Infective endocarditis in patients with heart transplantation
Por:
Martinez-Selles, M, Tattevin, P, Valerio-Minero, M, de Alarcon, A, Farinas, MC, Mirabet-Perez, S, Lavie-Badie, Y, Ambrosi, P, Chabanne, C, Duval, X, Lecomte, R, Lopez-Vilella, R, Uribarri, A, Vinuesa, D, Munoz, P
Publicada:
1 abr 2021
Ahead of Print:
1 feb 2021
Resumen:
Background: The incidence of nosocomial and health care-related infective endocarditis (IE) is increasing. Heart transplantation (HT) implies immunosuppression and frequent health care contact. Our aim was to describe the current profile and prognosis of IE in HT recipients. Methods: Multicenter retrospective registry-based study in Spain and France that included cases between 2008 and 2019. Results: During the study period, 8305 HT were performed in Spain and France. We identified 18 IE cases (rate 0.2%). Median age was 57 years; 12 were men (67%). Valve involvement did not have a predominant location and three patients (16.7%) had atrial or ventricular vegetations without valve involvement. The median age adjusted Charlson index was 4 (interquartile range 3-5). Eleven IE cases (61%) were nosocomial/health care related. Median time (range) between HT and development of IE was 43 months (interquartile range 6-104). The major pathogens were Staphylococcus sp. (n = 8, 44%), Enterococcus sp. (n = 4, 22%), and Aspergillus sp. (n = 3, 17%). Although eight patients (44%) had a surgical indication, it was only performed in three cases (17%). Three patients (17%) died during the first IE hospital admission. Conclusions: IE in HT recipients has specific characteristics. Valve involvement does not have a predominant location and non-valvular involvement is common. Three fifths have a nosocomial/health care-related origin. The major pathogens were staphylococci (44%), enterococci (22%), and Aspergillus (17%). In-hospital mortality was 17%. (c) 2020 Elsevier B.V. All rights reserved.
Filiaciones:
Martinez-Selles, M:
Univ Europea, Serv Cardiol, Hosp Gen Univ Gregorio Maranon, CIBERCV,Fac Ciencias Biomed, Madrid, Spain
Univ Complutense Madrid, Fac Med, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Tattevin, P:
Pontchaillou Univ Hosp, Infect Dis & Intens Care Unit, Rennes, France
Valerio-Minero, M:
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain
de Alarcon, A:
Univ Seville CSIC Univ Hosp Virgen del Rocio, Inst Biomed Seville IBiS, Infect Dis Res Grp, Clin Unit Infect Dis Microbiol & Prevent Med, Seville, Spain
Farinas, MC:
Univ Cantabria, Hosp Univ Marques de Valdecilla, Infect Dis Unit, Santander, Spain
Mirabet-Perez, S:
Hosp Santa Creu & Sant Pau, Unidad Insuficiencia Cardiaca, Serv Cardiol, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Programa Trasplante Cardiaco, Serv Cardiol, Barcelona, Spain
Lavie-Badie, Y:
Toulouse Univ Hosp 1, Heart Valve Ctr, Toulouse 9, France
Ambrosi, P:
Aix Marseille Univ, Marseille, France
Hop La Timone, Dept Cardiol, Marseille, France
Chabanne, C:
Pontchaillou Univ Hosp, Cardiol, Rennes, France
Duval, X:
Univ Paris Diderot Paris 7, Univ Hosp Bichat, AP H, Inserm CIC 1425,Inserm UMR 1137 IAME,UFR Med Bich, Paris, France
Lecomte, R:
CHU Nantes, Dept Infect Dis, CHU Hotel Dieu, Ctr Invest Clin,Unite Invest Clin 1413 INSERM, Nantes, France
Lopez-Vilella, R:
Hosp Univ & Politecn La Fe, Unidad Insuficiencia Cardiaca & Trasplante, Valencia, Spain
Uribarri, A:
Hosp Clin Univ Valladolid, Serv Cardiol, CIBER CV, Valladolid, Spain
Vinuesa, D:
Hosp Clin San Cecilio, Serv Med Interna & Enfermedades Infecciosas, Granada, Spain
Munoz, P:
Univ Complutense Madrid, Fac Med, Madrid, Spain
Inst Invest Sanitaria Gregorio Maranon, Madrid, Spain
Hosp Gen Univ Gregorio Maranon, Serv Microbiol Clin & Enfermedades Infecciosas, Madrid, Spain
CIBER Enfermedades Resp CIBERES CB06 06 0058, Madrid, Spain
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