Author | Sousa, Leonardo Paiva de | |
Author | Fortes, Cláudio Querido | |
Author | Damasco, Paulo Vieira | |
Author | Barbosa, Giovanna Ianini Ferraiuoli | |
Author | Golebiovski, Wilma Felix | |
Author | Weksler, Clara | |
Author | Garrido, Rafael Quaresma | |
Author | Siciliano, Rinaldo Focaccia | |
Author | Lamas, Cristiane da Cruz | |
Access date | 2023-08-26T15:44:35Z | |
Available date | 2023-08-26T15:44:35Z | |
Document date | 2023 | |
Citation | SOUSA, Leonardo Paiva de et al. Infective Endocarditis due to Non-HACEK Gram-Negative Bacilli: Clinical Characteristics and Risk Factors from a Prospective Multicenter Brazilian Cohort. Tropical Medicine and Infectious Disease, v. 8, n. 5, p. 1-11, May 2023. | en_US |
ISSN | 2414-6366 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/60238 | |
Description | Institutional Review Board Statement: The study was approved by each of the local Ethics Committee complying with ethical standards (No. 080/2005). Informed Consent Statement: Informed consent was obtained for all patients on their prospective inclusion in each site. Data Availability Statement: Data generated or analyzed in this study have not been made available due to confidentiality issues. Acknowledgments: We thank Bruce Macrae for language revision. We thank all medical colleagues and hospital staff for their care of patients, and we especially thank Francisca Pereira Ribeiro, from the Microbiology Lab at INC, for the laboratory support. We thank Marcelo Goulart Correia for statistical assistance. | en_US |
Sponsorship | C.d.C.L. received from Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) the grant Jovem Cientista do Nosso Estado (number # E26/202.782/2015). Funding was also provided by Fundação Pró Coração (FUNDACOR), for article processing charges and for the sustainace of Mestrado Profissional em Ciências Cardiovasculares, Instituto Nacional de Cardiologia, Rio de Janeiro. | en_US |
Language | eng | en_US |
Publisher | MDPI | en_US |
Rights | open access | en_US |
Title | Infective Endocarditis due to Non-HACEK Gram-Negative Bacilli: Clinical Characteristics and Risk Factors from a Prospective Multicenter Brazilian Cohort | en_US |
Type | Article | en_US |
DOI | 10.3390/tropicalmed8050283 | |
Abstract | Background: Non-HACEK Gram-negative bacilli (NGNB) infective endocarditis (IE) has a growing frequency. We aimed to describe cases of NGNB IE and find associated risk factors. Methods: We conducted a prospective observational study of consecutive patients with definitive IE according to the modified Duke criteria in four institutions in Brazil. Results: Of 1154 adult patients enrolled, 38 (3.29%) had IE due to NGNB. Median age was 57 years, males predominated, accounting for 25/38 (65.8%). Most common etiologies were Pseudomonas aeruginosa and Klebsiella spp. (8 episodes, 21% each). Worsening heart failure occurred in 18/38 (47.4%). Higher prevalence of embolic events was found (55,3%), mostly to the central nervous system 7/38 (18.4%). Vegetations were most commonly on aortic valves 17/38 (44.7%). Recent healthcare exposure was found in 52.6% and a central venous catheter (CVC) in 13/38 (34.2%). Overall mortality was 19/38 (50%). Indwelling CVC (OR 5.93; 95% CI, 1.29 to 27.3; p = 0.017), hemodialysis (OR 16.2; 95% CI, 1.78 to 147; p = 0.008) and chronic kidney disease (OR 4.8; 95% IC, 1.2 to 19.1, p = 0.049) were identified as risk factors for mortality. Conclusions: The rate of IE due to NGNB was similar to that in previous studies. Enterobacterales and P. aeruginosa were the most common etiologies. NGNB IE was associated with central venous catheters, prosthetic valves, intracardiac devices and hemodialysis and had a high mortality rate. | en_US |
Affilliation | Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Universidade Federal do Rio de Janeiro. Serviço de Doenças Infecciosas e Parasitárias. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Universidade do Estado do Rio de Janeiro. Serviço de Doenças Infecciosas e Parasitárias. Rio de Janeiro, RJ, Brazil / Universidade Federal do Estado do Rio de Janeiro. Departamento de Doenças Infecciosas. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brazil / Universidade do Estado do Rio de Janeiro. Serviço de Doenças Infecciosas e Parasitárias. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brazil. | en_US |
Affilliation | Universidade de São Paulo. Instituto do Coração (InCor). São Paulo, SP, Brazil. | en_US |
Affilliation | Instituto Nacional de Cardiologia. Rio de Janeiro, RJ, Brazil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil. | en_US |
Subject | Central venous catheter | en_US |
Subject | Gram-negative bacilli | en_US |
Subject | Healthcare-associated infection | en_US |
Subject | Hemodialysis | en_US |
Subject | Infective endocarditis | en_US |
Subject | Intracardiac devices | en_US |
Subject | Non-HACEK | en_US |
Subject | Prosthesis | en_US |
e-ISSN | 2414-6366 | |