scholarly journals Clinical and Microbiological Characteristics of Infective Endocarditis at a Cardiac Center in Saudi Arabia

2021 ◽  
Vol 11 (4) ◽  
pp. 435-443
Author(s):  
Mazin Barry ◽  
Syed Abdul Bari ◽  
Muhammad Yasin Akhtar ◽  
Faizah Al Nahdi ◽  
Richilda Erlandez ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Saudi Arabia ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Q Fever ◽  
Tertiary Care ◽  
Native Valve ◽  
Microbiological Characteristics ◽  
Results Management ◽  
Cardiac Center

Abstract Background Infective endocarditis (IE) is a serious disease with complex pathology and significant mortality. Little information is known regarding clinical and microbiological characteristics in Saudi Arabia. This study surveyed these characteristics at a Cardiac Center in Riyadh, Saudi Arabia over a period of 5 years. Methods This retrospective study was done on all infective endocarditis (IE) patients admitted to Prince Sultan Cardiac Center between January 1, 2015, and December 31, 2019. Clinical characteristics, microbiological results, management, and outcomes were assessed. Result A total of 340 cases of infective endocarditis were identified over the study period. Most patients (64%) were 50 years old or above, and 67% were males. Fever was the most common clinical presentation, and a murmur was audible in a fifth of patients. Blood cultures were positive in 177 (52%) cases. The most common organisms were Staphylococcus aureus, coagulase negative Staphylococcus and viridans group Streptococcus. Most common microbiological organisms causing native valve endocarditis were viridans group Streptococcus (32%) followed by methicillin-susceptible Staphylococcus aureus (21%), and for prosthetic valve endocarditis they were coagulase negative Staphylococcus (32%) followed by methicillin-susceptible Staphylococcus aureus (23%), the most common causes of culture negative endocarditis were Q-fever and brucellosis. Predisposing cardiac conditions were present in 127 (37%) patients, most commonly rheumatic heart disease and congenital heart disease. Surgical intervention was done in 26% of cases, with an overall in-hospital mortality rate of 6.76%. Conclusion We demonstrate the epidemiological, clinical, and microbiological profile of infective endocarditis in a tertiary care cardiac center in Saudi Arabia. It gives information concerning the prevalence of responsible organisms. This information will be helpful in assessing patients with suspected IE and in planning management of cases knowing the relative frequency of types of microorganisms encountered.

Clinical and pathogen features of infective endocarditis:A retrospective study of 111 episodes in a teaching hospital in southwest China

2019 ◽  
Author(s):  
Yuanfang Wang ◽  
Mei Kang ◽  
Ya Liu ◽  
Siyin Wu ◽  
Weili Zhang ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Laboratory Data ◽  
Clinical Manifestations ◽  
Resistance Rate ◽  
Native Valve ◽  
Duke Criteria ◽  
Preventive Medication ◽  
History Of

Abstract Background Infective endocarditis (IE) is a health-threaten infectious disease. Diverse and complicated etiology and causative microorganisms make IE difficult to diagnose and treat. As we know, current investigations of clinical and pathogen features of IE in West china are scarce. In this study, we aimed to investigate the epidemiology and pathogen characteristic of IE in our region. Methods A retrospective analysis of clinical and laboratory data was performed from all blood culture positive IE patients between 2012 to 2017 in Westchina Hospital of Sichuan University。The diagnosis is traditionally based on the modified Duke criteria. Results The mean age of the patient cohort was 40.7±21.5 years (ranging from 2-78); 73 cases (65.2%) were males and 39 cases (34.8%) were females. Of the 111 cases, 100 were native valve endocarditis (NVE) while 11 were prosthetic valve endocarditis (PVE), 87 cases (78.4%) were left-heart infection. Congenital heart disease (28.6%) and rheumatic heart disease (11.6%) were most common history of heart disease. Primary clinical manifestations were fever (87.5%) and heart murmur (78.6%).Streptococci spp (20.7%) was the most common organism, followed by Staphylococcus spp(17.9%). Streptococcus viridians showed no resistance to penicillin, erythromycin and clindamycin resistance rate were 47.4% and 40%. Benzocillin resistance rate of staphylococcus aureus to was 26.3%. Vancomycin or linezolid resistance staphylococcus aureus were not found. 75 patients died while 36 patients survived at last. With respect to risk factors, history of heart disease was the only prognostic risk factor (OR: 0.239, 95%CI 0.08-0.68) Conclusions Epidemiological and clinical characteristics of infective endocarditis are various and complex, distribution of pathogen is regional difference. Our research of infective endocarditis with bloodstream infection verified regional characteristics of infective endocarditis. The variations we observed in the study will be of important value to clinical preventive medication in our region.

scholarly journals The microbiological characteristics of Staphylococcus aureus isolated from patients with native valve infective endocarditis

