Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/10412
Title: Infective endocarditis in Rio de Janeiro, Brazil: a 5-year experience at two teaching hospitals
Authors: Damasco, P. V
Ramos, J. N
Correal, J. C. D
Potsch, M. V
Vieira, V. V
Camello, T. C. F
Pereira, M. P
Marques, V. D
Santos, K. R. N
Marques, E. A
Castier, M. B
Hirata Jr., R
Guaraldi, A. L. Mattos
Fortes, C. Q
Affilliation: Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto-HUPE. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Escola de Medicina e Cirurgia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Genética Molecular de Microrganismos. Instituto Nacional de Controle de Qualidade em Saúde, INCQS. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto-HUPE. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Estado do Rio de Janeiro. Escola de Medicina e Cirurgia. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Instituto Nacional de Controle de Qualidade em Saúde (INCQS). Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto-HUPE. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Estado do Rio de Janeiro. Escola de Medicina e Cirurgia. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto-HUPE. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Instituto de Microbiologia Paulo de Góes. Laboratório de Infecção Hospitalar. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Hospital Universitário Pedro Ernesto-HUPE. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Hospital Universitário Pedro Ernesto-HUPE. Rio de Janeiro, RJ, Brasil
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Faculdade de Ciências Médicas. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Faculdade de Medicina. Departamento de Medicina Preventiva. Hospital Clementino Fraga Filho. Rio de Janeiro, RJ, Brasil.
Abstract: INTRODUCTION: Despite the recent advances in diagnosis and treatment, mortality rates due to infective endocarditis (IE) remain high if not aggressively treated with antibiotics, whether or not associated with surgery. Data on the prevalence, epidemiology and etiology of IE from developing countries remain scarce. The aim of this observational, prospective cohort study was to report a 5-year experience of IE at two teaching hospitals in Rio de Janeiro, Brazil. MATERIAL AND METHODS: Demographical, anamnestic and microbiological characteristics of 71 IE patients were evaluated during the period of January 2009 to March 2013. RESULTS: The mean age of the IE patients was 49.8 ± 2.4 years, of which 41 (57.7%) were males. The median time between the onset of symptoms and diagnosis of IE was 35.8 ± 4.8 days. A total of 31 (43.6%) cases of community-acquired infective endocarditis (CAIE) and 40 (56.3%) cases of healthcare-acquired infective endocarditis (HAIE) were observed. Staphylococcus aureus (30%) was the predominant cause of IE. Streptococcus spp. (45.1 %) was the predominant cause of the CAIE while S. aureus (32.5%) and Enterococcus spp. (27.2 %) were the main etiological agents of HAIE. For 64 (90.1 %) patients with native valve endocarditis, the mitral valve was the most commonly affected (48.3%). The main source of IE in this cohort was intravascular catheter. The tricuspid valve and renal chronic insufficiency were more frequent in patients with HAIE than CAIE (p = 0.001). The risk factors associated with in-hospital mortality rate (46.4%) in IE patients were: age over 45 (OR 3.4; 95% CI 1.03-11.24; p = 0.04) and chronic renal insufficiency (OR 38.3; 95% CI 3.2-449.4; p = 0.004). CONCLUSIONS: At two main teaching hospitals in Brazil, Streptococcus spp. was the principal pathogen of CAIE while S. aureus and Enterococcus spp. were the most frequent causes of HAIE. IE remains a serious disease associated with high in-hospital mortality rate (46.6%); especially, in individuals over 45 years of age and with renal failure. Data suggest that early surgery may improve the outcome of IE patients.
Keywords: Infective endocarditis
Healthcare-associated infection
Community-associated infection
Developing countries
DeCS: Endocardite
Países em Desenvolvimento
Infecção
Assistência à Saúde
Issue Date: 2014
Publisher: Springer Link
Citation: DAMASCO, P. V. et al. Infective endocarditis in Rio de Janeiro, Brazil: a 5-year experience at two teaching hospitals. Infection, v.42, n.5, p.335-342, oct. 2014.
DOI: 10.1007/s15010-014-0640-2
ISSN: 1439-0973
Copyright: restricted access
Appears in Collections:INCQS - Artigos de Periódicos
IOC - Artigos de Periódicos

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