Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality

Infective endocarditis (IE) is defined as the infectious and inflammatory process of the heart’s internal structures. It can be caused by a broad group of bacteria and, rarely, fungi, with potentially life-threatening consequences. Objective: To profile bacterial resistance and identify mortality ri...

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Autores:
Solarte Bastidas, Gabriela
Herrera Calle, Pedro
Domínguez-Vargas, Alex
Iglesias Pertuz, Shirley
González-Torres, Henry J.
Tipo de recurso:
Fecha de publicación:
2023
Institución:
Universidad Simón Bolívar
Repositorio:
Repositorio Digital USB
Idioma:
eng
OAI Identifier:
oai:bonga.unisimon.edu.co:20.500.12442/13782
Acceso en línea:
https://hdl.handle.net/20.500.12442/13782
http://saber.ucv.ve/ojs/index.php/rev_gmc/article/view/27488/144814493246
Palabra clave:
Infective endocarditis
Outcome
Antimicrobial resistance
Heart failure
Endocarditis infecciosa
Resultado
Resistencia antimicrobiana
Insuficiencia cardíaca
Rights
openAccess
License
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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dc.title.eng.fl_str_mv Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
dc.title.translated.spa.fl_str_mv Endocarditis infecciosa en la región caribe colombiana: Perfil clínico, conocimientos microbiológicos y factores de riesgo de mortalidad
title Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
spellingShingle Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
Infective endocarditis
Outcome
Antimicrobial resistance
Heart failure
Endocarditis infecciosa
Resultado
Resistencia antimicrobiana
Insuficiencia cardíaca
title_short Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
title_full Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
title_fullStr Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
title_full_unstemmed Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
title_sort Infective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortality
dc.creator.fl_str_mv Solarte Bastidas, Gabriela
Herrera Calle, Pedro
Domínguez-Vargas, Alex
Iglesias Pertuz, Shirley
González-Torres, Henry J.
dc.contributor.author.none.fl_str_mv Solarte Bastidas, Gabriela
Herrera Calle, Pedro
Domínguez-Vargas, Alex
Iglesias Pertuz, Shirley
González-Torres, Henry J.
dc.subject.eng.fl_str_mv Infective endocarditis
Outcome
Antimicrobial resistance
Heart failure
topic Infective endocarditis
Outcome
Antimicrobial resistance
Heart failure
Endocarditis infecciosa
Resultado
Resistencia antimicrobiana
Insuficiencia cardíaca
dc.subject.spa.fl_str_mv Endocarditis infecciosa
Resultado
Resistencia antimicrobiana
Insuficiencia cardíaca
description Infective endocarditis (IE) is defined as the infectious and inflammatory process of the heart’s internal structures. It can be caused by a broad group of bacteria and, rarely, fungi, with potentially life-threatening consequences. Objective: To profile bacterial resistance and identify mortality risk factors in IE patients. Methods: This crosssectional study included clinically diagnosed IE patients. Sociodemographic, comorbidity, clinical, and microbiological data were recorded. Descriptive analyses, Chi-Square/Fisher’s exact tests, and Student’s t-tests examined variables in relation to IE outcomes (survival vs. mortality). Multivariate logistic regression calculated odds ratios and confidence intervals. Results: We enrolled 39 patients (mean age 51 ± 19.5 years, 54 % male). Common comorbidities included acute kidney injury (AKI) (46 %), heart failure (26 %), and ischemic stroke (21 %). Deceased patients had higher rates of fatigue (p=0.03), lower limb edema (p=0.01), and AKI (p=0.01) than survivors. Fifteen (38 %) patients had positive cultures; Staphylococcus aureus predominated in survivors (13 %) and deceased (13 %) patients (p=0.06). Multi-drug-resistant bacteria were found in six (15 %) patients, and one (2.6 %) had Extensively Drug-Resistant bacteria. Multivariate Logistic Regression indicated that lower limb edema (OR 8.6, 95 % CI 1.5–49, p=0.01), and AKI (OR 7.8, 95 % CI 1.65–37.2, p=0.01) increased mortality risk in IE patients. Conclusion: In this study, lower limb edema and AKI were significant predictors of mortality in IE patients, emphasizing their clinical importance in IE progression and resolution. Further research should explore additional variables and risk factors to enhance our ability to predict and manage outcomes in this population.
