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Microorganisms
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The Infective Endocarditis
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The Infective Endocarditis

A special issue of Microorganisms (ISSN 2076-2607). This special issue belongs to the section "Medical Microbiology".

Deadline for manuscript submissions: 31 July 2024 | Viewed by 3615

Special Issue Editors

Prof. Dr. Jose M. Miro

E-Mail Website
Guest Editor
1. Infectious Diseases Service, Hospital Clínic—IDIBAPS, University of Barcelona, Barcelona, Spain
2. CIBERINFEC Investigator, Instituto de Salud Carlos III, Madrid, Spain
Interests: infective endocarditis
Dr. Guillermo Cuervo

E-Mail Website
Guest Editor
Senior Specialist of Infectious Diseases, Hospital Clinic of Barcelona, Barcelona, Spain
Interests: infective endocarditis

Special Issue Information

Dear Colleagues,

Cardiovascular infections are life-threatening diseases with high morbidity and mortality, despite the advances in diagnosis, antimicrobial therapy and the role of cardiac surgery. Infective endocarditis (IE) is the most severe cardiovascular infection and is a constantly changing disease. In the next 10 years, IE will increase in the elderly population and patients with intracardiac devices (prosthetic valves, cardiac implantable electronic devices and TAVI) and in persons who inject drugs (PWID).  Improving strategies of prevention in the community and in hospitals (bacteremia-zero protocols) is key for avoiding IE. The endocarditis team (IE Team) plays an important role in improving patients’ diagnoses and outcomes. Diagnoses will be faster and more accurate with the new molecular biology and nuclear medicine tools and neurological complications will be reduced with mechanical thrombectomy. Staphylococcal and enterococcal infections are the leading IE etiologies. Antibiotic treatment schema will change the initial IV induction phase followed by oral antibiotic consolidation. Surgery plays an important role in the curation of these infections, as it is needed in around 50% of cases. The new aims in the surgical field include improving indications and timing. Machine learning and AI can help us to achieve some of these goals. As stated before, IE remains a disease of high morbidity and mortality, with far-reaching effects on the quality of life of survivors. In addition, vascular graft infections and LVAD infections are increasing and their management is challenging.

For this Special Issue, we invite you to submit contributions on infective endocarditis and cardiovascular infections, including experimental models, epidemiology, genetic susceptibility, infection mechanisms, staphylococcal and enterococcal endocarditis, endocarditis in the elderly, in people with CIED and prosthetic valves and TAVI and in PWID and novel medical and surgical treatment strategies, vascular graft infections and LVAD infections.

Prof. Dr. Jose M. Miro
Dr. Guillermo Cuervo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Microorganisms is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • infective endocarditis (IE)
  • native valve endocarditis
  • TAVI endocarditis
  • prosthetic valve endocarditis
  • staphylococcal endocarditis
  • enterococcal endocarditis
  • molecular biology diagnosis
  • cardiac PET/CT diagnosis
  • vascular graft infections
  • LVAD infections
  • endocarditis in the elderly
  • endocarditis in PWID
  • oral antimicrobial treatment of IE
  • cardiac surgery of IE
  • cardiovascular infections
  • cardiac implantable electronic device (CIED)-IE

Published Papers (4 papers)

