Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention


Por: Ramos-Martinez, A, Calderon-Parra, J, Miro, JM, Farinas, MC, Goenaga, MA, Marcos, FJM, Vinuesa, D, Sanchez, FF, Noureddine, M, Rosas, G, Lima, JD, Aramendi, J, Blanco, MJ, Blanco, R, Boado, MV, Lazaro, MC, Crespo, A, Goikoetxea, J, Iruretagoyena, JR, Zuazabal, JI, Lopez-Soria, L, Montejo, M, Nieto, J, Rodrigo, D, Rodriguez, D, Rodriguez, R, Vitoria, Y, Voces, R, Lopez, MVG, Georgieva, RI, Ojeda, G, Bailon, IR, Morales, JR, Cuende, AM, Echeverria, T, Fuerte, A, Gaminde, E, Goenaga, MA, Idigoras, P, Iribarren, JA, Yarza, AI, Urkola, XK, Reviejo, C, Carrasco, R, Climent, V, Llamas, P, Merino, E, Plazas, J, Reus, S, Alvarez, N, Bravo-Ferrer, JM, Castelo, L, Cuenca, J, Llinares, P, Rey, EM, Mayo, MR, Sanchez, E, Regueiro, DS, Martinez, FJ, Alonso, MD, Castro, B, Rosado, DG, Duran, MD, Gomez, MAM, Lacalzada, J, Nassar, I, Ciezar, AP, Iglesias, JMR, Alvarez, VA, Costas, C, de la Hera, J, Suarez, JF, Fraile, LI, Arguero, VL, Menendez, JL, Bajo, PM, Morales, C, Torrico, AM, Palomo, C, Martinez, BP, Esteban, AR, Garcia, RR, Asensio, MT, Almela, M, Ambrosioni, J, Azqueta, M, Brunet, M, Bodro, M, Cartana, R, Falces, C, Fita, G, Fuster, D, de la Maria, CG, Hernandez-Meneses, M, Perez, JL, Marco, F, Miro, JM, Moreno, A, Nicolas, D, Ninot, S, Quintana, E, Pare, C, Pereda, D, Pericas, JM, Pomar, JL, Ramirez, J, Rovira, I, Sandoval, E, Sitges, M, Soy, D, Tellez, A, Tolosana, JM, Vidal, B, Vila, J, Adan, I, Bermejo, J, Bouza, E, Celemin, D, Caballero, GC, Montero, AD, Cruz, AF, Mansilla, AG, Leoni, MEG, Ramallo, VG, Hernandez, MK, Hualde, AM, Marin, M, Martinez-Selles, M, Menarguez, MC, Munoz, P, Rincon, C, Rodriguez-Abella, H, Rodriguez-Creixems, M, Pinilla, B, Pinto, A, Valerio, M, Vazquez, P, Moreno, EV, Antorrena, I, Loeches, B, Quiros, AM, Moreno, M, Ramirez, U, Baston, VR, Romero, M, Saldana, A, Balbin, JA, Castillo, CA, Arnaiz, A, de las Revillas, FA, Belaustegui, MC, Farinas, MC, Farinas-Alvarez, C, Izquierdo, RG, Garcia, I, Rico, CG, Gutierrez-Cuadra, M, Diez, JG, Pajaron, M, Parra, JA, Teira, R, Zarauza, J, Dominguez, F, Pavia, PG, Gonzalez, J, Orden, B, Ramos, A, Centella, T, Hermida, JM, Moya, JL, Martin-Davila, P, Navas, E, Oliva, E, del Rio, A, Ruiz, S, Tenorio, CH, Delia, MA, Araji, O, Barquero, JM, Jambrina, RC, de Cueto, M, Acebal, JG, Mendez, I, Morales, I, Lopez-Cortes, LE, de Alarcon, A, Garcia, E, Haro, JL, Lepe, JA, Lopez, F, Luque, R, Alonso, LJ, Azcarate, P, Gutierrez, JMA, Blanco, JR, Villegas, AC, Garcia-Alvarez, L, Oteo, JA, Sanz, M, de Benito, N, Gurgui, M, Pacho, C, Pericas, R, Pons, G, Alvarez, M, Fernandez, AL, Martinez, A, Prieto, A, Regueiro, B, Tijeira, E, Vega, M, Blasco, AC, Mollar, JC, Arana, JCG, Uriarte, OG, Lopez, AM, de Zarate, ZO, Matos, JAU, Gloria, GD, Antonio, SP, Leal, JMA, Vazquez, EG, Torres, AH, Blazquez, A, Valenzuela, GD, Alonso, A, Aramburu, J, Calvo, FE, Rodriguez, AM, Tarabini-Castellani, P, Galvez, EH, Bellido, CM, Pau, JL, Sepulveda, MA, Sierra, PT, Iqbal-Mirza, SZ, Alcolea, EC, Yanez, IK, Ballesta, AP, Escobar, EM, Monje, AP, Cabrera, VS, Garcia, DV, Asenjo, MA, Luna, CC, Morcillo, JN, Seco, MCP, Villoslada, A, Guallar, A, Abad, NF, Mangas, PG, Adell, MM, Ruiz, MPP, Porres, JC, Vidal, BA, Trigueros, NC, Espin, MJD, Caro, JAG, Sanchez, RJ, Almazan, AJ, Freire, AO, Gonzalez, MV, Ramis, PP, Blanco, MAR, Bordes, ERD, Bonet, LV, Munera, MCB, Garaizabal, EE, Martinez, AT, Luque, JCS

