Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region

DAVUTOĞLU, Vedat; AKSOY, MEHMET; Sucu, Murat; ÖZER, Orhan

Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region

Murat SUCU, (Gaziantep Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Gaziantep, Türkiye)

Vedat DAVUTOĞLU, (Gaziantep Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Gaziantep, Türkiye)

Orhan ÖZER, (Gaziantep Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Gaziantep, Türkiye)

Mehmet AKSOY (Gaziantep Üniversitesi, Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Gaziantep, Türkiye)

Türk Kardiyoloji Derneği Arşivi

5 1

Yıl: 2010 Cilt: 38 Sayı: 2 Sayfa Aralığı: 107 - 111 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region

Öz:

Amaç: Üçüncü basamak üniversite hastanemizde enfektif endokarditin (EE) epidemiyolojik, klinik ve mikrobiyolojik özelliklerinin belirlenmesi amaçlandı. Çalışma planı: Çalışmada, 2004-2007 yılları arasında, modifiye Duke ölçütlerine göre kesin EE tanısı konan 72 hasta (31 kadın, 41 erkek; ort. yaş 45±16; dağılım 18-80) incelendi. Hastaların, yaş, cinsiyet, altta yatan kalp hastalığı, bakteremiye zemin hazırlayan etkenler, ekokardiyografik ve mikrobiyolojik bulgular, tedavi, komplikasyon ve mortalite ile ilgili bilgileri değerlendirildi. Bulgular: Enfektif endokardit 47 hastada (%65.3) doğal kapakta, 21 hastada (%29.2) mekanik protez kapakta, iki hastada (%2.8) kalp pili üzerinde saptandı. İki hastada (%2.8) enfeksiyonun yeri belirlenemedi. Romatizmal kalp hastalığı (%36.1) en yaygın kapak patolojisiydi. Hem doğal kapaklarda (%43.1) hem de prostatik kapaklarda (%13.9) en sık etkilenen kapak mitral kapak idi. En yaygın semptom ateş (n=60, %83.3) idi. Yirmi dört hastanın (%33.3) elektrokardiyografisinde anormal bulguya rastlandı. Transtorasik ve/veya transözofageal ekokardiyografide 63 olguda (%87.5) vejetasyon, 41 olguda (%56.9) orta-ciddi derecede mitral yetersizliği, 21 olguda (%29.2) aort yetersizliği, 29 olguda (%40.3) triküspit yetersizliği saptandı. Kültürlerde etken mikroorganizma olarak en sık stafilokok (%26.4) ve streptokok (%22.2) üredi; 26 olgunun kültürlerinde (%36.1) üreme olmadı. Yirmi hastaya (%27.8) cerrahi tedavi uygulandı. Ana komplikasyon olarak en sık konjestif kalp yetersizliği (n=23, %31.9) ve serebrovasküler olay (n=10, %13.9) görüldü. Hastane içi ölüm 11 olguda (%15.3) meydana geldi. Sonuç: Bulgularımız Güneydoğu Anadolu Bölgesi’nde üçüncü basamak bir hastanede EE’nin epidemiyolojik, klinik ve mikrobiyolojik özelliklerini yansıtmaktadır.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Güneydoğu Anadolu Bölgesi'nde üçüncü basamak bir hastanede enfektif endokarditin epidemiyolojik, klinik ve mikrobiyolojik özellikleri

Öz:

