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Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation

Background: The two most common organisms found in infective endocarditis following transcatheter aortic valve implantation (TAVI-IE) are enterococci (EC-IE) and staphylococci (SC-IE). We aimed to compare clinical characteristics and outcomes of patients with EC-IE and SC-IE. Methods: TAVI-IE patien...

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Autores principales: Gasior, Tomasz, Woitek, Felix J., Schroth, Antonia, Abdel-Wahab, Mohamed, Crusius, Lisa, Haussig, Stephan, Kiefer, Philipp, Scislo, Piotr, Huczek, Zenon, Dabrowski, Maciej, Witkowski, Adam, Olasinska-Wisniewska, Anna, Grygier, Marek, Protasiewicz, Marcin, Hudziak, Damian, Kappert, Utz, Holzhey, David, Wojakowski, Wojtek, Linke, Axel, Mangner, Norman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003722/
https://www.ncbi.nlm.nih.gov/pubmed/36902604
http://dx.doi.org/10.3390/jcm12051817
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author Gasior, Tomasz
Woitek, Felix J.
Schroth, Antonia
Abdel-Wahab, Mohamed
Crusius, Lisa
Haussig, Stephan
Kiefer, Philipp
Scislo, Piotr
Huczek, Zenon
Dabrowski, Maciej
Witkowski, Adam
Olasinska-Wisniewska, Anna
Grygier, Marek
Protasiewicz, Marcin
Hudziak, Damian
Kappert, Utz
Holzhey, David
Wojakowski, Wojtek
Linke, Axel
Mangner, Norman
author_facet Gasior, Tomasz
Woitek, Felix J.
Schroth, Antonia
Abdel-Wahab, Mohamed
Crusius, Lisa
Haussig, Stephan
Kiefer, Philipp
Scislo, Piotr
Huczek, Zenon
Dabrowski, Maciej
Witkowski, Adam
Olasinska-Wisniewska, Anna
Grygier, Marek
Protasiewicz, Marcin
Hudziak, Damian
Kappert, Utz
Holzhey, David
Wojakowski, Wojtek
Linke, Axel
Mangner, Norman
author_sort Gasior, Tomasz
collection PubMed
description Background: The two most common organisms found in infective endocarditis following transcatheter aortic valve implantation (TAVI-IE) are enterococci (EC-IE) and staphylococci (SC-IE). We aimed to compare clinical characteristics and outcomes of patients with EC-IE and SC-IE. Methods: TAVI-IE patients from 2007 to 2021 were included in this analysis. The 1-year mortality was the primary outcome measure of this retrospective multi-center analysis. Results: Out of 163 patients, 53 (32.5%) EC-IE and 69 (42.3%) SC-IE patients were included. Subjects were comparable with regard to age, sex, and clinically relevant baseline comorbidities. Symptoms at admission were not significantly different between groups, except for a lower risk for presenting with septic shock in EC-IE than SC-IE. Treatment was performed in 78% by antibiotics alone and in 22% of patients by surgery and antibiotics, with no significant differences between groups. The rate of any complication, in particular heart failure, renal failure, and septic shock during treatment for IE, was lower in EC-IE compared with SC-IE (p < 0.05). In-hospital (EC-IE: 36% vs. SC-IE: 56%, p = 0.035) and 1-year mortality (EC-IE: 51% vs. SC-IE: 70%, p = 0.009) were significantly lower in EC-IE compared with SC-IE. Conclusions: EC-IE, compared with SC-IE, was associated with a lower morbidity and mortality. However, absolute numbers are high, a finding that should trigger further research in appropriate perioperative antibiotic management and improvement of early IE diagnosis in the case of clinical suspicion.
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spelling pubmed-100037222023-03-11 Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation Gasior, Tomasz Woitek, Felix J. Schroth, Antonia Abdel-Wahab, Mohamed Crusius, Lisa Haussig, Stephan Kiefer, Philipp Scislo, Piotr Huczek, Zenon Dabrowski, Maciej Witkowski, Adam Olasinska-Wisniewska, Anna Grygier, Marek Protasiewicz, Marcin Hudziak, Damian Kappert, Utz Holzhey, David Wojakowski, Wojtek Linke, Axel Mangner, Norman J Clin Med Article Background: The two most common organisms found in infective endocarditis following transcatheter aortic valve implantation (TAVI-IE) are enterococci (EC-IE) and staphylococci (SC-IE). We aimed to compare clinical characteristics and outcomes of patients with EC-IE and SC-IE. Methods: TAVI-IE patients from 2007 to 2021 were included in this analysis. The 1-year mortality was the primary outcome measure of this retrospective multi-center analysis. Results: Out of 163 patients, 53 (32.5%) EC-IE and 69 (42.3%) SC-IE patients were included. Subjects were comparable with regard to age, sex, and clinically relevant baseline comorbidities. Symptoms at admission were not significantly different between groups, except for a lower risk for presenting with septic shock in EC-IE than SC-IE. Treatment was performed in 78% by antibiotics alone and in 22% of patients by surgery and antibiotics, with no significant differences between groups. The rate of any complication, in particular heart failure, renal failure, and septic shock during treatment for IE, was lower in EC-IE compared with SC-IE (p < 0.05). In-hospital (EC-IE: 36% vs. SC-IE: 56%, p = 0.035) and 1-year mortality (EC-IE: 51% vs. SC-IE: 70%, p = 0.009) were significantly lower in EC-IE compared with SC-IE. Conclusions: EC-IE, compared with SC-IE, was associated with a lower morbidity and mortality. However, absolute numbers are high, a finding that should trigger further research in appropriate perioperative antibiotic management and improvement of early IE diagnosis in the case of clinical suspicion. MDPI 2023-02-24 /pmc/articles/PMC10003722/ /pubmed/36902604 http://dx.doi.org/10.3390/jcm12051817 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gasior, Tomasz
Woitek, Felix J.
Schroth, Antonia
Abdel-Wahab, Mohamed
Crusius, Lisa
Haussig, Stephan
Kiefer, Philipp
Scislo, Piotr
Huczek, Zenon
Dabrowski, Maciej
Witkowski, Adam
Olasinska-Wisniewska, Anna
Grygier, Marek
Protasiewicz, Marcin
Hudziak, Damian
Kappert, Utz
Holzhey, David
Wojakowski, Wojtek
Linke, Axel
Mangner, Norman
Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation
title Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation
title_full Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation
title_fullStr Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation
title_full_unstemmed Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation
title_short Impact of Enterococci vs. Staphylococci Induced Infective Endocarditis after Transcatheter Aortic Valve Implantation
title_sort impact of enterococci vs. staphylococci induced infective endocarditis after transcatheter aortic valve implantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003722/
https://www.ncbi.nlm.nih.gov/pubmed/36902604
http://dx.doi.org/10.3390/jcm12051817
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