Publicada: 1 may 2019
Resumen:
Aim: To evaluate the effect of the type of surgical indication on mortality in infective endocarditis (IE) patients who are rejected for surgery. Methods and results: From January 2008 to December 2016, 2714 patients with definite left-sided IE were attended in the participating hospitals. One thousand six hundred and fifty-three patients (60.9%) presented surgical indications. Five hundred and thirty-eight patients (32.5%) presented surgical indications but received medical treatment alone. The indications for surgery in these patients were uncontrolled infection (366 patients, 68%), heart failure (168 patients, 31.3%) and prevention of embolism (148 patients, 27.6%). One hundred and thirty patients (24.2%) presented more than one indication. The mortality during hospital admission was 60% (323 patients). The in-hospital mortality of patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 75.6%, 61.4% and 54.7%, respectively (p < 0.001). Surgical indications due to heart failure (OR: 3.24; CI 95%: 1.99-5.9) or uncontrolled infection (OR: 1.83; CI 95%: 1.04-3.18) were independently associated with a fatal outcome during hospital admission. Mortality during the first year was 75.4%. The mortality during the first year in patients whose indication for surgery was heart failure, uncontrolled infection or risk of embolism was 85.9%, 76.7% and 72.7%, respectively (p = 0.016). Surgical indication due to heart failure (OR: 3.03; CI 95%: 1.53-5.98) were independently associated with fatal outcome during the first year. Conclusions: The type of surgical indication is associated with mortality in IE patients who are rejected for surgical intervention. (c) 2019 Elsevier B.V. All rights reserved.

Filiaciones:
Ramos-Martinez, A:
 Univ Puerta de Hierro, Med Interna Serv, Unidad Enfermedades Infecciosas, Madrid, Spain

Calderon-Parra, J:
 Hosp Univ Puerta de Hierro, Med Interna Serv, Madrid, Spain

Miro, JM:
 Univ Barcelona, Hosp Clin, IDIBAPS, Serv Enfermedades Infecciosas, Barcelona, Spain

Farinas, MC:
 Univ Cantabria, Hosp Univ Marques de Valdecilla, Infect Dis Unit, Santander, Spain

 Hosp Univ Marques de Valdecilla, Santander, Spain

Goenaga, MA:
 Hosp Univ Donosti, Serv Enfermedades Infecciosas, San Sebastian, Spain

