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TropicalMed
Special Issues
Clinical Presentation, Management and Treatment of Infective Endocarditis
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Clinical Presentation, Management and Treatment of Infective Endocarditis

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (4 March 2024) | Viewed by 6988

Special Issue Editors

Dr. Cristiane C. Lamas

E-Mail Website
Guest Editor
1. Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil
2. Instituto Nacional de Infectologia Evandro Chagas (INI), Rio de Janeiro 21040-900, Brazil
Interests: blood culture negative endocarditis; fungal endocarditis; HIV/AIDS; systemic mycosis; parasitic diseases; arboviral diseases; COVID-19
Prof. Dr. Emanuele Durante-Mangoni

E-Mail Website
Guest Editor
1. Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio, 7, 80138 Napoli, Italy
2. AORN Ospedali dei Colli—Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
Interests: infective endocarditis and cardiovascular infections; infections due to multidrug resistant organisms; infections and metabolic complications in organ transplant recipients; viral hepatitis B and C

Special Issue Information

Dear Colleagues,

Infective endocarditis is a serious entity, and its incidence is growing over the years. This is due to aging of populations, exposure to healthcare with the growing implantation of cardiac devices, and, for a large proportion of low- and middle-income countries, ongoing cases of rheumatic fever and consequent valvopathy as well as uncorrected congenital heart disease. It is primarily caused by bacteria, but fungi, especially Candida and, in some areas of the globe, Aspergillus, have been implicated. The incidence of blood culture negative endocarditis varies, and BCNE is a troublesome entity, as treatment becomes hazardous, and outcomes may be worse. Metagenomics has a role to play in this scenario which is worth discussing. Radiological diagnosis of endocarditis and its embolic complications have made a large contribution and its influence continues to expand. Valve replacement surgery is lifesaving in left-sided endocarditis, but its timing and indications are still debated. There are limited options in the antimicrobial treatment of endocarditis, and its duration is debated. The prevention of endocarditis is crucial, as is patient and professional education in this respect. In this Special Issue, we will address endocarditis in its many challenging and fascinating features. We invite submissions from infectious diseases physicians, cardiologists, radiologists, epidemiologists, cardiac surgeons, and other healthcare professionals who have a special interest in endocarditis to contribute with comprehensive or systematic reviews and original articles. Articles are submitted for peer-review and are subject to processing charges.

Dr. Cristiane C. Lamas
Prof. Dr. Emanuele Durante-Mangoni
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. Tropical Medicine and Infectious Disease 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
  • blood culture negative endocarditis
  • fungal endocarditis
  • microbiological diagnosis, metagenomics
  • prosthetic valve endocarditis
  • cardiac devices
  • radiological diagnosis of endocarditis and its complications
  • endocarditis treatment
  • cardiac surgery
  • endocarditis in special populations: the elderly
  • pregnancy and hemodialysis patients
  • intravenous drug users, children

Published Papers (5 papers)

