scholarly journals Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Torrance Oravec ◽  
S. Annie Oravec ◽  
Jennifer Leigh ◽  
Liam Matthews ◽  
Bahareh Ghadaki ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Mortality Rate ◽  
Streptococcus Agalactiae ◽  
Case Series ◽  
Case Control ◽  
Control Analysis ◽  
Source Of Infection ◽  
Prosthetic Valves ◽  
Duke Criteria ◽  
Nested Case Control

Abstract Background Infective endocarditis (IE) caused by Streptococcus agalactiae (GBS) is increasingly reported and associated with an aggressive course and high mortality rate. Existing literature on GBS IE is limited to case series; we compared the characteristics of patients with GBS IE to patients with GBS bacteremia without IE to identify risk factors for development of IE. Methods A nested case–control study in a cohort of adult patients with GBS bacteremia over a 18-year period was conducted across seven centres in three Canadian cities. A chart review identified patients with possible or definite IE (per Modified Duke Criteria) and patients with IE were matched to those without endocarditis in a 1:3 fashion. Multivariate analyses were completed using logistic regression. Results Of 520 patients with GBS bacteremia, 28 cases of possible or definite IE were identified (5.4%). 68% (19/28) met criteria for definite IE, surgery was performed in 29% (8/28), and the overall in-hospital mortality rate was 29% (8/28). Multivariate analysis demonstrated that IE was associated with injection drug use (OR = 19.6, 95% CI = 3.39–111.11, p = 0.001), prosthetic valve (OR = 11.5, 95% CI = 1.73–76.92, p = 0.011) and lack of identified source of bacteremia (OR = 3.81, 95% CI = 1.24–11.65, p = 0.019). Conclusions GBS bacteremia, especially amongst people who inject drugs, those with prosthetic valves, and those with no apparent source of infection, should increase clinical suspicion for IE.

scholarly journals Streptococcus pyogenes Infective Endocarditis – Association with Injection Drug Use: Case Series and Review of the Literature

2021 ◽  
Author(s):  
Melanie T Rebechi ◽  
Emily L Heil ◽  
Paul M Luethy ◽  
Sarah A Schmalzle
Keyword(s):  
Infective Endocarditis ◽  
Streptococcus Pyogenes ◽  
People Who Inject Drugs ◽  
Local Population ◽  
Case Series ◽  
Duke Criteria ◽  
Group A ◽  
Polymicrobial Bacteremia ◽  
Predominantly Female ◽  
Living With Hiv

Abstract Background Streptococcus pyogenes, or Group A Strep (GAS), is not considered a typical cause of infective endocarditis (IE), but has anecdotally been observed in unexpectedly high rates in people who inject drugs (PWID) at our institution. Methods All cases of possible or definite GAS IE per Modified Duke Criteria in adults at an academic hospital between 11/15/2015 and 11/15/2020 were identified. Medical records were reviewed for demographics, comorbidities, treatment, and outcomes related to GAS IE. Literature on cases of GAS IE was reviewed. Results 18 cases of probable (11) or definite (7) GAS IE were identified; mean age was 38 years, and the population was predominantly female (56%) and Caucasian (67%), which is inconsistent with local population demographics. Sixteen cases were in people who inject drugs (PWID) (89%), 14 were also homeless, six were also living with HIV (33%), and two were also pregnant. Antibiotic regimens were variable due to polymicrobial bacteremia (39%). One patient underwent surgical valve replacement. Four patients (22%) died due to complications of infection. Literature review revealed 42 adult cases of GAS IE, only 17 of which were in PWID (24%). Conclusions The 16 cases of possible and definite GAS IE in PWID over a five-year period in a single institution reported nearly doubles the number of cases in PWID from all previous reports. This suggests a potential increase in GAS IE particularly in PWID and PLWH, which warrants further epidemiologic investigation.

scholarly journals Infective endocarditis caused by HACEK group bacteria—a registry-based comparative study

