Document Detail

Etiology and risk factors of 180 cases of native valve endocarditis. Report from a 5-year national prospective survey in Slovak Republic.
MedLine Citation:
PMID:  9635234     Owner:  NLM     Status:  MEDLINE    
Risk factors, etiology, and outcome of 180 cases of infective endocarditis (IE) in the Slovak Republic for 5 years were prospectively studied in a national survey. According to the Duke Endocarditis Service Criteria (1994), 169 cases were considered definitive and 21 possible/probable. The aortic valve was infected in 46.7%, mitral in 47.2%, and tricuspidal/pulmonary in 6.1% of cases. The majority of endocarditis cases was caused by Staphylococcus aureus and coagulase-negative staphylococci (CNS) (33.3%); only 12.2% were due to viridans streptococci; 11.7% were due to Enterococcus faecalis; 6.1% due to Haemophilus spp.; 10.1% due to other organisms; and 26.7% were culture negative. Single positive cultures of CNS were not considered clinically significant. More than 25% of 180 patients were older than 60 years. Rheumatic fever was a risk factor in 35.5%, dental surgery in 20.5%, prior cardiosurgery in 7.8%, and neoplasia in 6.7%. All patients were treated with antimicrobials (average length of therapy was 29.5 days) and 33.3% of patients also had surgery (valvular prosthesis replacement). Forty (22.2%) died, and 140 (77.8%) survived at day 60 after the diagnosis of endocarditis was made. All 40 deaths were attributable to infection. Univariate analysis comparing deaths and survivors did not show significant differences in most of the recorded risk factors between both groups, except age > 60 (40.0% versus 21.4%, p < 0.05), staphylococcal etiology (55.0% versus 27.1%, p < 0.04), and antibiotic therapy < 21 days (without surgery) (65.0% versus 3.6%, p < 0.01). These risk factors were significantly more frequently associated with deaths. Viridans streptococcal IE and surgical therapy in addition to antibiotics were associated with lower mortality in comparison to staphylococcal endocarditis (p < 0.045) or to cases treated with antibiotics only (p < 0.05). In comparison to other nationally based surveys in Europe (Greece, Croatia, France), the percentage of culture-negative endocarditis and spectrum of pathogens differed significantly.
V Hricak; J Kovacik; P Marx; E Schramekova; V Fischer; D Vitekova; T Sedlak; I Duris; J Samudovsky; M Semanova; M Kovac; T Duris; O Herman; M Cernoskova; J Sefara; M Kojsova; D Baranikova; M Ayazi; J Dacok; M Mraz; S Krizan; J Danaj; A M Sulcava; D Neuschlova; V Krcmery
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diagnostic microbiology and infectious disease     Volume:  31     ISSN:  0732-8893     ISO Abbreviation:  Diagn. Microbiol. Infect. Dis.     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-27     Completed Date:  1998-08-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8305899     Medline TA:  Diagn Microbiol Infect Dis     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  431-5     Citation Subset:  IM    
National Institute of Cardiovascular Disease, School of Medicine, Bratislava, Slovak Republic.
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MeSH Terms
Age Distribution
Analysis of Variance
Bacterial Infections / epidemiology*,  etiology
Endocarditis, Bacterial / epidemiology*,  etiology
Health Surveys
Heart Valves / microbiology
Middle Aged
Pilot Projects
Prospective Studies
Risk Factors
Sex Distribution
Slovakia / epidemiology
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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