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Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis
BACKGROUND: Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly reported and associated with an aggressive course and high mortality rate. Existing literature on GBS IE is limited to case series; we compared the characteristics of patients with GBS IE to patients wit...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725325/ https://www.ncbi.nlm.nih.gov/pubmed/34983419 http://dx.doi.org/10.1186/s12879-021-06997-6 |
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author | Oravec, Torrance Oravec, S. Annie Leigh, Jennifer Matthews, Liam Ghadaki, Bahareh Mertz, Dominik Daley, Peter Shroff, Anjali |
author_facet | Oravec, Torrance Oravec, S. Annie Leigh, Jennifer Matthews, Liam Ghadaki, Bahareh Mertz, Dominik Daley, Peter Shroff, Anjali |
author_sort | Oravec, Torrance |
collection | PubMed |
description | BACKGROUND: Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly reported and associated with an aggressive course and high mortality rate. Existing literature on GBS IE is limited to case series; we compared the characteristics of patients with GBS IE to patients with GBS bacteremia without IE to identify risk factors for development of IE. METHODS: A nested case–control study in a cohort of adult patients with GBS bacteremia over a 18-year period was conducted across seven centres in three Canadian cities. A chart review identified patients with possible or definite IE (per Modified Duke Criteria) and patients with IE were matched to those without endocarditis in a 1:3 fashion. Multivariate analyses were completed using logistic regression. RESULTS: Of 520 patients with GBS bacteremia, 28 cases of possible or definite IE were identified (5.4%). 68% (19/28) met criteria for definite IE, surgery was performed in 29% (8/28), and the overall in-hospital mortality rate was 29% (8/28). Multivariate analysis demonstrated that IE was associated with injection drug use (OR = 19.6, 95% CI = 3.39–111.11, p = 0.001), prosthetic valve (OR = 11.5, 95% CI = 1.73–76.92, p = 0.011) and lack of identified source of bacteremia (OR = 3.81, 95% CI = 1.24–11.65, p = 0.019). CONCLUSIONS: GBS bacteremia, especially amongst people who inject drugs, those with prosthetic valves, and those with no apparent source of infection, should increase clinical suspicion for IE. |
format | Online Article Text |
id | pubmed-8725325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87253252022-01-06 Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis Oravec, Torrance Oravec, S. Annie Leigh, Jennifer Matthews, Liam Ghadaki, Bahareh Mertz, Dominik Daley, Peter Shroff, Anjali BMC Infect Dis Research BACKGROUND: Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly reported and associated with an aggressive course and high mortality rate. Existing literature on GBS IE is limited to case series; we compared the characteristics of patients with GBS IE to patients with GBS bacteremia without IE to identify risk factors for development of IE. METHODS: A nested case–control study in a cohort of adult patients with GBS bacteremia over a 18-year period was conducted across seven centres in three Canadian cities. A chart review identified patients with possible or definite IE (per Modified Duke Criteria) and patients with IE were matched to those without endocarditis in a 1:3 fashion. Multivariate analyses were completed using logistic regression. RESULTS: Of 520 patients with GBS bacteremia, 28 cases of possible or definite IE were identified (5.4%). 68% (19/28) met criteria for definite IE, surgery was performed in 29% (8/28), and the overall in-hospital mortality rate was 29% (8/28). Multivariate analysis demonstrated that IE was associated with injection drug use (OR = 19.6, 95% CI = 3.39–111.11, p = 0.001), prosthetic valve (OR = 11.5, 95% CI = 1.73–76.92, p = 0.011) and lack of identified source of bacteremia (OR = 3.81, 95% CI = 1.24–11.65, p = 0.019). CONCLUSIONS: GBS bacteremia, especially amongst people who inject drugs, those with prosthetic valves, and those with no apparent source of infection, should increase clinical suspicion for IE. BioMed Central 2022-01-04 /pmc/articles/PMC8725325/ /pubmed/34983419 http://dx.doi.org/10.1186/s12879-021-06997-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Oravec, Torrance Oravec, S. Annie Leigh, Jennifer Matthews, Liam Ghadaki, Bahareh Mertz, Dominik Daley, Peter Shroff, Anjali Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis |
title | Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis |
title_full | Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis |
title_fullStr | Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis |
title_full_unstemmed | Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis |
title_short | Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis |
title_sort | streptococcus agalactiae infective endocarditis in canada: a multicenter retrospective nested case control analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725325/ https://www.ncbi.nlm.nih.gov/pubmed/34983419 http://dx.doi.org/10.1186/s12879-021-06997-6 |
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