2021 ◽  
Author(s):  
Anna Bläckberg ◽  
Christian Morenius ◽  
Lars Olaison ◽  
Andreas Berge ◽  
Magnus Rasmussen
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Mortality Rate ◽  
Haemophilus Influenzae ◽  
Comparative Study ◽  
Clinical Characteristics ◽  
Prosthetic Valve ◽  
Prosthetic Valve Endocarditis ◽  
Common Cause ◽  
Prosthetic Valves

AbstractInfective endocarditis (IE) caused by bacteria within Haemophilus (excluding Haemophilus influenzae), Aggregatibacter, Cardiobacterium, Eikenella and Kingella (HACEK) is rare. This study aimed to describe clinical features of IE caused by HACEK genera in comparison with IE due to other pathogens. Cases of IE due to HACEK were identified through the Swedish Registry of Infective Endocarditis (SRIE). Clinical characteristics of IE cases caused by HACEK were compared with cases of IE due to other pathogens reported to the same registry. Ninety-six patients with IE caused by HACEK were identified, and this corresponds to 1.8% of all IE cases. Eighty-three cases were definite endocarditis, and the mortality rate was 2%. The median age was 63 years, which was lower compared to patients with IE caused by other pathogens (66, 70 and 73 years respectively, p ≤ 0.01). Patients with IE caused by Haemophilus were younger compared to patients with IE due to Aggregatibacter (47 vs 67 years, p ≤ 0.001). Patients with IE due to HACEK exhibited longer duration from onset of symptoms to hospitalization and had more prosthetic valve endocarditis compared to patients with IE due to Staphylococcus aureus (10 vs 2 days, p ≤ 0.001, and 35 vs 14%, p ≤ 0.001). This is, to date, the largest study on IE due to HACEK. Aggregatibacter was the most common cause of IE within the group. The condition has a subacute onset and often strikes in patients with prosthetic valves, and the mortality rate is relatively low.

scholarly journals 705. Factors Associated with Local Invasion in Infective Endocarditis: a Nested Case-control Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S403-S403
Author(s):  
Abarna Ramanathan ◽  
James Witten ◽  
Steven M Gordon ◽  
Brian Griffin ◽  
Gosta Pettersson ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Case Control Study ◽  
Cleveland Clinic ◽  
Case Control ◽  
Paravalvular Leak ◽  
Multivariable Logistic Regression Model ◽  
Local Invasion ◽  
Nested Case Control ◽  
Control Study

Abstract Background A substantial proportion of infective endocarditis (IE) cases are complicated by local invasion. The purpose of this study was to identify patient and disease characteristics that increase the odds of local invasion in surgically treated IE patients. Methods This was a nested case-control study. All episodes of IE for patients admitted to Cleveland Clinic from January 1st, 2013 – June 30th, 2016 were identified from the Cleveland Clinic IE Registry. Patients >18 years of age who underwent surgery for IE were included. Data was compiled by manual review of the Electronic Medical Record. Local invasion, defined as peri-annular extension, peri-valvular abscess, intra-cardiac fistula or pseudoaneurysm, was ascertained from the surgical operative note. Associations of selected factors with local invasion were examined in a multivariable logistic regression model. Results Among 510 patients who met inclusion criteria, 206 had local invasion. Mean age was 56 years and 369 (72 %) were male. Overall 344 (67 %) had aortic valve, 228 (45%) mitral valve, and 66 (13%) tricuspid or pulmonic valve involvement. Aortic valve involvement (OR 5.76, 95% CI 3.44 – 9.98), mechanical valve (OR 7.63, 95% CI 3.63 – 17.07), bioprosthetic valve (OR 3.20, 95% CI 1.99 – 5.19), significant paravalvular leak (OR 2.27, 95% CI 1.09 – 4.97), new atrioventricular nodal block (OR 3.05, 95% CI 1.57 – 6.09), Staphylococcus aureus infection (OR 2.11, 95% CI 1.20 – 3.76), coagulase negative staphylococcal infection (OR 2.38, 95% CI1.27 – 4.54), and non- viridans group streptococcal infection (OR 4.21, 95% CI 1.81 – 10.06) were significantly associated with local invasion. Conclusion Intra-cardiac and microorganism factors, but not comorbid conditions, are associated with local invasion in IE. Disclosures All Authors: No reported disclosures