publishDate 2023
dc.date.issued.none.fl_str_mv 2023
dc.date.accessioned.none.fl_str_mv 2024-01-16T14:47:24Z
dc.date.available.none.fl_str_mv 2024-01-16T14:47:24Z
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dc.type.spa.spa.fl_str_mv Artículo científico
dc.identifier.issn.none.fl_str_mv 27390012
27390012 (en línea)
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12442/13782
dc.identifier.doi.none.fl_str_mv 10.47307/GMC.2023.131.4.17
dc.identifier.url.none.fl_str_mv http://saber.ucv.ve/ojs/index.php/rev_gmc/article/view/27488/144814493246
identifier_str_mv 27390012
27390012 (en línea)
10.47307/GMC.2023.131.4.17
url https://hdl.handle.net/20.500.12442/13782
http://saber.ucv.ve/ojs/index.php/rev_gmc/article/view/27488/144814493246
dc.language.iso.eng.fl_str_mv eng
language eng
dc.rights.*.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
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rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
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eu_rights_str_mv openAccess
dc.format.mimetype.spa.fl_str_mv pdf
dc.publisher.spa.fl_str_mv ACADEMIA NACIONAL DE MEDICINA
Facultad de Ciencias de la Salud
dc.source.spa.fl_str_mv Gaceta Médica de Caracas
Gac Méd Caracas
dc.source.none.fl_str_mv Vol. 131 No. 4 (2023)
institution Universidad Simón Bolívar
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spelling Solarte Bastidas, Gabrielaed74fbc5-84cd-42f3-a095-750d2c1fcf26Herrera Calle, Pedro9043abaf-dec0-413e-b756-227c35c22f23Domínguez-Vargas, Alexd3599d9a-0024-4ac5-9bfb-269da6854041Iglesias Pertuz, Shirleye58c5220-716c-4716-a524-a0bfb0290f4bGonzález-Torres, Henry J.b2b56f8b-392d-4598-87b4-b87427fdebe82024-01-16T14:47:24Z2024-01-16T14:47:24Z20232739001227390012 (en línea)https://hdl.handle.net/20.500.12442/1378210.47307/GMC.2023.131.4.17http://saber.ucv.ve/ojs/index.php/rev_gmc/article/view/27488/144814493246Infective endocarditis (IE) is defined as the infectious and inflammatory process of the heart’s internal structures. It can be caused by a broad group of bacteria and, rarely, fungi, with potentially life-threatening consequences. Objective: To profile bacterial resistance and identify mortality risk factors in IE patients. Methods: This crosssectional study included clinically diagnosed IE patients. Sociodemographic, comorbidity, clinical, and microbiological data were recorded. Descriptive analyses, Chi-Square/Fisher’s exact tests, and Student’s t-tests examined variables in relation to IE outcomes (survival vs. mortality). Multivariate logistic regression calculated odds ratios and confidence intervals. Results: We enrolled 39 patients (mean age 51 ± 19.5 years, 54 % male). Common comorbidities included acute kidney injury (AKI) (46 %), heart failure (26 %), and ischemic stroke (21 %). Deceased patients had higher rates of fatigue (p=0.03), lower limb edema (p=0.01), and AKI (p=0.01) than survivors. Fifteen (38 %) patients had positive cultures; Staphylococcus aureus predominated in survivors (13 %) and deceased (13 %) patients (p=0.06). Multi-drug-resistant bacteria were found in six (15 %) patients, and one (2.6 %) had Extensively Drug-Resistant bacteria. Multivariate Logistic Regression indicated that lower limb edema (OR 8.6, 95 % CI 1.5–49, p=0.01), and