Session Type: ePosters
Session Title: ePosters
Authors(s): D. Akyol (1), G. Guliyeva (1), S. Özcam Bardak (1), M. Kayikçioglu (2), T. Yamazhan (1), H. Pullukçu (1), B. Arda (1), S. Ulusoy (1), H. Sipahi (3), M. Tasbakan (1), O.R. Sipahi (1)
Authors Affiliations(s): (1) Infectious Diseases, Turkey, (2) Cardiology, Turkey, (3) Public Health, Turkey
Background:
In spite of developments in medicine and antibiotics, infective endocarditis (IE) is still associated with significant morbidity and mortality. In this retrospective cohort study it was aimed to analyse the clinical characteristics and outcomes of IE cases.
Methods:Patients that were followed up for definite IE (diagnosed according to modified Duke criteria) in our tertiary-care educational hospital between March 2007 and November 2020 were analysed retrospectively. Patients were evaluated in terms of demographic features, underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality.
Results:There were 178 patients diagnosed with IE [114 men, mean age 53.9 ± 16.7 years (ranging 18-91 years)]. Prosthetic valve IE was present in 34 patients (19.1%) while congenital cardiac disease in 23 (12.9%), central venous catheter in 19 (10.6%), tooth extraction history in 18 (10.1%), and intravenous drug usage in seven (3.9%) cases. The most frequently seen complaints in patients were fever (88.2%), cold-shiver (54.5%), dyspnea (29.2%), weight-loss (24.2%), and tachycardia (23.6%). Heart murmur was detected cardiac auscultation of 87 patients (48.9%). Mean blood leukocyte count, C-reactive protein and erythrocyte sedimentation rate were 12487+/-9390/mm3 (min 1012, max 102270), 11.10+/-8.79 mg/dl (min 0.05, max 48.28) and 62,7+/-31.7 mm/h (min 2, max 140), respectively. Blood culture was positive in 131 patients (73,5%). The most common etiologic agents were; S. viridans 27%), S. aureus (18%) and E. feacalis (11.8%). The therapy of 36 patients with native valve endocarditis comprised penicillin and gentamicin (other therapy combinations were cephazolin and gentamicin [n=8], ampicillin/sulbactam and gentamicin [n=27] ). Antistaphylococcal penicillin is not available in our country. Four of 34 patients with prosthetic valve endocarditis were treated with vancomycin, rifampicin and gentamicin. The most frequently developed complications were septic embolisms (intracranial in 6.2%s, splenic in 5.6%, renal in 1.7% and pulmonary embolism in 1.7%). In hospital mortality was 20.8% (37/178). Mortality rates between blood culture positive and negative cases were similar (Chi-square test 0.434) while mortality in S. viridans was less than S. aureus or enterococci (Chi-square test p:0.006, Table 1).
Conclusions:IE is still associated with significant mortality. More interventions are needed to further decrease the complication and mortality rates.
Keyword(s): Infective endocarditis, S. viridans, Modified Duke criteriaSession Type: ePosters
Session Title: ePosters
Authors(s): D. Akyol (1), G. Guliyeva (1), S. Özcam Bardak (1), M. Kayikçioglu (2), T. Yamazhan (1), H. Pullukçu (1), B. Arda (1), S. Ulusoy (1), H. Sipahi (3), M. Tasbakan (1), O.R. Sipahi (1)
Authors Affiliations(s): (1) Infectious Diseases, Turkey, (2) Cardiology, Turkey, (3) Public Health, Turkey
Background:
In spite of developments in medicine and antibiotics, infective endocarditis (IE) is still associated with significant morbidity and mortality. In this retrospective cohort study it was aimed to analyse the clinical characteristics and outcomes of IE cases.
Methods:Patients that were followed up for definite IE (diagnosed according to modified Duke criteria) in our tertiary-care educational hospital between March 2007 and November 2020 were analysed retrospectively. Patients were evaluated in terms of demographic features, underlying diseases, risk factors, clinical and laboratory findings, therapy responses, complications, and mortality.
Results:There were 178 patients diagnosed with IE [114 men, mean age 53.9 ± 16.7 years (ranging 18-91 years)]. Prosthetic valve IE was present in 34 patients (19.1%) while congenital cardiac disease in 23 (12.9%), central venous catheter in 19 (10.6%), tooth extraction history in 18 (10.1%), and intravenous drug usage in seven (3.9%) cases. The most frequently seen complaints in patients were fever (88.2%), cold-shiver (54.5%), dyspnea (29.2%), weight-loss (24.2%), and tachycardia (23.6%). Heart murmur was detected cardiac auscultation of 87 patients (48.9%). Mean blood leukocyte count, C-reactive protein and erythrocyte sedimentation rate were 12487+/-9390/mm3 (min 1012, max 102270), 11.10+/-8.79 mg/dl (min 0.05, max 48.28) and 62,7+/-31.7 mm/h (min 2, max 140), respectively. Blood culture was positive in 131 patients (73,5%). The most common etiologic agents were; S. viridans 27%), S. aureus (18%) and E. feacalis (11.8%). The therapy of 36 patients with native valve endocarditis comprised penicillin and gentamicin (other therapy combinations were cephazolin and gentamicin [n=8], ampicillin/sulbactam and gentamicin [n=27] ). Antistaphylococcal penicillin is not available in our country. Four of 34 patients with prosthetic valve endocarditis were treated with vancomycin, rifampicin and gentamicin. The most frequently developed complications were septic embolisms (intracranial in 6.2%s, splenic in 5.6%, renal in 1.7% and pulmonary embolism in 1.7%). In hospital mortality was 20.8% (37/178). Mortality rates between blood culture positive and negative cases were similar (Chi-square test 0.434) while mortality in S. viridans was less than S. aureus or enterococci (Chi-square test p:0.006, Table 1).
Conclusions:IE is still associated with significant mortality. More interventions are needed to further decrease the complication and mortality rates.
Keyword(s): Infective endocarditis, S. viridans, Modified Duke criteria