Marcos, FJM:
 Complejo Hosp Univ Huelva, Unidad Gest Clin Enfermedades Infecciosas, Huelva, Spain

Vinuesa, D:
 Hosp Clin San Cecilio, Serv Med Interna & Enfermedades Infecciosas, Granada, Spain

Sanchez, FF:
 Hosp Costa del Sol, Marbella, Spain

Noureddine, M:
 Hosp Costa del Sol, Marbella, Spain

Rosas, G:
 Hosp Costa del Sol, Marbella, Spain

Lima, JD:
 Hosp Costa del Sol, Marbella, Spain

Aramendi, J:
 Hosp Univ Cruces, Bilbao, Spain

Blanco, MJ:
 Hosp Univ Cruces, Bilbao, Spain

Blanco, R:
 Hosp Univ Cruces, Bilbao, Spain

Boado, MV:
 Hosp Univ Cruces, Bilbao, Spain

Lazaro, MC:
 Hosp Univ Cruces, Bilbao, Spain

Crespo, A:
 Hosp Univ Cruces, Bilbao, Spain

Goikoetxea, J:
 Hosp Univ Cruces, Bilbao, Spain

Iruretagoyena, JR:
 Hosp Univ Cruces, Bilbao, Spain

Zuazabal, JI:
 Hosp Univ Cruces, Bilbao, Spain

Lopez-Soria, L:
 Hosp Univ Cruces, Bilbao, Spain

Montejo, M:
 Hosp Univ Cruces, Bilbao, Spain

Nieto, J:
 Hosp Univ Cruces, Bilbao, Spain

Rodrigo, D:
 Hosp Univ Cruces, Bilbao, Spain

Rodriguez, D:
 Hosp Univ Cruces, Bilbao, Spain

Rodriguez, R:
 Hosp Univ Cruces, Bilbao, Spain

Vitoria, Y:
 Hosp Univ Cruces, Bilbao, Spain

Voces, R:
 Hosp Univ Cruces, Bilbao, Spain

Lopez, MVG:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Georgieva, RI:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Ojeda, G:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Bailon, IR:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Morales, JR:
 Hosp Univ Virgen de la Victoria, Malaga, Spain

Cuende, AM:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Echeverria, T:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Fuerte, A:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Gaminde, E:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Goenaga, MA:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Idigoras, P:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Iribarren, JA:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Yarza, AI:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Urkola, XK:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Reviejo, C:
 Hosp Univ Donostia Policlin Gipuzkoa, San Sebastian, Spain

Carrasco, R:
 Hosp Gen Univ Alicante, Alicante, Spain

Climent, V:
 Hosp Gen Univ Alicante, Alicante, Spain

Llamas, P:
 Hosp Gen Univ Alicante, Alicante, Spain

Merino, E:
 Hosp Gen Univ Alicante, Alicante, Spain

Plazas, J:
 Hosp Gen Univ Alicante, Alicante, Spain

Reus, S:
 Hosp Gen Univ Alicante, Alicante, Spain

Alvarez, N:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Bravo-Ferrer, JM:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Castelo, L:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Cuenca, J:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Llinares, P:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Rey, EM:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Mayo, MR:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Sanchez, E:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Regueiro, DS:
 Complejo Hosp Univ A Coruna, La Coruna, Spain

