciences UniversityAnkaraTurkey
  17. 17.Department of Infectious Diseases and Clinical MicrobiologyBezmialem Vakıf University School of MedicineIstanbulTurkey
  18. 18.Department of Infectious Diseases and Clinical Microbiology, Antalya Training and Research HospitalHealth Sciences UniversityAntalyaTurkey
  19. 19.Department of Medicine, Infectious Diseases DivisionKing Saud University HospitalRiyadhSaudi Arabia
  20. 20.Department of Infectious Diseases and Clinical MicrobiologyCorlu State Hospital, TekirdagAntalyaTurkey
  21. 21.Department of Infectious Diseases, Centre Hospitalier Universitaire Saint-PierreUniversité libre de Bruxelles (ULB)BrusselsBelgium
  22. 22.Department of Infectious DiseasesAarhus University HospitalAarhusDenmark
  23. 23.Department of Infectious Diseases and Clinical MicrobiologyDicle University Faculty of MedicineDiyarbakırTurkey
  24. 24.Department of Infectious Diseases and Clinical MicrobiologyOndokuz Mayis University School of MedicineSamsunTurkey
  25. 25.Department of Infectious Diseases, School of MedicineThe University of JordanAmmanJordan
  26. 26.Dr Victor Babes Clinical Hospital of Infectious and Tropical DiseaseBucharestRomania
  27. 27.Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa Medical FacultyIstanbul UniversityIstanbulTurkey
  28. 28.Department of Infectious Diseases and Clinical Microbiology, Faculty of MedicineFirat UniversityElazigTurkey
  29. 29.Department of Infectious DiseasesUMC LjubljanaLjubljanaSlovenia
  30. 30.Department of Health Promotion Sciences and Mother and Child Care “G. D’Alessandro”University of PalermoPalermoItaly
  31. 31.Clinical Infectious Diseases HospitalOvidius University of ConstantaConstantaRomania
  32. 32.Department of PathologyKecioren Training and Research HospitalAnkaraTurkey
  33. 33.Department of Infectious Diseases and Clinical MicrobiologyMersin University School of MedicineMersinTurkey
  34. 34.Department of Infectious Diseases and Clinical MicrobiologyEge University Faculty of MedicineIzmirTurkey
  35. 35.Department of Infectious Disease and Clinical MicrobiologyIzzet Baysal University School of MedicineBoluTurkey
  36. 36.Department of Infectious Diseases and Clinical MicrobiologyDiyarbakir Training and Research HospitalDiyarbakirTurkey
  37. 37.Department of Infectious Diseases and Clinical MicrobiologyCigli Regional Education HospitalIzmirTurkey
  38. 38.Department of Intensive Care UnitTurkey Advanced Specialty Education and Research HospitalAnkaraTurkey
  39. 39.Department of Infectious Diseases and Clinical MicrobiologyIzmir Bozyaka Training and Research HospitalIzmirTurkey
  40. 40.Department of Infectious Disease and Clinical MicrobiologyUsak University School of MedicineUsakTurkey
  41. 41.Department of Infectious Diseases and Clinical MicrobiologyMedeniyet University, Goztepe Training and Research HospitalIstanbulTurkey
  42. 42.Department of Infectious Diseases and Clinical Microbiology, Faculty of MedicineBulent Ecevit UniversityZonguldakTurkey
  43. 43.Department of Infectious Diseases and Clinical MicrobiologyOnsekiz Mart University School of MedicineCanakkaleTurkey
  44. 44.Department of NephrologyAmerican HospitalTiranaAlbania
  45. 45.Department of Infectious Diseases and Clinical MicrobiologyAdnan Menderes University School of MedicineAydinTurkey
  46. 46.Department of Clinical and Molecular Biomedicine, Section of Infectious DiseasesUniversity of CataniaCataniaItaly
  47. 47.Department of Infectious Diseases and Clinical MicrobiologyFatih Sultan Mehmet Training and Research HospitalIstanbulTurkey

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