Predictors for anaerobic bacteraemia beyond the source of infection: Retrospective, nested, case-control study

2009 ◽  
Vol 41 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Jihad Bishara ◽  
Morad Wattad ◽  
Leonard Leibovici ◽  
Zmira Samra ◽  
Bruria Lev ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Source Of Infection ◽  
Nested Case Control ◽  
Control Study

scholarly journals Risk of Dysglycemia in Pregnancy amongst Kenyan Women with HIV Infection: A Nested Case-Control Analysis from the STRiDE Study

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Sonak D. Pastakia ◽  
Wycliffe K. Kosgei ◽  
Astrid Christoffersen-Deb ◽  
Benson Kiragu ◽  
John N. Hector ◽  
...  
Keyword(s):  
Family History ◽  
Pregnant Women ◽  
Gestational Age ◽  
Fasting Glucose ◽  
Case Control ◽  
Oral Glucose ◽  
Control Analysis ◽  
History Of ◽  
Women With Hiv ◽  
Nested Case Control

Introduction. Gestational diabetes is a common complication, whose incidence is growing globally. There is a pressing need to obtain more data on GDM in low- and middle-income countries, especially amongst high-risk populations, as most of the data on GDM comes from high-income countries. With the growing awareness of the role HIV plays in the progression of noncommunicable diseases and the disproportionate HIV burden African countries like Kenya face, investigating the potential role HIV plays in increasing dysglycemia amongst pregnant women with HIV is an important area of study. Methods. The STRiDE study is one of the largest ever conducted studies of GDM in Kenya. This study enrolled pregnant women aged between 16 and 50 who were receiving care from public and private sector facilities in Eldoret, Kenya. Within this study, women received venous testing for glycosylated hemoglobin (HbA1c) and fasting glucose between 8- and 20-week gestational age. At their 24-32-week visit, they received a venous 75 g oral glucose tolerance test (OGTT). Because of the pressing need to assess the burden of GDM within the population of pregnant women with HIV, a nested case-control study design was used. Pregnant women with HIV within the larger STRiDE cohort were matched to non-HIV-infected women within the STRiDE cohort at a 1 : 3 ratio based on body mass index, parity, family history of GDM, gestational age, and family history of hypertension. The measurements of glucose from the initial visit (fasting glucose and HbA1c) and follow-up visit (OGTT) were compared between the two groups of HIV+ cases and matched HIV- controls. Results. A total of 83 pregnant women with HIV were well matched to 249 non-HIV-infected women from the STRiDE cohort with marital status being the only characteristic that was statistically significantly different between the two groups. Statistically significant differences were not observed in the proportion of women who developed GDM, the fasting glucose values, the HbA1c, or OGTT measurements between the two groups. Discussion. Significant associations were not seen between the different measures of glycemic status between pregnant women with and without HIV. While significant differences were not seen in this cohort, additional investigation is needed to better describe the association of dysglycemia with HIV, especially in Kenyan populations with a higher prevalence of GDM.

613 The Floating Hip: A Distinct Injury Pattern? A Descriptive Study and Case-Control Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Wong ◽  
M Ghobrial ◽  
W M Han ◽  
J Alsousou ◽  
D Chou ◽  
...  
Keyword(s):  
Case Series ◽  
Femoral Fractures ◽  
Descriptive Study ◽  
Case Control ◽  
Injury Pattern ◽  
Pelvic Fractures ◽  
Control Group ◽  
Control Analysis ◽  
Hip Injury ◽  
Case Control Analysis