Martinez, FJ:
 Complejo Hosp Univ Huelva, Huelva, Spain

Alonso, MD:
 Hosp Univ Canarias, Canarias, Spain

Castro, B:
 Hosp Univ Canarias, Canarias, Spain

Rosado, DG:
 Hosp Univ Canarias, Canarias, Spain

Duran, MD:
 Hosp Univ Canarias, Canarias, Spain

Gomez, MAM:
 Hosp Univ Canarias, Canarias, Spain

Lacalzada, J:
 Hosp Univ Canarias, Canarias, Spain

Nassar, I:
 Hosp Univ Canarias, Canarias, Spain

Ciezar, AP:
 Hosp Reg Univ Malaga, Malaga, Spain

Iglesias, JMR:
 Hosp Reg Univ Malaga, Malaga, Spain

Alvarez, VA:
 Hosp Univ Cent Asturias, Oviedo, Spain

Costas, C:
 Hosp Univ Cent Asturias, Oviedo, Spain

de la Hera, J:
 Hosp Univ Cent Asturias, Oviedo, Spain

Suarez, JF:
 Hosp Univ Cent Asturias, Oviedo, Spain

Fraile, LI:
 Hosp Univ Cent Asturias, Oviedo, Spain

Arguero, VL:
 Hosp Univ Cent Asturias, Oviedo, Spain

Menendez, JL:
 Hosp Univ Cent Asturias, Oviedo, Spain

Bajo, PM:
 Hosp Univ Cent Asturias, Oviedo, Spain

Morales, C:
 Hosp Univ Cent Asturias, Oviedo, Spain

Torrico, AM:
 Hosp Univ Cent Asturias, Oviedo, Spain

Palomo, C:
 Hosp Univ Cent Asturias, Oviedo, Spain

Martinez, BP:
 Hosp Univ Cent Asturias, Oviedo, Spain

Esteban, AR:
 Hosp Univ Cent Asturias, Oviedo, Spain

Garcia, RR:
 Hosp Univ Cent Asturias, Oviedo, Spain

Asensio, MT:
 Hosp Univ Cent Asturias, Oviedo, Spain

Almela, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Ambrosioni, J:
 Univ Barcelona, Hosp Clin, IDIBAPS, Serv Enfermedades Infecciosas, Barcelona, Spain

 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Azqueta, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Brunet, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Bodro, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Cartana, R:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Falces, C:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Fita, G:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Fuster, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

de la Maria, CG:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Hernandez-Meneses, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Perez, JL:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Marco, F:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Miro, JM:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Moreno, A:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Nicolas, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Ninot, S:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Quintana, E:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pare, C:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pereda, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pericas, JM:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Pomar, JL:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Ramirez, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Rovira, I:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Sandoval, E:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Sitges, M:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Soy, D:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Tellez, A:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Tolosana, JM:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Vidal, B:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Vila, J:
 Univ Barcelona, Hosp Clin IDIBAPS, Barcelona, Spain

Adan, I:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Bermejo, J:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Bouza, E:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Celemin, D:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Caballero, GC:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Montero, AD:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Cruz, AF:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Mansilla, AG:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Leoni, MEG:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Ramallo, VG:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Hernandez, MK:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Hualde, AM:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Marin, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Martinez-Selles, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Menarguez, MC:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Munoz, P:
 Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain

 Univ Complutense Madrid, Fac Med, CIBER Enfermedades Resp CIBERES CB06 06 0058, Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain

 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Rincon, C:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Rodriguez-Abella, H:
 Hosp Gen Univ Gregorio Maranon, Serv Cirugia Cardiaca, Madrid, Spain

 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Rodriguez-Creixems, M:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Pinilla, B:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Pinto, A:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Valerio, M:
 Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain

 Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain

 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Vazquez, P:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Moreno, EV:
 Hosp Gen Univ Gregorio Maranon, Madrid, Spain

Antorrena, I:
 Hosp Univ La Paz, Madrid, Spain

Loeches, B:
 Hosp Univ La Paz, Madrid, Spain

Quiros, AM:
 Hosp Univ La Paz, Madrid, Spain

Moreno, M:
 Hosp Univ La Paz, Madrid, Spain

Ramirez, U:
 Hosp Univ La Paz, Madrid, Spain

Baston, VR:
 Hosp Univ La Paz, Madrid, Spain

Romero, M:
 Hosp Univ La Paz, Madrid, Spain

Saldana, A:
 Hosp Univ La Paz, Madrid, Spain

Balbin, JA:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Castillo, CA:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Arnaiz, A:
 Hosp Univ Marques de Valdecilla, Santander, Spain

de las Revillas, FA:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Belaustegui, MC:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Farinas, MC:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Farinas-Alvarez, C:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Izquierdo, RG:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Garcia, I:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Rico, CG:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Gutierrez-Cuadra, M:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Diez, JG:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Pajaron, M:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Parra, JA:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Teira, R:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Zarauza, J:
 Hosp Univ Marques de Valdecilla, Santander, Spain