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Research

12 pages, 2693 KiB  
Article
Clinical Profile and Prognosis of Patients with Left-Sided Infective Endocarditis with Surgical Indication Who Are Not Operated
by María de Miguel, Javier López, Isidre Vilacosta, Carmen Olmos, Carmen Sáez, Gonzalo Cabezón, Pablo Zulet, Adrián Jerónimo, Daniel Gómez, Paloma Pulido, Adrián Lozano, Andrea Oña, Itziar Gómez-Salvador and J. Alberto San Román
Microorganisms 2024, 12(3), 607; https://doi.org/10.3390/microorganisms12030607 - 19 Mar 2024
Viewed by 599
Abstract
Approximately a quarter of patients with infective endocarditis (IE) who have surgical indication only receive antibiotic treatment. Their short-term prognosis is dismal. We aimed to describe the characteristics of this group of patients to evaluate the mortality according to the cause of rejection [...] Read more.
Approximately a quarter of patients with infective endocarditis (IE) who have surgical indication only receive antibiotic treatment. Their short-term prognosis is dismal. We aimed to describe the characteristics of this group of patients to evaluate the mortality according to the cause of rejection and type of surgical indication and to analyze their prognostic factors of mortality. From 2005 to 2022, 1105 patients with definite left-sided IE were consecutively attended in three tertiary hospitals. Of them, 912 (82.5%) had formal surgical indication according to the most recent European Guidelines available in each period of the study and 303 (33%) only received medical treatment. These were older, had more comorbidities and higher in-hospital (46% vs. 24%; p < 0.001) and one year mortality (57.1% vs. 27.6%; p < 0.001) than operated patients. The main reason for surgical rejection was high surgical risk (57.1%) and the highest mortality when the cause were severe neurological conditions (76%). When the endocarditis team took the decision not to operate (25.5% of the patients), in-hospital (7%) and one-year mortality (17%) were low. In-hospital mortality associated with each surgical indication was 67% in heart failure, 53% in uncontrolled infection and 45% in prevention of embolisms (p < 0.001). Heart failure (OR: 2.26 CI95%: 1.29–3.96; p = 0.005), Staphylococcus aureus (OR: 3.17; CI95%: 1.72–5.86; p < 0.001) and persistent infection (OR: 5.07 CI95%: 2.85–9.03) are the independent risk factors of in-hospital mortality. One third of the patients with left-sided IE and formal surgical indication are rejected for surgery. In-hospital mortality is very high, especially when heart failure is the indication for surgery and when severe neurological conditions the reason for rejection. Short term prognosis of patients rejected by a specialized endocarditis team is favorable. Full article
(This article belongs to the Special Issue The Infective Endocarditis)
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18 pages, 841 KiB  
Article
Mortality and Costs of Cardiac Implantable Electronic Device (CIED) Infections According to the Therapeutic Approach: A Single-Center Cohort Study
by Encarnación Gutiérrez-Carretero, Eduardo Arana-Rueda, Antonio Ortiz-Carrellán, Alonso Pedrote-Martínez, Mariano García-de-la-Borbolla and Arístides De Alarcón
Microorganisms 2024, 12(3), 537; https://doi.org/10.3390/microorganisms12030537 - 07 Mar 2024
Viewed by 633
Abstract
Background: Cardiac device infections are serious adverse events associated with considerable morbidity and mortality, significant costs, and increased healthcare utilization. The aim of this study is to calculate the costs of treatment of cardiac implantable electrostimulation device (CIED)-related infections for different types of [...] Read more.
Background: Cardiac device infections are serious adverse events associated with considerable morbidity and mortality, significant costs, and increased healthcare utilization. The aim of this study is to calculate the costs of treatment of cardiac implantable electrostimulation device (CIED)-related infections for different types of infection (local or systemic) and therapeutic approaches. Patients and Methods: Single-center cohort (1985–2018). The costs of the CIED-related infections were analyzed according to initial treatment (antimicrobial treatment exclusively, local approach, or transvenous lead extraction (TLE)). Total costs (including those for hospitalization stay, drugs, extraction material, and newly implanted devices) were assigned to each case until its final resolution. Results: A total of 380 cases (233 local and 147 systemic infections) were analyzed. The average cost of systemic infection was EUR 34,086, mainly due to hospitalization (78.5%; mean: 24 ± 14 days), with a mortality rate of 10.8%. Local infection had a mortality rate of 2.5% (mainly related to the extraction procedure) and an average cost of EUR 21,790, which was higher in patients with resynchronization therapy devices and defibrillators (46% of total costs). Surgical procedures limited to the pocket for local infections resulted in a high rate of recurrence (87%), evolved to systemic infections in 48 patients, and had a higher cost compared to TLE (EUR 42,978 vs. EUR 24,699; p < 0.01). Conclusions: The costs of treating CIED-related infections are high and mainly related to the type of treatment and length of hospitalization. Complete device removal is always the most effective approach and is a cost-saving strategy. Full article