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14 pages, 270 KiB  
Article
Impact of the SARS-CoV-2 Pandemic on the Management and Prognosis of Infective Endocarditis
by Lucie Ailhaud, Robinson Gravier-Dumonceau, Florent Arregle, Sandrine Hubert, Jean-Paul Casalta, Alberto Riberi, Laetitia Tessonnier, Roch Giorgi, Gilbert Habib and Frédérique Gouriet
Trop. Med. Infect. Dis. 2024, 9(4), 86; https://doi.org/10.3390/tropicalmed9040086 - 17 Apr 2024
Viewed by 416
Abstract
Background: Infective endocarditis (IE) is a serious condition which is difficult to diagnose and to treat, both medically and surgically. Objectives: The objective of this study was to evaluate the impact of the SARS-CoV-2 pandemic on the management of patients with IE. Methods: [...] Read more.
Background: Infective endocarditis (IE) is a serious condition which is difficult to diagnose and to treat, both medically and surgically. Objectives: The objective of this study was to evaluate the impact of the SARS-CoV-2 pandemic on the management of patients with IE. Methods: We conducted a single-centre retrospective study including patients hospitalized for IE during the pandemic (Group 2) compared with the same period the year before (Group 1). We compared clinical, laboratory, imagery, therapeutic, and patient outcomes between the two groups. Results: A total of 283 patients were managed for possible or definite IE (164 in Group 1 and 119 in Group 2). There were more intravenous drug-related IE patients in Group 2 (p = 0.009). There was no significant difference in surgery including intra-cardiac device extraction (p = 0.412) or time to surgery (p = 0.894). The one-year mortality was similar in both groups (16% versus 17.7%, p = 0.704). The recurrence rate was not significantly different between the two groups (5.9% in Group 2 versus 9.1% in Group 1, p = 0.311). Conclusions: The SARS-CoV-2 pandemic did not appear to have had a negative impact on the management of patients with IE. Maintenance of the activities of the endocarditis team within the referral centre probably contributed to this result. Nevertheless, the high proportion of intravenous drug-addicted patients in the pandemic cohort suggests that the SARS-CoV-2 pandemic had a major psychosocial impact. Full article
(This article belongs to the Special Issue Clinical Presentation, Management and Treatment of Infective Endocarditis)
10 pages, 418 KiB  
Article
The Predictive Value of Sepsis Scores for In-Hospital Mortality in Patients with Left-Sided Infective Endocarditis
by Bianca Leal de Almeida, Tania Mara Varejao Strabelli, Marcio Sommer Bittencourt, Vítor Falcão de Oliveira, Danielle Menosi Gualandro, Alfredo Jose Mansur, Flavio Tarasouchi, Lucas Pocebon, Milena Paixão, Flora Goldemberg, Reinaldo Salomão and Rinaldo Focaccia Siciliano
Trop. Med. Infect. Dis. 2024, 9(1), 23; https://doi.org/10.3390/tropicalmed9010023 - 16 Jan 2024
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Abstract
Background: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores [...] Read more.
Background: As infective endocarditis has particular characteristics compared to other infectious diseases, it is not clear if sepsis scores are reported with good accuracy in these patients. The aim of this study is to evaluate the accuracy of the qSOFA and SOFA scores to predict mortality in patients with infective endocarditis. Methods: Between January 2010 and June 2019, 867 patients with suspected left-sided endocarditis were evaluated; 517 were included with left-sided infective endocarditis defined as “possible” or “definite” endocarditis, according to the Modified Duke Criteria. ROC curves were constructed to assess the accuracy of qSOFA and SOFA sepsis scores for the prediction of in-hospital mortality. Results: The median age was 57 years, 65% were male, 435 (84%) had pre-existing heart valve disease, and the overall mortality was 28%. The most frequent etiologies were Streptococcus spp. (36%), Enterococcus spp. (10%), and Staphylococcus aureus (9%). The sepsis scores from the ROC curves used to predict in-hospital mortality were qSOFA 0.601 (CI95% 0.522–0.681) and SOFA score 0.679 (CI95% 0.602–0.756). A sub-group analysis in patients with and without pre-existing valve disease for SOFA ≥ 2 showed ROC curves of 0.627 (CI95% 0.563–0.690) and 0.775 (CI95% 0.594–0.956), respectively. Conclusions: qSOFA and SOFA scores were associated with increased in-hospital mortality in patients with infective endocarditis. However, as accuracy was relatively lower compared to other sites of bacterial infections, we believe that this score may have lower accuracy when predicting the prognosis of patients with IE, because, in this disease, the patient’s death may be more frequently linked to valvular and cardiac dysfunction, as well as embolic events, and less frequently directly associated with sepsis. Full article
(This article belongs to the Special Issue Clinical Presentation, Management and Treatment of Infective Endocarditis)
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11 pages, 769 KiB  
Article
Trends of Infective Endocarditis at Two Teaching Hospitals: A 12-Year Retrospective Cohort Study in Rio de Janeiro, Brazil
by Paulo Vieira Damasco, Victor Edgar Fiestas Solórzano, Natália Rodrigues Querido Fortes, Daniel Xavier de Brito Setta, Aloysio Guimaraes da Fonseca, Mario Castro Alvarez Perez, João Carlos Jazbick, Jonathan Gonçalves-Oliveira, Marco Aurélio Pereira Horta, Elba Regina Sampaio de Lemos and Claudio Querido Fortes
Trop. Med. Infect. Dis. 2023, 8(12), 516; https://doi.org/10.3390/tropicalmed8120516 - 12 Dec 2023
Viewed by 1343
Abstract
Background: Despite advances in diagnosis and treatment, the incidence and mortality of infective endocarditis (IE) have increased in recent decades. Studies on the risk factors for mortality in endocarditis in Latin America are scarce. Methods: This retrospective cohort study included 240 patients diagnosed [...] Read more.
Background: Despite advances in diagnosis and treatment, the incidence and mortality of infective endocarditis (IE) have increased in recent decades. Studies on the risk factors for mortality in endocarditis in Latin America are scarce. Methods: This retrospective cohort study included 240 patients diagnosed with IE according to the modified Duke criteria who were admitted to two university hospitals in Rio de Janeiro, Brazil from January 2009 to June 2021. Poisson regression analysis was performed for trend tests. The multivariate Cox proportional hazards model was used to estimate the hazard ratio (HR) of predictors of in-hospital mortality. Findings: The median age was 55 years (IQR: 39–66 years), 57% were male, and 41% had a Charlson comorbidity index (CCI) score > 3. Healthcare-associated infective endocarditis (54%), left-sided native valve IE (77.5%), and staphylococcal IE (26%) predominated. Overall, in-hospital mortality was 45.8%, and mortality was significantly higher in the following patients: aged ≥ 60 years (53%), CCI score ≥ 3 (60%), healthcare-associated infective endocarditis (HAIE) (53%), left-sided IE (51%), and enterococcal IE (67%). Poisson regression analysis showed no trend in in-hospital mortality per year. The adjusted multivariate model determined that age ≥ 60 years was an independent risk factor for in-hospital mortality (HR = 1.9; 95% CI 1.2–3.1; p = 0.008). Interpretation: In this 12-year retrospective cohort, there was no evidence of an improvement in survival in patients with IE. Since older age is a risk factor for mortality, consensus is needed for the management of IE in this group of patients. Full article
(This article belongs to the Special Issue Clinical Presentation, Management and Treatment of Infective Endocarditis)
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11 pages, 305 KiB  
Article
Infective Endocarditis due to Non-HACEK Gram-Negative Bacilli: Clinical Characteristics and Risk Factors from a Prospective Multicenter Brazilian Cohort
by Leonardo Paiva de Sousa, Cláudio Querido Fortes, Paulo Vieira Damasco, Giovanna Ianini Ferraiuoli Barbosa, Wilma Felix Golebiovski, Clara Weksler, Rafael Quaresma Garrido, Rinaldo Focaccia Siciliano and Cristiane da Cruz Lamas
Trop. Med. Infect. Dis. 2023, 8(5), 283; https://doi.org/10.3390/tropicalmed8050283 - 17 May 2023
Cited by 1 | Viewed by 1430
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Clinical Presentation, Management and Treatment of Infective Endocarditis)