Dominguez, F:
 Hosp Univ Puerta de Hierro, Serv Cardiol, Madrid, Spain

 Hosp Univ Puerta de Hierro, Madrid, Spain

Pavia, PG:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Gonzalez, J:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Orden, B:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Ramos, A:
 Hosp Univ Puerta de Hierro, Madrid, Spain

Centella, T:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Hermida, JM:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Moya, JL:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Martin-Davila, P:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Navas, E:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Oliva, E:
 Hosp Univ Ramon y Cajal, Madrid, Spain

del Rio, A:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Ruiz, S:
 Hosp Univ Ramon y Cajal, Madrid, Spain

Tenorio, CH:
 Hosp Univ Virgen de las Nieves, Granada, Spain

Delia, MA:
 Hosp Univ Virgen Macarena, Seville, Spain

Araji, O:
 Hosp Univ Virgen Macarena, Seville, Spain

Barquero, JM:
 Hosp Univ Virgen Macarena, Seville, Spain

Jambrina, RC:
 Hosp Univ Virgen Macarena, Seville, Spain

de Cueto, M:
 Hosp Univ Virgen Macarena, Seville, Spain

Acebal, JG:
 Hosp Univ Virgen Macarena, Seville, Spain

Mendez, I:
 Hosp Univ Virgen Macarena, Seville, Spain

Morales, I:
 Hosp Univ Virgen Macarena, Seville, Spain

Lopez-Cortes, LE:
 Hosp Univ Virgen Macarena, Seville, Spain

de Alarcon, A:
 Univ Virgen del Rocio & Virgen Macarena, Univ Seville, CSIC,Inst Biomed Seville IBIS, Clin Unit Infect Dis,Microbiol & Prevent Med Infe, Seville, Spain

 Hosp Univ Virgen del Rocio, Seville, Spain

Garcia, E:
 Hosp Univ Virgen del Rocio, Seville, Spain

Haro, JL:
 Hosp Univ Virgen del Rocio, Seville, Spain

Lepe, JA:
 Hosp Univ Virgen del Rocio, Seville, Spain

Lopez, F:
 Hosp Univ Virgen del Rocio, Seville, Spain

Luque, R:
 Univ Virgen del Rocio & Virgen Macarena, Univ Seville, CSIC,Inst Biomed Seville IBIS, Clin Unit Infect Dis,Microbiol & Prevent Med Infe, Seville, Spain

 Hosp Univ Virgen del Rocio, Seville, Spain

Alonso, LJ:
 Hosp San Pedro, Logrono, Spain

Azcarate, P:
 Hosp San Pedro, Logrono, Spain

Gutierrez, JMA:
 Hosp San Pedro, Logrono, Spain

Blanco, JR:
 Hosp San Pedro, Logrono, Spain

Villegas, AC:
 Hosp San Pedro, Logrono, Spain

Garcia-Alvarez, L:
 Hosp San Pedro, Logrono, Spain

Oteo, JA:
 Hosp San Pedro, CIBLR, Serv Enfermedades Infecciosas, Logrono, Spain

 Hosp San Pedro, Logrono, Spain

Sanz, M:
 Hosp San Pedro, Logrono, Spain

de Benito, N:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Gurgui, M:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pacho, C:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pericas, R:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Pons, G:
 Hosp Santa Creu & Sant Pau, Barcelona, Spain

Alvarez, M:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Fernandez, AL:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Martinez, A:
 Univ Puerta de Hierro, Med Interna Serv, Unidad Enfermedades Infecciosas, Madrid, Spain