Objectives: We aimed to evaluate epidemiological, clinical, and microbiological features of infective endocarditis (IE) in a tertiary university hospital. Study design: The study included 72 patients (31 women, 41 men; mean age 45±16 years; range 18 to 80 years) who were diagnosed as having definite IE, according to the modified Duke criteria, between 2004 and 2007. Data were reviewed on age, sex, underlying heart disease, predisposing conditions for bacteremia, echocardiographic and microbiological findings, treatment, complications, and mortality. Results: Infective endocarditis developed on a native valve in 47 (65.3%), a mechanical prosthetic valve in 21 (29.2%), and a pacemaker in two cases. The location of IE could not be determined in two cases (2.8%). Rheumatic heart disease (36.1%) was the most common preexisting valvular abnormality. The mitral valve was the most commonly affected valve in both native valves (43.1%) and prosthetic valves (13.9%). The most frequent symptom was fever (n=60, 83.3%). Electrocardiography showed abnormal findings in 24 cases (33.3%). Transthoracic and/or transesophageal echocardiography showed a vegetation in 63 cases (87.5%), moderate or severe mitral regurgitation in 41 cases (56.9%), aortic regurgitation in 21 cases (29.2%), and tricuspid regurgitation in 29 cases (40.3%). Staphylococci (26.4%) and streptococci (22.2%) were the most common causative agents. Cultures were negative in 26 cases (36.1%). Twenty patients (27.8%) underwent surgical treatment. Congestive heart failure (n=23, 31.9%) and cerebrovascular accidents (n=10, 13.9%) were the major complications. In-hospital mortality occurred in 11 cases (15.3%). Conclusion: Our data reflect epidemiological, clinical, and microbiological profile of IE in a tertiary hospital located in the Southeastern Anatolia.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Durack DT, Lukes AS, Bright DK. New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Duke Endocarditis Service. Am J Med 1994;96:200-9.
2. Ako J, Ikari Y, Hatori M, Hara K, Ouchi Y. Changing spectrum of infective endocarditis: review of 194 episodes over 20 years. Circ J 2003;67:3-7.
3. Houpikian P, Raoult D. Blood culture-negative endocarditis in a reference center: etiologic diagnosis of 348 cases. Medicine 2005;84:162-73.
4. Iung B, Baron G, Tornos P, Gohlke-Bärwolf C, Butchart EG, Vahanian A. Valvular heart disease in the community: a European experience. Curr Probl Cardiol 2007; 32:609-61.
5. Hoen B, Alla F, Selton-Suty C, Béguinot I, Bouvet A, Briançon S, et al. Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA 2002;288:75-81.
6. Loupa C, Mavroidi N, Boutsikakis I, Paniara O, Deligarou O, Manoli H, et al. Infective endocarditis in Greece: a changing profile. Epidemiological, microbiological and therapeutic data. Clin Microbiol Infect 2004;10:556-61.
7. Letaief A, Boughzala E, Kaabia N, Ernez S, Abid F, Ben Chaabane T, et al. Epidemiology of infective endocarditis in Tunisia: a 10-year multicenter retrospective study. Int J Infect Dis 2007;11:430-3.
8. Roca B, Marco JM. Presentation and outcome of infective endocarditis in Spain: a retrospective study. Int J Infect Dis 2007;11:198-203.
9. Gotsman I, Meirovitz A, Meizlish N, Gotsman M, Lotan C, Gilon D. Clinical and echocardiographic predictors of morbidity and mortality in infective endocarditis: the significance of vegetation size. Isr Med Assoc J 2007;9:365 9.
10. Ferreiros E, Nacinovich F, Casabé JH, Modenesi JC, Swieszkowski S, Cortes C, et al. Epidemiologic, clinical, and microbiologic profile of infective endocarditis in Argentina: a national survey. The Endocarditis Infecciosa en la República Argentina-2 (EIRA-2) Study. Am Heart J 2006;151:545-52.
11. Chu J, Wilkins G, Williams M. Review of 65 cases of infective endocarditis in Dunedin Public Hospital. N Z Med J 2004;117:U1021.
12. Schulz R, Werner GS, Fuchs JB, Andreas S, Prange H, Ruschewski W, et al. Clinical outcome and echocardiographic findings of native and prosthetic valve endocarditis in the 1990’s. Eur Heart J 1996;17:281-8.
13. Cabell CH, Jollis JG, Peterson GE, Corey GR, Anderson DJ, Sexton DJ, et al. Changing patient characteristics and the effect on mortality in endocarditis. Arch Intern Med 2002;162:90-4.
14. Çetinkaya Y, Akova M, Akalın HE, Aşçıoğlu S, Hayran M, Uzun O, et al. A retrospective review of 228 episodes of infective endocarditis where rheumatic valvular disease is still common. Int J Antimicrob Agents 2001;18:1-7.
15. Benn M, Hagelskjaer LH, Tvede M. Infective endocarditis, 1984 through 1993: a clinical and microbiological survey. J Intern Med 1997;242:15-22.
16. Lerakis S, Martin RP. Infective endocarditis: diagnosis and management, up to-date. J Echocardiogr 2005; 3:129-35.
17. Fowler VG Jr, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E, et al. Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA 2005;293:3012-21.
18. Krcmery V, Hricak V, Babelova O. Culture negative endocarditis: analysis of 201 cases. Scand J Infect Dis 2007;39:384.
19. Eishi K, Kawazoe K, Kuriyama Y, Kitoh Y, Kawashima Y, Omae T. Surgical management of infective endocarditis associated with cerebral complications. Multi-center retrospective study in Japan. J Thorac Cardiovasc Surg 1995;110:1745-55.
20. Tuğcu A, Yıldırımtürk Ö, Baytaroğlu C, Kurtoğlu H, Köse Ö, Şener M, et al. Clinical spectrum, presentation, and risk factors for mortality in infective endocarditis: a review of 68 cases at a tertiary care center in Turkey. Turk Kardiyol Dern Ars 2009;37:9-18.

