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Epidemiological and clinical profile of infective endocarditis at a Brazilian tertiary care center: an eight-year prospective study

Damasco, P. V., Correal, J. C. D., Cruz-Campos, A. C. D., Wajsbrot, B. R., Cunha, R. G. D., Fonseca, A. G. D., Castier, M. B., Fortes, C. Q., Jazbick, J. C., Lemos, E. R. S. D., Rossen, J. W., Leão, R. D. S., Hirata Junior, R. & Guaraldi, A. L. D. M., 6-Jun-2019, In : Revista da Sociedade Brasileira de Medicina Tropical. 52, 9 p., e2018375.

Research output: Contribution to journalArticleAcademicpeer-review

  • Paulo Vieira Damasco
  • Julio Cesar Delgado Correal
  • Ana Carolina Da Cruz-Campos
  • Bruno Reznik Wajsbrot
  • Rodrigo Guimarães da Cunha
  • Aloysio Guimarães da Fonseca
  • Márcia Bueno Castier
  • Claudio Querido Fortes
  • João Carlos Jazbick
  • Elba Regina Sampaio de Lemos
  • John Wilhelmus Rossen
  • Robson de Souza Leão
  • Raphael Hirata Junior
  • Ana Luíza de Mattos Guaraldi

INTRODUCTION: Infective endocarditis (IE) is a systemic infectious disease requiring a multidisciplinary team for treatment. This study presents the epidemiological and clinical data of 73 cases of IE in Rio de Janeiro, Brazil.

METHODS: This observational prospective cohort study of endocarditis patients during an eight-year study period described 73 episodes of IE in 70 patients (three had IE twice). Community-associated (CAIE) and healthcare-acquired infective endocarditis (HAIE) were diagnosed according to the modified Duke criteria. The collected data included demographic, epidemiologic, and clinical characteristics, including results of blood cultures, echocardiographic findings, surgical interventions, and outcome.

RESULTS: Analysis of data from the eight-year study period and 73 cases (70 patients) of IE showed a mean age of 46 years (SD=2.5 years; 1-84 years) and that 65.7% were male patients. The prevalence of CAIE and HAIE was 32.9% and 67.1%, respectively. Staphylococcus aureus (30.1%), Enterococcus spp. (19.1%), and Streptococcus spp. (15.0%) were the prevalent microorganisms. The relevant signals and symptoms were fever (97.2%; mean 38.6 + 0.05°C) and heart murmur (87.6%). Vegetations were observed in the mitral (41.1%) and aortic (27.4%) valves. The mortality rate of the cases was 47.9%.

CONCLUSIONS: In multivariate analysis, chronic renal failure (relative risk [RR]= 1.60; 95% confidence interval [CI] 1.01-2.55), septic shock (RR= 2.19; 95% CI 1.499-3.22), and age over 60 years (RR= 2.28; 95% CI 1.44-3.59) were indirectly associated with in-hospital mortality. The best prognosis was related to the performance of cardiovascular surgery (hazard ratio [HR]= 0.51; 95% CI 0.26-0.99).

Original languageEnglish
Article numbere2018375
Number of pages9
JournalRevista da Sociedade Brasileira de Medicina Tropical
Volume52
Publication statusE-pub ahead of print - 6-Jun-2019

    Keywords

  • Infectious endocarditis; HAIE; CAIE; Staphylococcus aureus; Enterococcus spp.; Streptococcus spp.

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