scholarly journals Three Separate Clinical Entities of Infective Endocarditis—A Population-Based Study From Southern Finland 2013–2017

2020 ◽  
Vol 7 (9) ◽  
Author(s):  
Mika Halavaara ◽  
Timi Martelius ◽  
Veli-Jukka Anttila ◽  
Asko Järvinen
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Prosthetic Valve ◽  
Risk Group ◽  
Case Fatality ◽  
Risk Groups ◽  
Population Based ◽  
Intravenous Drug Use ◽  
Population Based Study ◽  
Population Based Survey

Abstract Background Health care–associated infective endocarditis (HAIE) and intravenous drug use–related IE (IDUIE) have emerged as major groups in infective endocarditis (IE). We studied their role and clinical picture in a population-based survey. Methods A population-based retrospective study including all adult patients diagnosed with definite or possible IE in Southern Finland in 2013–2017. IE episodes were classified according to the mode of acquisition into 3 groups: community-acquired IE (CAIE), HAIE, and IDUIE. Results Total of 313 episodes arising from 291 patients were included. Incidence of IE was 6.48/100 000 person-years. CAIE accounted for 38%, HAIE 31%, and IDUIE 31% of IE episodes. Patients in the IDUIE group were younger, and they more frequently had right-sided IE (56.7% vs 5.0%; P < .001) and S. aureus as etiology (74.2% vs 17.6%; P < .001) compared with the CAIE group. In-hospital (15.1% vs 9.3%; P = .200) and cumulative 1-year case fatality rates (18.5% vs 17.5%; P = .855) were similar in CAIE and IDUIE. Patients with HAIE had more comorbidities, prosthetic valve involvement (29.9% vs 10.9%; P = .001), enterococcal etiology (20.6% vs 5.9%; P = .002), and higher in-hospital (27.8% vs 15.1%; P = .024) and cumulative 1-year case fatality rates (43.3% vs 18.5%; P < .001) than patients with CAIE. Staphylococcus aureus caused one-fifth of IE episodes in both groups. Conclusions Our study indicates that in areas where injection drug use is common IDUIE should be regarded as a major risk group for IE, along with HAIE, and not seen as part of CAIE. Three different risk groups, CAIE, HAIE, and IDUIE, with variable characteristics and outcome should be recognized in IE.

scholarly journals Infective Endocarditis Related to Unusual Microorganisms: A Prospective Population-Based Study

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Silvia Limonta ◽  
Emmanuelle Cambau ◽  
Marie-Line Erpelding ◽  
Caroline Piau-Couapel ◽  
François Goehringer ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Heart Valve ◽  
Prosthetic Valve ◽  
Heart Valves ◽  
Population Based ◽  
Population Based Study ◽  
Molecular Microbiology ◽  
Cutibacterium Acnes ◽  
Vertebral Biopsy

Abstract Background Increased access to heart valves through early surgery and progress in molecular microbiology have reduced the proportion of infective endocarditis (IE) with no microbiological documentation and increased the proportion of IE associated with unusual microorganisms. Methods We performed an ancillary study of a large prospective population-based survey on IE. Unusual-microorganism IE was defined as definite IE (Duke-Li criteria) due to microorganisms other than streptococci, staphylococci, or enterococci. Results Of 471 cases of documented IE, 46 (9.8%) were due to unusal microorganisms; the following were involved in >1 case: Candida albicans (n = 4), Cutibacterium acnes (n = 4), Pseudomonas aeruginosa (n = 3), Cardiobacterium hominis (n = 3), and Coxiella burnetii (n = 2). Cases were documented with blood cultures (n = 37, 80.4%), heart valve polymerase chain reaction (PCR; n = 5), heart valve culture (n = 2), PCR on vertebral biopsy (n = 1), or serology (n = 1). As compared with IE due to staphylococci, streptococci, or enterococci (n = 420), IE due to unusual microorganisms occurred more frequently in patients with previously known heart disease (69.0% vs 44.3%; P = .002), prosthetic valve (40.5% vs 18.1%; P = .0006), longer duration of fever (mean, 35.1 ± 46.8 days vs 12.5 ± 17.8; P = .003), and who were more often nosocomial (38.1% vs 20.2%; P = .02). Conclusions In this population-based study, 9.8% of IE cases were due to unusual microorganisms, with a predominance of anaerobes, yeast, and gram-negative bacilli. As compared with IE related to staphylococci, streptococci, or enterococci, IE cases related to unusual microorganisms were associated with previously known heart disease, prosthetic valve, longer duration of fever, and nosocomial acquisition. Trial registration ORCID 0000-0003-3617-5411

scholarly journals Risk Factors for Pneumonia and Death in Adult Patients With Seasonal Influenza and Establishment of Prediction Scores: A Population-Based Study

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Koichi Miyashita ◽  
Eiji Nakatani ◽  
Hironao Hozumi ◽  
Yoko Sato ◽  
Yoshiki Miyachi ◽  
...  
Keyword(s):  
High Risk ◽  
Seasonal Influenza ◽  
Prediction Models ◽  
Validation Cohort ◽  
Risk Groups ◽  
Population Based ◽  
Limited Data ◽  
Population Based Study ◽  
Relative Risks ◽  
Primary Care Settings