AKI (OR 7.8, 95 % CI 1.65–37.2, p=0.01) increased mortality risk in IE patients. Conclusion: In this study, lower limb edema and AKI were significant predictors of mortality in IE patients, emphasizing their clinical importance in IE progression and resolution. Further research should explore additional variables and risk factors to enhance our ability to predict and manage outcomes in this population.La endocarditis infecciosa (EI) se define como el proceso infeccioso e inflamatorio de las estructuras internas del corazón. Puede ser causada por un amplio grupo de bacterias y, rara vez, por hongos, con consecuencias potencialmente mortales. Objetivo: perfilar la resistencia bacteriana e identificar factores de riesgo de mortalidad en pacientes con EI. Métodos: Este estudio transversal incluyó pacientes con EI clínicamente diagnosticada. Se registraron datos sociodemográficos, de comorbilidad, clínicos y microbiológicos. Los análisis descriptivos, las pruebas de Chi-Cuadrado/exactas de Fisher y las pruebas t de Student examinaron las variables en relación con los resultados de IE (supervivencia versus mortalidad). La regresión logística multivariada calculó los Odds ratios y los intervalos de confianza. Resultados: Se incluyeron 39 pacientes (edad media 51 ± 19,5 años, 54 % hombres). Las comorbilidades comunes incluyeron lesión renal aguda (IRA) (46 %), insuficiencia cardíaca (26 %) y accidente cerebrovascular isquémico (21 %). Los pacientes fallecidos tuvieron tasas más altas de fatiga (p=0,03), edema de miembros inferiores (p=0,01) y IRA (p=0,01) que los supervivientes. Quince (38 %) pacientes tuvieron cultivos positivos; Staphylococcus aureus predominó en los pacientes sobrevivientes (13 %) y fallecidos (13 %) (p=0,06). Se encontraron bacterias multirresistentes en seis (15 %) pacientes y uno (2,6 %) tenía bacterias extremadamente resistentes a los medicamentos. La regresión logística multivariada indicó que el edema de las extremidades inferiores (OR 8,6, IC 95 % 1,5–49, p = 0,01) y la IRA (OR 7,8, IC 95 % 1,65–37,2, p = 0,01) aumentaron el riesgo de mortalidad en pacientes con EI. Conclusión: En este estudio, el edema de las extremidades inferiores y la IRA fueron predictores significativos de mortalidad en pacientes con EI, enfatizando su importancia clínica en la progresión y resolución de la EI. Investigaciones adicionales deberían explorar variables y factores de riesgo adicionales para mejorar nuestra capacidad de predecir y gestionar los resultados en esta población.pdfengACADEMIA NACIONAL DE MEDICINAFacultad de Ciencias de la SaludAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Gaceta Médica de CaracasGac Méd CaracasVol. 131 No. 4 (2023)Infective endocarditisOutcomeAntimicrobial resistanceHeart failureEndocarditis infecciosaResultadoResistencia antimicrobianaInsuficiencia cardíacaInfective endocarditis in the colombian caribbean region: clinical profile, microbiological insights, and risk factors for mortalityEndocarditis infecciosa en la región caribe colombiana: Perfil clínico, conocimientos microbiológicos y factores de riesgo de mortalidadinfo:eu-repo/semantics/articleArtículo científicohttp://purl.org/coar/version/c_970fb48d4fbd8a85http://purl.org/coar/resource_type/c_2df8fbb1Wang A, Gaca JG, Chu VH. Management Considerations in Infective Endocarditis: A Review. JAMA. 2018;320(1):72-83.Bussani R, DE-Giorgio F, Pesel G, Zandonà L, Sinagra G, Grassi S, et al. Overview and Comparison of Infectious Endocarditis and Non-infectious Endocarditis: A Review of 814 Autoptic Cases. In Vivo. 2019;33(5):1565-1572.Chomette G, Auriol M, Baubion D, de Frejacques C. Non-bacterial thrombotic endocarditis. Autopsy study, clinicopathological correlations (author’s transl). Ann Med Interne (Paris). 