Abstract Aim A “Floating Hip” injury describes a simultaneous ipsilateral fracture of the femur and pelvis. We performed a descriptive study of the injury patterns, management, and outcomes of floating hip patients, and compared these patients to those with similar pelvic fractures without femoral involvement. Method This was a retrospective case-series review with secondary case-control analysis. Medical records of patients presenting with a floating hip injury to our tertiary orthopaedics department between 2015 and 2020 were reviewed. The control group comprised of patients with pelvic fractures but without associated femoral fractures, matched by age, sex, pelvic fracture classification, and mechanism of injury. Results 46 Floating Hip cases were identified (34 males), of average age 39 (15-86) years. 20 had acetabular fractures, 21 had pelvic ring fractures and 5 had both fractures, concomitant with ipsilateral femoral fractures. The most common site of femoral fracture was mid-shaft (21.7%), followed by distal (19.6%). 69.6% of P/A fractures were managed surgically, with ORIF (43%) the most common option. 4 (12.50%) patients suffered complications, including 2 infections and 1 DVT. Compared to controls, Floating Hip patients were more likely to require surgical management (67.6% vs 47.8%, p = 0.03), and had higher rates of surgical complications (12.5% vs 4.6%), though not statistically significant (p = 0.3). Conclusions Our study describes the patterns, management, and outcomes of Floating Hip injuries, and observes differences in the management and complications compared to similar pelvic fractures without femoral involvement. These findings suggest Floating Hip cases may warrant consideration as a distinct injury pattern.

scholarly journals Risk of hand osteoarthritis in new users of hormone replacement therapy: A nested case-control analysis

Maturitas ◽  
2020 ◽  
Vol 132 ◽  
pp. 17-23
Author(s):  
Theresa Burkard ◽  
Marlene Rauch ◽  
Julia Spoendlin ◽  
Daniel Prieto-Alhambra ◽  
Susan S. Jick ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Case Control ◽  
Hand Osteoarthritis ◽  
Control Analysis ◽  
Case Control Analysis ◽  
Nested Case Control

Damage accrual related to pregnancies before and after diagnosis of systemic lupus erythematosus: a cross-sectional and nested case-control analysis from a lupus registry

Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 176-181
Author(s):  
M Morishita ◽  
K-E Sada ◽  
K Ohashi ◽  
Y Miyawaki ◽  
Y Asano ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Confidence Interval ◽  
Lupus Erythematosus ◽  
Odds Ratio ◽  
Case Control ◽  
Control Analysis ◽  
Systemic Lupus ◽  
Before And After ◽  
Case Control Analysis ◽  
Nested Case Control

Objective The objective of this study was to evaluate the chronic damage associated with pregnancies before and after the diagnosis of systemic lupus erythematosus (SLE). Methods Using childbearing-aged female SLE patient data registered at the Okayama and Showa University Hospitals, a nested case-control analysis was performed to investigate the relationship between pregnancy and chronic damage using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Results Pregnancy occurred in 22 patients before and 13 patients after the diagnosis of SLE in 104 eligible patients. Live births occurred in 82% (33/40) and 50% (9/18) of the pregnancies before and after the diagnosis of SLE, respectively. After matching age and disease duration, 33 case patients with chronic damage (SDI ≥ 1) and 33 control patients without chronic damage (SDI = 0) were selected. Hypertension was more frequent in cases than in controls (48% vs. 24%, p = 0.041). Pregnancies before and after the diagnosis of SLE were comparable between cases and controls (before the diagnosis: nine case patients and eight control patients; after the diagnosis: three case patients and five control patients; p = 1.00). Even after adjusting for hypertension using multivariate analysis, the pregnancies before and after the diagnosis were not significant predictors for chronic damage (odds ratio = 1.48 (95% confidence interval 0.33–6.65)), p = 0.60 of the pregnancy before the diagnosis; odds ratio = 0.78 (95% confidence interval 0.13–4.74), p = 0.78 of the pregnancy after the diagnosis). Conclusion Pregnancies, either before or after the diagnosis of SLE, did not show any differences in chronic damage. Our results help alleviate fears regarding childbearing in female patients with SLE and their families.

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