Virulence ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 948-956
Author(s):  
Chung-Jong Kim ◽  
Kyoung-Ho Song ◽  
Pyoeng Gyun Choe ◽  
Wan Beom Park ◽  
Eu Suk Kim ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Native Valve ◽  
Microbiological Characteristics

scholarly journals Microbiological and Clinicoepidemiological Profile of a Series of Patients with Infective Endocarditis at a Center in Eastern Nepal

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sohani Bajracharya ◽  
Basudha Khanal ◽  
Shraddha Siwakoti ◽  
Rupa Rajbhandari Singh ◽  
Sanjib Kumar Sharma
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Local Level ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Treatment Protocol ◽  
Native Valve ◽  
Microbiological Methods

Background. The microbiological and clinicoepidemiological profile of infective endocarditis (IE) has undergone significant change over time. The pattern of IE studied at local level provides broader vision in understanding the current scenario of this disease. This study aimed to depict the overall picture of IE and its changing profile by evaluating the microbiological and clinicoepidemiological features in the context of a tertiary care center of eastern Nepal. Methods. The descriptive study was conducted from September 2017 to August 2018 among IE patients presenting to B. P. Koirala Institute of Health Sciences, Nepal. Detailed history and clinical manifestations of patients were noted. Microorganisms isolated from the blood culture were processed for identification by standard microbiological methods, and susceptibility testings were done. Each patient was assessed daily during hospital stay. Results. Ten definite and 7 possible endocarditis cases were studied. The mean age was 41.4 ± 15.85 (17–70) years with predominance of male (4.7 : 1). Rheumatic heart disease (41.1%) was the most common underlying heart disease observed followed by injection drug user endocarditis (23.5%). All the cases had native valve endocarditis. Aortic valve was the most common valve involved (35.3%) followed by mitral, tricuspid, and pulmonary valves. Blood culture positivity was 53%. Staphylococcus aureus was the major causative agent responsible for 23.5% of the cases followed by Enterococcus faecium, Enterococcus faecalis, and Pseudomonas aeruginosa. Mortality of 2 cases (11.8%) was associated with S. aureus and P. aeruginosa. Majority of patients developed acute kidney injury (35.3%) and congestive cardiac failure (23.5%). Conclusion. IE patients in our center exhibited differences from the west in terms of age at presentation and predisposing factors but held similarity in terms of commonly isolated microorganisms. The changing patterns of IE, etiological agents, and their antimicrobial susceptibility observed in this study may be helpful for clinicians in formulating a new empirical antibiotic treatment protocol.

scholarly journals Clinicomicrobiological profile of infective endocarditis in a tertiary care center of Nepal

2013 ◽  
Vol 8 (4) ◽  
pp. 34-41
Author(s):  
M Ghimire ◽  
P Karki ◽  
B Khanal ◽  
P Acharya ◽  
SK Sharma ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Care Center ◽  
Tertiary Care ◽  
Health Sciences ◽  
Cross Sectional ◽  
Acinetobacter Species ◽  
Female Ratio ◽  
History Of

Background Infective endocarditis is a common problem and data regarding its clinical and microbiological pattern from developing countries are sparse. We studied clinical features and the microbiological pathogens in patients with Infective Endocarditis in our Hospital. Objective To study the clinical profile and microbiological pathogens involved in patients with Infective Endocarditis, admitted under Department of Internal Medicine of B.P Koirala Institute of Health Sciences. Materials and methods A total of 54 patients with history of fever and underlying heart disease were studied. It was a hospital based cross sectional descriptive study done in patients with infective endocarditis presented to us from March 2007 to February 2008 in B.P Koirala Institute of Health Sciences. Results Out of 54 patients, 11 (20.4%) had Dukes definite IE. The male: female ratio was 1.2:1. The mean age of the study group was 27.3 years (range=16-55). In IE group, fever was present in 100% cases (n=11) as it was the inclusion criteria of the study, followed by SOB 81.8% (n=9). History of antibiotic therapy prior to the presentation was present in 36.7 % (n=4) patients. Pallor was the most common sign 63.6% (n=7). Splenomegaly was seen in 18.2% (n=2). Anaemia (Hb<10gm %) in 36.4% (n=4) and microscopic haematuria in 72.3% (n=8) cases. Blood culture positivity was seen in 36.4 %. The most common pathogens were Staphylococcus aureus in 27.3% (n=3) and Acinetobacter species in 9.1% (n=1). Conclusion In our study we found that the clinical spectrum of IE was different from the west in that the majority of patients being young in our study. However, RHD still is the commonest underlying heart disease and Staphylococcus aureus being the commonest isolate. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 34-41 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8698  