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10 pages, 1333 KiB  
Case Report
Endocarditis with Streptococcus pseudoporcinus Associated with Mastocytosis and Spondylodiscitis—A Coincidental Association? A Case Report
by Victoria Birlutiu, Rares-Mircea Birlutiu, Minodora Teodoru, Alina Camelia Catana and Cristian Ioan Stoica
Trop. Med. Infect. Dis. 2023, 8(5), 247; https://doi.org/10.3390/tropicalmed8050247 - 25 Apr 2023
Cited by 1 | Viewed by 1411
Abstract
Streptococcus pseudoporcinus is a nonmotile Gram-positive, catalase, and benzidine negative, arranged in short chains, isolated from the genitourinary tract group B Streptococcus. S. pseudoporcinus was also identified from blood, urine, skin, cervical area, wounds, rectum, and placenta samples. Two cases of infective endocarditis [...] Read more.
Streptococcus pseudoporcinus is a nonmotile Gram-positive, catalase, and benzidine negative, arranged in short chains, isolated from the genitourinary tract group B Streptococcus. S. pseudoporcinus was also identified from blood, urine, skin, cervical area, wounds, rectum, and placenta samples. Two cases of infective endocarditis have been reported in the literature. Based on these data, the identification of a case of S. pseudoporcinus infective endocarditis associated with spondylodiscitis in a patient with undiagnosed systemic mastocytosis until the age of 63 years is unusual. Two sets of blood specimens were collected, and both sets were positive for S. pseudoporcinus. Transesophageal echocardiography revealed, multiple vegetations on the mitral valve. A lumbar spine MRI revealed L5-S1 spondylodiscitis that associates prevertebral and right paramedian epidural abscesses with compressive stenosis. The performed bone marrow biopsy, and cellularity examination revealed 5–10% mast cells in the areas of medullary tissue, an aspect that is suggestive of mastocytosis. Antibiotic therapy was initiated, under which the patient presented intermittent fever. A second transesophageal echocardiography revealed a mitral valve abscess. A mitral valve replacement with a mechanical heart valve device through a minimally invasive approach was performed, with a favorable evolution under treatment. S. pseudoporcinus can be responsible for infectious endocarditis in certain immunodepressed cases, but also in a profibrotic, proatherogenic field, as shown by the association with mastocytosis in the presented case. Full article
(This article belongs to the Special Issue Clinical Presentation, Management and Treatment of Infective Endocarditis)
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