 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

 Complejo Hosp Univ Albacete, Albacete, Spain

Prieto, A:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Regueiro, B:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Tijeira, E:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Vega, M:
 Complejo Hosp Univ Santiago de Compostela, La Coruna, Spain

Blasco, AC:
 Hosp Santiago Apostol, Vitoria, Spain

Mollar, JC:
 Hosp Santiago Apostol, Vitoria, Spain

Arana, JCG:
 Hosp Santiago Apostol, Vitoria, Spain

Uriarte, OG:
 Hosp Santiago Apostol, Vitoria, Spain

Lopez, AM:
 Hosp Santiago Apostol, Vitoria, Spain

de Zarate, ZO:
 Hosp Santiago Apostol, Vitoria, Spain

Matos, JAU:
 Hosp Santiago Apostol, Vitoria, Spain

Gloria, GD:
 Hosp SAS Linea Concepcion, Cadiz, Spain

Antonio, SP:
 Hosp SAS Linea Concepcion, Cadiz, Spain

Leal, JMA:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Vazquez, EG:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Torres, AH:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Blazquez, A:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Valenzuela, GD:
 Hosp Clin Univ Virgen de la Arrixaca, Murcia, Spain

Alonso, A:
 Hosp Txagorritxu, Vitoria, Spain

Aramburu, J:
 Hosp Txagorritxu, Vitoria, Spain

Calvo, FE:
 Hosp Txagorritxu, Vitoria, Spain

Rodriguez, AM:
 Hosp Txagorritxu, Vitoria, Spain

Tarabini-Castellani, P:
 Hosp Txagorritxu, Vitoria, Spain

Galvez, EH:
 Hosp Virgen de la Salud, Toledo, Spain

Bellido, CM:
 Hosp Virgen de la Salud, Toledo, Spain

Pau, JL:
 Hosp Virgen de la Salud, Toledo, Spain

Sepulveda, MA:
 Hosp Virgen de la Salud, Toledo, Spain

Sierra, PT:
 Hosp Virgen de la Salud, Toledo, Spain

Iqbal-Mirza, SZ:
 Hosp Virgen de la Salud, Toledo, Spain

Alcolea, EC:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Yanez, IK:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Ballesta, AP:
 Hosp Rafael Mendez, Lorca Murcia, Spain

Escobar, EM:
 Hosp Univ San Cecilio, Granada, Spain

Monje, AP:
 Hosp Univ San Cecilio, Granada, Spain

Cabrera, VS:
 Hosp Univ San Cecilio, Granada, Spain

Garcia, DV:
 Hosp Univ San Cecilio, Granada, Spain

Asenjo, MA:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Luna, CC:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Morcillo, JN:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Seco, MCP:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Villoslada, A:
 Hosp Son Llatzer, Palma De Mallorca, Spain

Guallar, A:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Abad, NF:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Mangas, PG:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Adell, MM:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Ruiz, MPP:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Porres, JC:
 Hosp Univ Miguel Servet, Zaragoza, Spain

Vidal, BA:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Trigueros, NC:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Espin, MJD:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Caro, JAG:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Sanchez, RJ:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Almazan, AJ:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Freire, AO:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Gonzalez, MV:
 Hosp Gen Univ Santa Lucia, Cartagena, Spain

Ramis, PP:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Blanco, MAR:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Bordes, ERD:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Bonet, LV:
 Hosp Univ Son Espases, Palma De Mallorca, Spain

Munera, MCB:
 Complejo Hosp Univ Albacete, Albacete, Spain

Garaizabal, EE:
 Complejo Hosp Univ Albacete, Albacete, Spain

Martinez, AT:
 Complejo Hosp Univ Albacete, Albacete, Spain

Luque, JCS:
 Complejo Hosp Univ Albacete, Albacete, Spain
ISSN: 01675273
Editorial
ELSEVIER IRELAND LTD, ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND, Irlanda
Tipo de documento: Article
Volumen: 282 Número:
Páginas: 24-30
WOS Id: 000460380800005
ID de PubMed: 30718134
imagen Green Accepted

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