Methicillin-Resistant Staphylococcus aureus in Two Tertiary-Care Centers in Jeddah, Saudi Arabia

2001 ◽  
Vol 22 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Tariq A. Madani ◽  
Nabeela A. Al-Abdullah ◽  
Ali A. Al-Sanousi ◽  
Tawfik M. Ghabrah ◽  
Shadia Z. Afandi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Saudi Arabia ◽  
Tertiary Care ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Total Mortality ◽  
Control Measures ◽  
Methicillin Resistant ◽  
Mrsa Infection ◽  
Tertiary Care Hospitals

AbstractObjective:To review clinical experience with methicillin-resistant Staphylococcus aureus (MRSA) in tertiary-care hospitals in Jeddah, Saudi Arabia.Design:Retrospective review for the year 1998.Setting:Two tertiary-care hospitals.Methods:Results of MRSA-positive cultures of clinical specimens obtained as part of investigations for suspected infections were retrieved from the microbiology laboratories' records. Charts of patients were reviewed, with standardized data collection.Results:Of 673 S aureus isolates identified, 222 (33%, or 6.8 isolates/1,000 admissions) were MRSA Overall MRSA prevalence was 2% in 1988. Nosocomial acquisition occurred in 84.2% of cases. All age groups were affected, and 52% of patients had at least one comorbidity. MRSA prevalence was highest in the intensive care units (26.6% of all isolates), the medical wards (24.8%), and the surgical wards (19.8%). Seventy-three percent of isolates caused infection; the rest represented colonization. Surgical wounds (35.2%), the chest (29%), and central venous catheters (13%) were the most common sites of infection. Bacteremia occurred in 15.4% of patients. Local signs (84%) and fever (75.9%) were the most common clinical manifestations. Respiratory distress and septic shock occurred in 30.2% and 13.6% of cases, respectively. Of 162 patients with MRSA infection and 60 patients with MRSA colonization, 95.7% and 70% received antibiotics in the preceding 6 weeks, respectively (P<.0001). The total mortality of patients with MRSA infection was 53.7%: 36.4% as a result of MRSA infection and 17.3% as a result of other causes.Conclusions:The prevalence of MRSA is high and rapidly increasing in the two hospitals, as it is worldwide. Control measures to prevent die spread of MRSA in hospitals should continue, with reinforcement of hygienic precautions and development of policies to restrict the use of antibiotics.

scholarly journals Ten-year experience of Q fever endocarditis in a tertiary cardiac center in Saudi Arabia

2019 ◽  
Vol 88 ◽  
pp. 21-26 ◽  
Author(s):  
Fatehi E. Elzein ◽  
Nisreen Alsherbeeni ◽  
Khalid Alnajashi ◽  
Eid Alsufyani ◽  
M.Y. Akhtar ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Q Fever ◽  
Cardiac Center

scholarly journals Addition of Rifampin to Standard Therapy for Treatment of Native Valve Infective Endocarditis Caused by Staphylococcus aureus

2008 ◽  
Vol 52 (7) ◽  
pp. 2463-2467 ◽  
Author(s):  
David J. Riedel ◽  
Elizabeth Weekes ◽  
Graeme N. Forrest
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Drug Interactions ◽  
Standard Therapy ◽  
Cohort Analysis ◽  
Urban Hospital ◽  
Hepatitis C Infection ◽  
Native Valve ◽  
Duke Criteria ◽  
The Impact

ABSTRACT Staphylococcus aureus is a common cause of native valve infective endocarditis (IE). Rifampin is often added to traditional therapy for the management of serious S. aureus infections. There are no large, prospective studies documenting the safety and efficacy of adjunctive therapy with rifampin for treatment of native valve S. aureus IE. We reviewed all cases of definite native valve S. aureus IE confirmed by modified Duke criteria in a large urban hospital between 1 January 2004 and 31 December 2005. A retrospective cohort analysis was used to assess the impact of the addition of rifampin to standard therapy. There were 42 cases of S. aureus IE treated with the addition of rifampin and 42 controls. Cases received a median of 20 days of rifampin (range, 14 to 48 days). Rifampin-resistant S. aureus isolates developed in nine cases who received rifampin before clearance of bacteremia (56%), while significant hepatic transaminase elevations also occurred in nine cases, all of whom had hepatitis C infection. Unrecognized significant drug-drug interactions with rifampin occurred frequently (52%). Cases were more likely to have a longer duration of bacteremia (5.2 versus 2.1 days; P < 0.001) and were less likely to survive (79% versus 95%; P = 0.048) than controls. Our results suggest that the potential for hepatotoxicity, drug-drug interactions, and the emergence of resistant S. aureus isolates warrants a careful risk-benefit assessment before adding rifampin to standard antibiotic treatment of native valve S. aureus IE until further clinical studies are performed.

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