Left endocarditis, changes in the new millennium.

Abstract:

INTRODUCTION:a description of infective left endocarditis at the turn of the millennium. METHOD:A multicentre prospective study into the left endocarditis using data collected from the Andalusian cohort for the study of cardiovascular infections during 1984-2014. RESULTS:Of the 1,604 endocarditis cases collected, 382 belonged to G1 (group-1, period 1983-1999) and 1,222 to G2 (group-2, 2000-2014). Patients in the new millennium have a significantly higher mean age, have more comorbidity and concomitant diseases, and nosocomial and health-related endocarditis are more frequent, as well as complications. An increase in methicillin-resistant Staphylococcus aureus, Enterococcus sp., Gram-negative bacilli and Streptococcus bovis was noted. Regarding treatment, there is an increase in the use of cephalosporins and a decrease in penicillins; there is more surgery when admitted to hospital and less delay. Mortality stands at around 30% in both millennia. In the multivariate analysis, mortality was associated with: previous millennium (G1), age, Charlson index, renal failure and septic shock, and aetiologically with Staphylococcus aureus. CONCLUSIONS:Mortality remains stable, despite diagnostic and therapeutic improvements, because patients are older, have greater comorbidity, a closer relationship with the health care system (nosocomial) and microorganisms are more aggressive.

journal_name

Med Clin (Barc)

journal_title

Medicina clinica

authors

Noureddine-López M,de la Torre-Lima J,Ruiz-Morales J,Gálvez-Acebal J,Hidalgo-Tenorio C,de Alarcón González CA,por el Grupo para el Estudio de las Infecciones Cardiovasculares de la Sociedad Andaluza de Enfermedades Infecciosas (SAEI).

doi

10.1016/j.medcli.2018.04.018

subject

Has Abstract

pub_date

2019-07-19 00:00:00

pages

63-66

issue

2

eissn

0025-7753

issn

1578-8989

pii

S0025-7753(18)30288-4

journal_volume

153

pub_type

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