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701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study

BACKGROUND: Bloodstream infections (BSIs) confer an increased risk of infective endocarditis (IE) in patients with a prosthetic cardiac valve. This relationship is less well established in patients undergoing valve repair. We conducted a retrospective population-based study to determine the incidenc...

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Autores principales: McHugh, Jack, Khawaja, Talha, Baddour, Larry M, Crestanello, Juan, Arghami, Arman, DeSimone, Daniel, Sauver, Jennifer St
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777890/
http://dx.doi.org/10.1093/ofid/ofaa439.893
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author McHugh, Jack
Khawaja, Talha
Baddour, Larry M
Baddour, Larry M
Crestanello, Juan
Arghami, Arman
DeSimone, Daniel
Sauver, Jennifer St
author_facet McHugh, Jack
Khawaja, Talha
Baddour, Larry M
Baddour, Larry M
Crestanello, Juan
Arghami, Arman
DeSimone, Daniel
Sauver, Jennifer St
author_sort McHugh, Jack
collection PubMed
description BACKGROUND: Bloodstream infections (BSIs) confer an increased risk of infective endocarditis (IE) in patients with a prosthetic cardiac valve. This relationship is less well established in patients undergoing valve repair. We conducted a retrospective population-based study to determine the incidence of BSIs following valve repair and identify risk factors associated with the development of IE. METHODS: The Rochester Epidemiology Project (REP) data linkage system was used to identify all persons who underwent valve repair in a 7-county region in Southeastern Minnesota between January 1, 2010 and December 31, 2018. Medical records were screened for the development of a BSI from time of procedure until May 15, 2020. Patients were classified as having BSI only, BSI with IE at outset, or BSI with subsequent development of new IE. IE at outset was defined as cases where IE was diagnosed at the time of initial positive blood culture. RESULTS: A total of 387 patients underwent valve repair surgery. A total of 31 (8%) patients subsequently developed a BSI, 4% within one year of surgery. Seventeen patients underwent mitral repair with annuloplasty, 9 underwent tricuspid annuloplasty, and 5 had concurrent repairs. Median time to the development of BSI was 338 days. Of the 31 patients with BSI, 4 (13%) had BSI with IE at outset. No patients developed IE subsequent to BSI, Enterococcus spp. was responsible for 3 cases of IE, and MSSA for 1. All cases occurred within one year of surgery. Given the low incidence, statistical analysis of associated risk factors for IE was not feasible. All patients with BSI and IE at outset, however, died by the end of the study period, versus 11/27 in the BSI only group. CONCLUSION: Incidence of BSIs was higher in patients undergoing cardiac valve repair than in the general population. The incidence of IE with a BSI was 13%, which is lower than what has been previously published. It is notable that all cases of IE occurred within one year of surgery. Recognizing that endothelialization of device surfaces occurs, it is tempting to speculate that the risk of IE may be time dependent and may decline over time. Subsequent investigation of this theory is underway. DISCLOSURES: Larry M. Baddour, MD, Boston Scientific (Consultant)
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spelling pubmed-77778902021-01-07 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study McHugh, Jack Khawaja, Talha Baddour, Larry M Baddour, Larry M Crestanello, Juan Arghami, Arman DeSimone, Daniel Sauver, Jennifer St Open Forum Infect Dis Poster Abstracts BACKGROUND: Bloodstream infections (BSIs) confer an increased risk of infective endocarditis (IE) in patients with a prosthetic cardiac valve. This relationship is less well established in patients undergoing valve repair. We conducted a retrospective population-based study to determine the incidence of BSIs following valve repair and identify risk factors associated with the development of IE. METHODS: The Rochester Epidemiology Project (REP) data linkage system was used to identify all persons who underwent valve repair in a 7-county region in Southeastern Minnesota between January 1, 2010 and December 31, 2018. Medical records were screened for the development of a BSI from time of procedure until May 15, 2020. Patients were classified as having BSI only, BSI with IE at outset, or BSI with subsequent development of new IE. IE at outset was defined as cases where IE was diagnosed at the time of initial positive blood culture. RESULTS: A total of 387 patients underwent valve repair surgery. A total of 31 (8%) patients subsequently developed a BSI, 4% within one year of surgery. Seventeen patients underwent mitral repair with annuloplasty, 9 underwent tricuspid annuloplasty, and 5 had concurrent repairs. Median time to the development of BSI was 338 days. Of the 31 patients with BSI, 4 (13%) had BSI with IE at outset. No patients developed IE subsequent to BSI, Enterococcus spp. was responsible for 3 cases of IE, and MSSA for 1. All cases occurred within one year of surgery. Given the low incidence, statistical analysis of associated risk factors for IE was not feasible. All patients with BSI and IE at outset, however, died by the end of the study period, versus 11/27 in the BSI only group. CONCLUSION: Incidence of BSIs was higher in patients undergoing cardiac valve repair than in the general population. The incidence of IE with a BSI was 13%, which is lower than what has been previously published. It is notable that all cases of IE occurred within one year of surgery. Recognizing that endothelialization of device surfaces occurs, it is tempting to speculate that the risk of IE may be time dependent and may decline over time. Subsequent investigation of this theory is underway. DISCLOSURES: Larry M. Baddour, MD, Boston Scientific (Consultant) Oxford University Press 2020-12-31 /pmc/articles/PMC7777890/ http://dx.doi.org/10.1093/ofid/ofaa439.893 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
McHugh, Jack
Khawaja, Talha
Baddour, Larry M
Baddour, Larry M
Crestanello, Juan
Arghami, Arman
DeSimone, Daniel
Sauver, Jennifer St
701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study
title 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study
title_full 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study
title_fullStr 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study
title_full_unstemmed 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study
title_short 701. Blood Stream Infection And Risk Of Endocarditis Following Cardiac Valve Repair: A Population-Based Study
title_sort 701. blood stream infection and risk of endocarditis following cardiac valve repair: a population-based study
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777890/
http://dx.doi.org/10.1093/ofid/ofaa439.893
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