Details

Autor(en) / Beteiligte

• Miro, Josù M.
• Anguera, Ignasi
• Cabell, Christopher H.
• Chen, Anita Y.
• Stafford, Judith A.
• Corey, G. Ralph
• Olaison, Lars
• Eykyn, Susannah
• Hoen, Bruno
• Abrutyn, Elias
• Raoult, Didier
• Bayer, Arnold
• Fowler, Vance G.

Titel

Staphylococcus aureus Native Valve Infective Endocarditis: Report of 566 Episodes from the International Collaboration on Endocarditis Merged Database

Ist Teil von

• Clinical infectious diseases, 2005-08, Vol.41 (4), p.507-514

Ort / Verlag

Chicago, IL: The University of Chicago Press

Erscheinungsjahr

2005

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background. Staphylococcus aureus native valve infective endocarditis (SA-NVIE) is not completely understood. The objective of this investigation was to describe the characteristics of a large, international cohort of patients with SA-NVIE. Methods. The International Collaboration on Endocarditis Merged Database (ICE-MD) is a combination of 7 existing electronic databases from 5 countries that contains data on 2212 cases of definite infective endocarditis (IE). Results. Of patients with native valve IE, 566 patients (34%) had IE due to S. aureus, and 1074 patients had IE due to pathogens other than S. aureus (non–SA-NVIE). Patients with S. aureus IE were more likely to die (20% vs. 12%; P < .001), to experience an embolic event (60% vs. 31%; P < .001), or to have a central nervous system event (20% vs. 13%; P < .001) and were less likely to undergo surgery (26% vs. 39%; P < .001) than were patients with non–SA-NVIE. Multivariate analysis of prognostic factors of mortality identified age (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1–1.7), periannular abscess (OR, 2.4; 95% CI, 1.1–5.6), heart failure (OR, 3.9; 95% CI, 2.3–6.7), and absence of surgical therapy (OR, 2.3; 95% CI, 1.3–4.2) as variables that were independently associated with mortality in patients with SA-NVIE. After adjusting for patient-, pathogen-, and treatment-specific characteristics by multivariate analysis, geographical region was also found to be associated with mortality in patients with SA-NVIE (P < .001). Conclusions. S. aureus is an important and common cause of IE. The outcome of SA-NVIE is worse than that of non–SA-NVIE. Several clinical parameters are independently associated with mortality for patients with SA-NVIE. The clinical characteristics and outcome of SA-NVIE vary significantly by geographic region, although the reasons for such regional variations in outcomes of SA-NVIE are unknown and are probably multifactorial. A large, prospective, multinational cohort study of patients with IE is now under way to further investigate these observations.