Evolution of epidemiological characteristics of infective endocarditis in Greece.

Autor:	Giannitsioti E; Fourth Department of Internal Medicine, 'Attikon' University General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece. Electronic address: gianiemi@hotmail.com., Pefanis A; Department of Internal Medicine, 'Sotiria' Hospital for Chest Diseases, Athens, Greece., Gogos C; Department of Internal Medicine, Rio University Hospital, University of Patras, Rio, Greece., Lekkou A; Department of Internal Medicine, Rio University Hospital, University of Patras, Rio, Greece., Dalekos GN; Department of Internal Medicine, Larissa University Hospital, Faculty of Medicine, University of Thessaly, Larissa, Greece., Gatselis N; Department of Internal Medicine, Larissa University Hospital, Faculty of Medicine, University of Thessaly, Larissa, Greece., Georgiadou S; Department of Internal Medicine, Larissa University Hospital, Faculty of Medicine, University of Thessaly, Larissa, Greece., Nikou P; Department of Internal Medicine, Tripolis General Hospital, Tripolis, Greece., Vrettou A; Second Department of Cardiology, 'Attikon' University General Hospital, NKUA, Athens, Greece., Rigopoulos A; Second Department of Cardiology, 'Attikon' University General Hospital, NKUA, Athens, Greece., Tryfonopoulos C; Department of Informatics and Telecommunications, University of Peloponnese, Tripolis, Greece., Tsaganos T; Fourth Department of Internal Medicine, 'Attikon' University General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece., Karofilakis E; Fourth Department of Internal Medicine, 'Attikon' University General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece., Psarrakis C; Fourth Department of Internal Medicine, 'Attikon' University General Hospital, National and Kapodistrian University of Athens (NKUA), Athens, Greece., Argyriou M; Cardiosurgical Department 'Evangelismos' General Hospital, Athens, Greece., Gargalianos-Kakolyris P; First Department of Internal Medicine, 'G. Gennimatas' General Hospital, Athens, Greece., Adamis G; First Department of Internal Medicine, 'G. Gennimatas' General Hospital, Athens, Greece., Lourida P; First Department of Internal Medicine, 'G. Gennimatas' General Hospital, Athens, Greece., Kofteridis D; Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece., Andrianaki A; Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece., Loupa C; Department of Internal Medicine, 'Amalia Fleming' Hospital, Athens, Greece., Kostis E; Department of Clinical Therapeutics, 'Alexandra' Hospital, NKUA, Athens, Greece., Sinapidis D; Department of Clinical Therapeutics, 'Alexandra' Hospital, NKUA, Athens, Greece., Sympardi S; First Department of Internal Medicine, 'Thriassio' General Hospital, Elefsina, Attiki, Greece., Alexiou N; First Department of Internal Medicine, 'Thriassio' General Hospital, Elefsina, Attiki, Greece., Karaiskos I; First Department of Internal Medicine - Infectious Diseases, 'Hygeia' Hospital, Athens, Greece., Masgala A; First Department of Internal Medicine, 'Agia Olga' Hospital, Athens, Greece., Maltezos E; Department of Internal Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece., Panagopoulos P; Department of Internal Medicine, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece., Sachpekidis V; Second Cardiology Department 'Papageorgiou' General Hospital, Aristotele University of Thessaloniki, Thessaloniki, Greece., Evdoridis C; Cardiology Department, 'Elpis' Hospital, Athens, Greece., Sipsas NV; Pathophysiology Department, 'Laikon' General Hospital of Athens, NKUA, Athens, Greece., Daikos G; First Department of Internal Medicine, 'Laikon 'General Hospital of Athens, NKUA, Athens, Greece., Giamarellou H; First Department of Internal Medicine - Infectious Diseases, 'Hygeia' Hospital, Athens, Greece.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2021 May; Vol. 106, pp. 213-220. Date of Electronic Publication: 2021 Mar 09.
DOI:	10.1016/j.ijid.2021.03.009
Abstrakt:	Objective: The clinical profile, management and outcome of infective endocarditis (IE) may be influenced by socioeconomic issues. Methods: A nationwide prospective study evaluated IE during the era of deep economic crisis in Greece. Epidemiological data and factors associated with 60-day mortality were analyzed through descriptive statistics, logistic and Cox-regression models. Results: Among 224 patients (male 72.3%, mean age 62.4 years), Staphylococcus aureus (n = 62; methicillin-resistant S. aureus (MRSA) 33.8%) predominated in the young without impact on mortality (p = 0.593), whilst Enterococci (n = 36) predominated in the elderly. Complications of IE were associated with mortality: heart failure [OR 2.415 (95% CI: 1.159-5.029), p = 0.019], stroke [OR 3.206 (95% CI: 1.190-8.632), p = 0.018] and acute kidney injury [OR 2.283 (95% CI: 1.085-4.805), p = 0.029]. A 60-day survival benefit was solely related to cardiac surgery for IE during hospitalization [HR 0.386 (95% CI: 0.165-0.903), p = 0.028] and compliance with antimicrobial treatment guidelines [HR 0.487 (95% CI: 0.259-0.916), p = 0.026]. Compared with a previous country cohort study, history of rheumatic fever and native valve predisposition had declined, whilst underlying renal disease and right-sided IE had increased (p < 0.0001); HIV infection had emerged (p = 0.002). No difference in rates of surgery and outcome was assessed. Conclusions: A country-wide survey of IE highlighted emergence of HIV, right-sided IE and predominance of MRSA in the youth during a severe socioeconomic crisis. Compliance with treatment guidelines promoted survival. (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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