1980;131(7):443-447.Yallowitz AW, Decker LC. Infectious Endocarditis. StatPearls. 2023.Delgado V, Ajmone Marsan N, de Waha S, Bonaros N, Brida M, Burri H, et al. 2023 ESC Guidelines for the management of endocarditis. Eur Heart J. 2023.Ojha N, Dhamoon AS. Fungal Endocarditis. StatPearls. 2023.Nakagawa N. Infective Endocarditis in Congenital Heart Disease. In: Endocarditis - Diagnosis and Treatment. IntechOpen; 2022.Moreno AR, Sánchez MA, Domínguez JCC, Rubio JRS, Vallés Belsué F, Calvo FT. Endocarditis por hongos en pacientes no adictos a drogas por vía parenteral. Nuestra experiencia en 10 años. Rev Española Cardiol. 2000;53(4):507-510.Keynan Y, Rubinstein E. Pathophysiology of infective endocarditis. Curr Infect Dis Rep. 2013;15(4):342-346.Alvarado Rubio E, Brugada Molina R, Alvarado Ávila E, González Mora A, González López A. Infective Endocarditis: Inflammatory Response, Genetic Susceptibility, Oxidative Stress, and Multiple Organ Failure. In: Infective Endocarditis. IntechOpen. 2019.R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. URL https://www.Rproject. org/.ten Hove D, Slart RHJA, Sinha B, Glaudemans AWJM, Budde RPJ. 18F-FDG PET/CT in Infective Endocarditis: Indications and Approaches for Standardization. Curr Cardiol Rep. 2021;23(9):130.Gupta R, Kaushal V, Goyal A, Kumar P, Gupta D, Tandon R, et al. Changing microbiological profile and antimicrobial susceptibility of the isolates obtained from patients with infective endocarditis – The time to relook into the therapeutic guidelines. Indian Heart J. 2021;73(6):704-710.Perek S, Nussinovitch U, Sagi N, Gidron Y, Raz- Pasteur A. Prognostic implications of ultra-short heart rate variability indices in hospitalized patients with infective endocarditis. Tekleab AM, editor. PLoS One. 2023;18(6):e0287607.Liesman RM, Pritt BS, Maleszewski JJ, Patel R. Laboratory Diagnosis of Infective Endocarditis. Kraft CS, editor. J Clin Microbiol. 2017;55(9):2599-2608.McDonald JR. Acute Infective Endocarditis. Infect Dis Clin North Am. 2009;23(3):643-664.Lagier J-C, Letranchant L, Selton-Suty C, Nloga J, Aissa N, Alauzet C, et al. Staphylococcus aureus bacteremia and endocarditis. Ann Cardiol Angeiol (Paris). 2008;57(2):71-77.Petti CA, Fowler VG. Staphylococcus aureus bacteremia and endocarditis. Cardiol Clin. 2003;21(2):219-233, vii.Khalid N, Shlofmitz E, Ahmad SA. Aortic Valve Endocarditis. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26341945Murray RJ. Staphylococcus aureus infective endocarditis: Diagnosis and management guidelines. Intern Med J. 2005;35(Suppl 2):S25-S44.Correction to Comparative effectiveness of β-lactams for empirical treatment of methicillinsusceptible Staphylococcus aureus bacteremia: a prospective cohort study. J Antimicrob Chemother. 