Abstract Background Seasonal influenza remains a global health problem; however, there are limited data on the specific relative risks for pneumonia and death among outpatients considered to be at high risk for influenza complications. This population-based study aimed to develop prediction models for determining the risk of influenza-related pneumonia and death. Methods We included patients diagnosed with laboratory-confirmed influenza between 2016 and 2017 (main cohort, n = 25 659), those diagnosed between 2015 and 2016 (validation cohort 1, n = 16 727), and those diagnosed between 2017 and 2018 (validation cohort 2, n = 34 219). Prediction scores were developed based on the incidence and independent predictors of pneumonia and death identified using multivariate analyses, and patients were categorized into low-, medium-, and high-risk groups based on total scores. Results In the main cohort, age, gender, and certain comorbidities (dementia, congestive heart failure, diabetes, and others) were independent predictors of pneumonia and death. The 28-day pneumonia incidence was 0.5%, 4.1%, and 10.8% in the low-, medium-, and high-risk groups, respectively (c-index, 0.75); the 28-day mortality was 0.05%, 0.7%, and 3.3% in the low-, medium-, and high-risk groups, respectively (c-index, 0.85). In validation cohort 1, c-indices for the models for pneumonia and death were 0.75 and 0.87, respectively. In validation cohort 2, c-indices for the models were 0.74 and 0.87, respectively. Conclusions We successfully developed and validated simple-to-use risk prediction models, which would promptly provide useful information for treatment decisions in primary care settings.

scholarly journals Estimates and Determinants of SARS-Cov-2 Seroprevalence and Infection Fatality Ratio Using Latent Class Analysis: The Population-Based Tirschenreuth Study in the Hardest-Hit German County in Spring 2020

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1118
Author(s):  
Ralf Wagner ◽  
David Peterhoff ◽  
Stephanie Beileke ◽  
Felix Günther ◽  
Melanie Berr ◽  
...  
Keyword(s):  
Latent Class Analysis ◽  
Latent Class ◽  
Care Home ◽  
Case Fatality ◽  
The Elderly ◽  
Population Based ◽  
Class Analysis ◽  
Population Based Study ◽  
Targeted Testing ◽  
June July

SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60–69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.

A Population-Based Study of the Incidence and Case Fatality of Non-aneurysmal Subarachnoid Hemorrhage

2014 ◽  
Vol 22 (3) ◽  
pp. 409-413 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Nauman Jahangir ◽  
Mushtaq H. Qureshi ◽  
Archie Defillo ◽  
Ahmed A. Malik ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Fatality ◽  
Population Based ◽  
Population Based Study

The Lived Experience of Nurses Caring for Patients Diagnosed With Intravenous Drug Use–Associated Infective Endocarditis in Appalachia: A Phenomenological Study

2021 ◽  
pp. 107839032110377
Author(s):  
Kendrea L. Todt ◽  
Sandra P. Thomas
Keyword(s):  
Substance Use ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Substance Use Disorder ◽  
Phenomenological Study ◽  
Care Delivery ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Central Theme ◽  
Number Of Patients

BACKGROUND: The number of patients admitted with infective endocarditis (IE) from intravenous drug use (IVDU) in Appalachia is increasing, a direct downstream effect of the opioid crisis. Extant literature highlights the pejorative attitudes health care workers have toward patients with substance use disorder, with nurses among the most punitive. Rather than describe attitudes, the purpose of this study was to describe the lived experiences of nurses caring for patients diagnosed with IE from IVDU in Appalachia. OBJECTIVE: To describe an unexplored phenomenon in Appalachia to inform nursing practice, nursing education, and health policy. METHOD: Qualitative phenomenological study using the University of Tennessee method based on the tenets of Maurice Merleau-Ponty. Nine nurses (ages 29-53 years) recruited using purposive and snowball sampling participated in unstructured phenomenological interviews. RESULTS: The essential meaning or central theme of the nurse experience working with these patients was a sense of hopelessness/hope, with four interrelated themes derived from the central theme: (1) guarding/escaping, (2) responsibility and revulsion, (3) apathy/empathy, and (4) grief and sorrow/cold and unemotional. Universally, nurses perceived caring for this population as futile, feeling a sense of powerlessness to change the outcome. CONCLUSIONS: These care experiences frustrated nurses, who described being physically and emotionally drained. To improve care delivery and improve patient outcomes, emphasis must be placed on nurse addiction education and standardizing nurse to patient with substance use disorder ratios to decrease work-related stress on nurses.

Drug use-related right-sided infective endocarditis complicated by empyema and bronchopleural fistula

2022 ◽  
Vol 15 (1) ◽  
pp. e246663
Author(s):  
Lindsey M Shain ◽  
Taha Ahmed ◽  
Michele L Bodine ◽  
Jennifer G Bauman
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Bronchopleural Fistula ◽  
Disease Process ◽  
Intravenous Drug ◽  
Pulmonary Emboli ◽  
Intravenous Drug Use ◽  
Respiratory Complications

Right-sided infective endocarditis is frequently accompanied by septic pulmonary emboli, which may result in a spectrum of respiratory complications. We present the case of a 25-year-old woman diagnosed with infective endocarditis secondary to intravenous drug use. During a long and arduous hospital course, the patient developed empyema with bronchopleural fistula, representing severe but uncommon sequelae that may arise from this disease process. She was treated with several weeks of antibiotics as well as surgical thorascopic decortication and parietal pleurectomy.

Sign in / Sign up

Export Citation Format

Share Document