TY - JOUR
TI - Evolution of epidemiological characteristics of infective endocarditis in Greece
AU - Giannitsioti, E.
AU - Pefanis, A.
AU - Gogos, C.
AU - Lekkou, A.
AU - Dalekos, G.N.
AU - Gatselis, N.
AU - Georgiadou, S.
AU - Nikou, P.
AU - Vrettou, A.
AU - Rigopoulos, A.
AU - Tryfonopoulos, C.
AU - Tsaganos, T.
AU - Karofilakis, E.
AU - Psarrakis, C.
AU - Argyriou, M.
AU - Gargalianos-Kakolyris, P.
AU - Adamis, G.
AU - Lourida, P.
AU - Kofteridis, D.
AU - Andrianaki, A.
AU - Loupa, C.
AU - Kostis, E.
AU - Sinapidis, D.
AU - Sympardi, S.
AU - Alexiou, N.
AU - Karaiskos, I.
AU - Masgala, A.
AU - Maltezos, E.
AU - Panagopoulos, P.
AU - Sachpekidis, V.
AU - Evdoridis, C.
AU - Sipsas, N.V.
AU - Daikos, G.
AU - Giamarellou, H.
AU - Pontikis, K.
AU - Lioris, I.
AU - Lelekis, M.
AU - Trikkas, A.
AU - Aggouras, D.
AU - Kolias, V.
AU - Rokkas, C.
AU - Nana-Anastasiou, M.
AU - Miyakis, S.
AU - On behalf of the Hellenic Society of Chemotherapy
JO - International Journal of Infectious Diseases
PY - 2021
VL - 106
TODO - null
SP - 213-220
PB - Elsevier B.V.
SN - 1201-9712
TODO - 10.1016/j.ijid.2021.03.009
TODO - antibiotic agent;  antiinfective agent, abscess;  acute kidney failure;  adult;  aged;  antimicrobial therapy;  Article;  bacterial endocarditis;  blood culture;  cardiovascular mortality;  cerebrovascular accident;  clinical outcome;  cohort analysis;  controlled study;  Coxiella burnetii;  data analysis software;  descriptive research;  echocardiography;  Enterococcus;  Enterococcus faecalis;  Enterococcus faecium;  epidemiological data;  female;  Greece;  groups by age;  heart failure;  heart surgery;  hospitalization;  human;  Human immunodeficiency virus infection;  juvenile;  kidney disease;  Legionella;  major clinical study;  male;  methicillin resistant Staphylococcus aureus;  methicillin susceptible Staphylococcus aureus;  middle aged;  polymerase chain reaction;  practice guideline;  prospective study;  prosthetic valve endocarditis;  protocol compliance;  rheumatic fever;  septic shock;  serology;  social status;  Staphylococcus aureus;  Streptococcus group D;  Streptococcus oralis;  survival;  valvular heart disease;  very elderly;  adolescent;  endocarditis;  Greece;  microbiology;  mortality;  virology, Adolescent;  Adult;  Aged;  Anti-Bacterial Agents;  Cohort Studies;  Endocarditis;  Greece;  Humans;  Male;  Middle Aged;  Prospective Studies
TODO - 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. © 2021 The Authors
ER -