APA	Sucu M, DAVUTOĞLU V, ÖZER O, AKSOY M (2010). Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. , 107 - 111.
Chicago	Sucu Murat,DAVUTOĞLU Vedat,ÖZER Orhan,AKSOY MEHMET Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. (2010): 107 - 111.
MLA	Sucu Murat,DAVUTOĞLU Vedat,ÖZER Orhan,AKSOY MEHMET Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. , 2010, ss.107 - 111.
AMA	Sucu M,DAVUTOĞLU V,ÖZER O,AKSOY M Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. . 2010; 107 - 111.
Vancouver	Sucu M,DAVUTOĞLU V,ÖZER O,AKSOY M Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. . 2010; 107 - 111.
IEEE	Sucu M,DAVUTOĞLU V,ÖZER O,AKSOY M "Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region." , ss.107 - 111, 2010.
ISNAD	Sucu, Murat vd. "Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region". (2010), 107-111.

APA	Sucu M, DAVUTOĞLU V, ÖZER O, AKSOY M (2010). Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. Türk Kardiyoloji Derneği Arşivi, 38(2), 107 - 111.
Chicago	Sucu Murat,DAVUTOĞLU Vedat,ÖZER Orhan,AKSOY MEHMET Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. Türk Kardiyoloji Derneği Arşivi 38, no.2 (2010): 107 - 111.
MLA	Sucu Murat,DAVUTOĞLU Vedat,ÖZER Orhan,AKSOY MEHMET Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. Türk Kardiyoloji Derneği Arşivi, vol.38, no.2, 2010, ss.107 - 111.
AMA	Sucu M,DAVUTOĞLU V,ÖZER O,AKSOY M Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. Türk Kardiyoloji Derneği Arşivi. 2010; 38(2): 107 - 111.
Vancouver	Sucu M,DAVUTOĞLU V,ÖZER O,AKSOY M Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region. Türk Kardiyoloji Derneği Arşivi. 2010; 38(2): 107 - 111.
IEEE	Sucu M,DAVUTOĞLU V,ÖZER O,AKSOY M "Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region." Türk Kardiyoloji Derneği Arşivi, 38, ss.107 - 111, 2010.
ISNAD	Sucu, Murat vd. "Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region". Türk Kardiyoloji Derneği Arşivi 38/2 (2010), 107-111.