Περίληψη:
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
Συγγραφείς:
Giannitsioti, E.
Pefanis, A.
Gogos, C.
Lekkou, A.
Dalekos, G.N.
Gatselis, N.
Georgiadou, S.
Nikou, P.
Vrettou, A.
Rigopoulos, A.
Tryfonopoulos, C.
Tsaganos, T.
Karofilakis, E.
Psarrakis, C.
Argyriou, M.
Gargalianos-Kakolyris, P.
Adamis, G.
Lourida, P.
Kofteridis, D.
Andrianaki, A.
Loupa, C.
Kostis, E.
Sinapidis, D.
Sympardi, S.
Alexiou, N.
Karaiskos, I.
Masgala, A.
Maltezos, E.
Panagopoulos, P.
Sachpekidis, V.
Evdoridis, C.
Sipsas, N.V.
Daikos, G.
Giamarellou, H.
Pontikis, K.
Lioris, I.
Lelekis, M.
Trikkas, A.
Aggouras, D.
Kolias, V.
Rokkas, C.
Nana-Anastasiou, M.
Miyakis, S.
On behalf of the Hellenic Society of Chemotherapy
Λέξεις-κλειδιά:
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
