Evolution of epidemiological characteristics of infective endocarditis in Greece
| Autor: | Thomas Tsaganos, Dimitris Sinapidis, Charalampos Gogos, Ilias Karaiskos, Alexandra Lekkou, Athanasios Trikkas, Nikolaos V. Sipsas, Efthymia Giannitsioti, Angelos G. Rigopoulos, Nikolaos Alexiou, Angelos Pefanis, Georgios N. Dalekos, Georgios Daikos, Agathi Vrettou, Diamantis P. Kofteridis, Constantinos Evdoridis, Aggeliki Andrianaki, Chris K. Rokkas, Christos Tryfonopoulos, Emmanouil Karofilakis, Michail Argyriou, Sara Georgiadou, Panagiotis Gargalianos-Kakolyris, Georgios Adamis, Spiros Miyakis, Ioannis Lioris, Chariclia Loupa, Konstantinos Pontikis, Maria Nana-Anastasiou, Efstratios Maltezos, Vasileios Sachpekidis, Periklis Panagopoulos, Moysis Lelekis, Styliani Sympardi, A Masgala, Panagiota Lourida, Christos Psarrakis, Dimitrios Aggouras, Nikolaos K. Gatselis, Paraskevas Nikou, Evangelos Kostis, Helen Giamarellou, Vasilios Kolias |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) Staphylococcus aureus medicine.medical_specialty Adolescent 030106 microbiology Infectious and parasitic diseases RC109-216 Guidelines Cohort Studies 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology medicine Humans Prospective Studies 030212 general & internal medicine Mortality Prospective cohort study Stroke Aged Enterococcal Endocarditis Greece business.industry Acute kidney injury General Medicine Cardiac surgery Middle Aged medicine.disease Anti-Bacterial Agents Infectious Diseases Infective endocarditis Rheumatic fever business Cohort study |
| Zdroj: | International Journal of Infectious Diseases, Vol 106, Iss, Pp 213-220 (2021) |
| ISSN: | 1201-9712 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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