(This article belongs to the Special Issue The Infective Endocarditis)
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15 pages, 2684 KiB  
Article
Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020
by Peter Laursen Graversen, Lauge Østergaard, Marianne Voldstedlund, Malthe Faurschou Wandall-Holm, Morten Holdgaard Smerup, Lars Køber and Emil Loldrup Fosbøl
Microorganisms 2023, 11(10), 2403; https://doi.org/10.3390/microorganisms11102403 - 26 Sep 2023
Cited by 2 | Viewed by 745
Abstract
Microbiological etiology has been associated with surgery for infective endocarditis (IE) during admission, especially Staphylococcus aureus. We aimed to compare patient characteristics, microbiological characteristics, and outcomes by treatment choice (surgery or not). We identified patients with first-time IE between 2010 and 2020 [...] Read more.
Microbiological etiology has been associated with surgery for infective endocarditis (IE) during admission, especially Staphylococcus aureus. We aimed to compare patient characteristics, microbiological characteristics, and outcomes by treatment choice (surgery or not). We identified patients with first-time IE between 2010 and 2020 and examined the microbiological etiology of IE according to treatment choice. To identify factors associated with surgery during initial admission, we used the Aalen–Johansen estimator and an adjusted cause-specific Cox model. One-year mortality stratified by microbiological etiology and treatment choice was assessed using unadjusted Kaplan–Meier estimates and an adjusted Cox proportional hazard model. A total of 6255 patients were included, of which 1276 (20.4%) underwent surgery during admission. Patients who underwent surgery were younger (65 vs. 74 years) and less frequently had cerebrovascular disease, cardiovascular disease, diabetes, and chronic kidney disease. Patients with Staphylococcus aureus IE were less likely to undergo surgery during admission (13.6%) compared to all other microbiological etiologies. One-year mortality according to microbiological etiology in patients who underwent surgery was 7.0%, 5.3%, 5.5%, 9.6%, 13.2, and 11.2% compared with 24.2%, 19.1%, 27,6%, 25.2%, 21%, and 16.9% in patients who received medical therapy for Staphylococcus aureus, Streptococcus spp., Enterococcus spp., coagulase-negative Staphylococci, “other microbiological etiologies”, and blood culture-negative infective endocarditis, respectively. Patients with IE who underwent surgery differed in terms of microbiology, more often having Streptococci than those who received medical therapy. Contrary to expectations, Staphylococcus aureus was more common among patients who received medical therapy only. Full article
(This article belongs to the Special Issue The Infective Endocarditis)
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11 pages, 1017 KiB  
Article
Does Quality of Life in Survivors of Surgery for Acute Left-Sided Infective Endocarditis Differ from Non-Endocarditis Patients?
by Alejandro Fernández-Cisneros, Aida Andreu, Marta Hernández-Meneses, Jaume Llopis, Elena Sandoval, Daniel Pereda, Jorge Alcocer, Manuel Castellá, Jose M. Miró and Eduard Quintana
Microorganisms 2023, 11(4), 1058; https://doi.org/10.3390/microorganisms11041058 - 18 Apr 2023
Viewed by 962
Abstract
Surgery for left-sided infective endocarditis (IE) has been demonstrated to improve patients’ survival rates but information about quality of life (QoL) after surgery is scarce. The aim of this study was to assess the postoperative outcomes and QoL after surgery for IE patients [...] Read more.
Surgery for left-sided infective endocarditis (IE) has been demonstrated to improve patients’ survival rates but information about quality of life (QoL) after surgery is scarce. The aim of this study was to assess the postoperative outcomes and QoL after surgery for IE patients compared to patients undergoing cardiac surgery for non-IE indications. Adult patients with definite acute left-sided IE were matched 1:1 to patients who underwent cardiac surgery for non-endocarditic purposes from 2014 to 2019. QoL was assessed using the SF-36 survey at the last follow-up. A total of 105 patients were matched. The IE group had higher rates of preoperative stroke (21% vs. 7.6%, p = 0.005) and higher stages of NYHA class (p < 0.001), EuroSCORE II (12.3 vs. 3.0, p < 0.001) and blood cell count abnormalities (p < 0.001). The IE group had higher incidence of low cardiac output syndrome (13.3% vs. 4.8%, p = 0.029), dialysis (10.5% vs 1.0%, p = 0.007) and prolonged mechanical ventilation (16.2% vs. 2.9%, p = 0.002) after surgery. At the last follow-up, subcomponents of the SF-36 QoL survey were not different between the groups. Patients who underwent cardiac surgery for IE demonstrated a higher risk profile with a higher rate of postoperative complications. Once recovered from the acute phase of the disease, the reported QoL at follow-up was comparable to that of matched cardiac patients operated for non-IE purposes. Full article
(This article belongs to the Special Issue The Infective Endocarditis)
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