2023;78(7):1811.Chopra T, Kaatz GW. Treatment strategies for infective endocarditis. Expert Opin Pharmacother. 2010;11(3):345-360.Ioannou P. Special Issue “Infective Endocarditis: What Is New in the Clinical Research?”. J Clin Med. 2023;12(15).Keynan Y, Singal R, Kumar K, Arora RC, Rubinstein E. Infective endocarditis in the intensive care unit. Crit Care Clin. 2013;29(4):923-951.Sede BarranquillaEspecialización en Medicina InternaORIGINALPDF.pdfPDF.pdfapplication/pdf268928https://bonga.unisimon.edu.co/bitstreams/2b084592-932b-4ef1-942f-df0ff0629bea/download5a4f15e134197838283d1364cb77248eMD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8805https://bonga.unisimon.edu.co/bitstreams/c80b0803-7797-4e65-8a48-d3f4a7e983d2/download4460e5956bc1d1639be9ae6146a50347MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8381https://bonga.unisimon.edu.co/bitstreams/a8a79f29-f2de-47bc-aeb6-04c640af8f68/download733bec43a0bf5ade4d97db708e29b185MD53TEXTInfective Endocarditis in the Colombian Caribbean Region Clinical Profile, Microbiological Insights, and Risk Factors for Mortality.pdf.txtInfective Endocarditis in the Colombian Caribbean Region Clinical Profile, Microbiological Insights, and Risk Factors for Mortality.pdf.txtExtracted texttext/plain30585https://bonga.unisimon.edu.co/bitstreams/07b79968-96b3-4483-a0db-df1ed9ff3b77/download46cd4e292cca26f3d846859fe82d30faMD54PDF.txtPDF.txtExtracted texttext/plain30585https://bonga.unisimon.edu.co/bitstreams/eed0d72a-07cd-4028-8224-d0465e84dd5b/download46cd4e292cca26f3d846859fe82d30faMD56PDF.pdf.txtPDF.pdf.txtExtracted texttext/plain30585https://bonga.unisimon.edu.co/bitstreams/842096f6-f34c-48e0-957a-9731589ca16d/download46cd4e292cca26f3d846859fe82d30faMD58THUMBNAILInfective Endocarditis in the Colombian Caribbean Region Clinical Profile, Microbiological Insights, and Risk Factors for Mortality.pdf.jpgInfective Endocarditis in the Colombian Caribbean Region Clinical Profile, Microbiological Insights, and Risk Factors for Mortality.pdf.jpgGenerated Thumbnailimage/jpeg5261https://bonga.unisimon.edu.co/bitstreams/ccb854f0-122e-4e0f-8ba5-4656de3c905c/downloadcf5f5a15ee52b7f555fc53199c13ceb6MD55PDF.jpgPDF.jpgGenerated Thumbnailimage/jpeg5261https://bonga.unisimon.edu.co/bitstreams/feabe941-e9ca-4ef7-9dc9-710e884608e5/downloadcf5f5a15ee52b7f555fc53199c13ceb6MD57PDF.pdf.jpgPDF.pdf.jpgGenerated Thumbnailimage/jpeg5261https://bonga.unisimon.edu.co/bitstreams/4dec7662-ee84-4d5f-81f0-80143458d56d/downloadcf5f5a15ee52b7f555fc53199c13ceb6MD5920.500.12442/13782oai:bonga.unisimon.edu.co:20.500.12442/137822024-08-14 21:52:10.359http://creativecommons.org/licenses/by-nc-nd/4.0/Attribution-NonCommercial-NoDerivatives 4.0 Internacionalrestrictedhttps://bonga.unisimon.edu.coRepositorio Digital Universidad Simón Bolívarrepositorio.digital@unisimon.edu.coPGEgcmVsPSJsaWNlbnNlIiBocmVmPSJodHRwOi8vY3JlYXRpdmVjb21tb25zLm9yZy9saWNlbnNlcy9ieS1uYy80LjAvIj48aW1nIGFsdD0iTGljZW5jaWEgQ3JlYXRpdmUgQ29tbW9ucyIgc3R5bGU9ImJvcmRlci13aWR0aDowO3dpZHRoOjEwMHB4OyIgc3JjPSJodHRwczovL2kuY3JlYXRpdmVjb21tb25zLm9yZy9sL2J5LW5jLzQuMC84OHgzMS5wbmciIC8+PC9hPjxici8+RXN0YSBvYnJhIGVzdMOhIGJham8gdW5hIDxhIHJlbD0ibGljZW5zZSIgaHJlZj0iaHR0cDovL2NyZWF0aXZlY29tbW9ucy5vcmcvbGljZW5zZXMvYnktbmMvNC4wLyI+TGljZW5jaWEgQ3JlYXRpdmUgQ29tbW9ucyBBdHJpYnVjacOzbi1Ob0NvbWVyY2lhbCA0LjAgSW50ZXJuYWNpb25hbDwvYT4u