Microbiological spectrum of pathogens in nosocomial forms of infective endocarditis
Nosocomial infective endocarditis (IE) is an important public health problem and rates according to the literature 10–34% of all cases of IE. This disease is associated with nosocomial infection and accompanied by a high mortality rate when compared with community-acquired IE.
Objective. To study the influence of nosocomial factor on microbiological spectrum of infective endocarditis.
Materials and methods. Clinical data of 116 patients with infective endocarditis, who passed examination and treatment in SE “Amosov National Institute of Cardio-Vascular surgery of the Academy of Medical Sciences of Ukraine” from January 2014 to December 2016, were enrolled. Bacteriological blood tests were performed in all 116 patients with infective endocarditis.
Results. The incidence of nosocomial forms of infective endocarditis was 26.7% (31 case). In cases of hospital-acquired forms of IE Enterococcus spp was more prevalent – 13 (48.1%) cases, when compared with Staphylococcus spp. – 12 (18.5%) patients (p=0.018). The presence of Enterococcus spp. in blood cultures was associated with more frequent of registration of the mycelium of fungi in the intraoperative material – 12 (44%) patients (p=0.008). In cases of hospital-acquired IE fungal flora was identificated almost 2 times more often compared with community-acquired IE (p=0.019).
Conclusion. High frequency of simultaneous registration of enterococci combination with fungal flora points out to the need for timely administration of fungicidal drugs in patients with nosocomial forms of infective endocarditis.
2. Sy R. W., Kritharides L. Health care exposure and age in infective endocarditis: results of a contemporary population-based profile of 1536 patients in Australia // Eur Heart J. – 2010. – Vol. 31 (15). – P. 1890–1897.
3. Health care-associated native valve endocarditis: importance of non-nosocomial acquisition / Benito N., Miro J. M., de Lazzari E. et al. // Ann Intern Med. – 2009. – Vol. 150 (9). – P. 586–594.
4. Infective endocarditis: a prospective study atthe end of the twentieth century-new predisposing conditions, newetiologic agents, and still a high mortality / Bouza E., Menasalvas A., Munoz P. et al. // Medicine (Baltimore). – 2001. – Vol. 80 (5). – P. 298–307.
5. Evaluation of epidemiological, clinical, and microbiological features of definite infective endocarditis / Faraji R., Behjati-Ardakani M., Moshtaghioun S. M. et al. // GMS Hyg Infect Control. – 2017. – Vol. 12. – P. 772–779.
6. Kritharides L. Development and validation of a time-dependent risk model for predicting mortality in infective endocarditis / Sy R. W., Chawantanpipat C., Richmond D. R. et al. // Eur Heart J. – 2011. – Vol. 32. – P. 2016–2026.
7. Non-nosocomial healthcare-associated infective endocarditis in Taiwan: an underrecognized disease with poor outcome / Wu K. S., Lee S. S., Tsai H. C. et al. // BMC Infect Dis. – 2011. – Vol. 11. – P. 221.
8. Analysis of the impact of early surgery on in-hospital mortality of native valve endocarditis: use of propensity score and instrumental variable methods to adjust for treatment-selection bias / Lalani T., Cabell C. H., Benjamin D. K. et al. // Circulation. – 2010. – Vol. 121. – P. 1005–1013.
9. Risk factors for in-hospital mortality during infective endocarditis in patients with congenital heart disease / Yoshinaga M., Niwa K., Niwa A. et al. // Am J Cardiol. – 2008. – Vol. 101. – P. 114–118. Microbiological spectrum of pathogens i
10. Infective endocarditis in congenital heart disease: a frequent community-acquired complication / Fortun J., Centella T., Martin-Davila P. et al. // Infection. – 2013. – Vol. 41. – P. 167–174.
11. Changing profile of infective endocarditis: aclinicopathologic study of 220 patients in a single medical center from 1998 through2009 / Li L., Wang H., Wang L. et al. // Tex Heart Inst J. – 2014. – Vol. 41. – P. 491–498.
12. Underlying heart disease and microbiological spectrum ofadult infective endocarditis in one Chinese university hospital: a 10-year retrospective study / Ma X. Z., Li X. Y., Que C. L. et al. // Intern Med J. – 2013. – Vol. 43. – P. 1303–1309.