The Microbiology of Infective Native Aortic Aneurysms in a Population-Based Setting
(2022) In Annals of Vascular Surgery 78. p.112-122- Abstract
- Objective: The aim was to describe the microbiology of surgically treated infective native (mycotic) aortic aneurysms (INAAs), and associated survival and development of infection-related complications (IRCs). Methods: Data were pooled from 2 nationwide studies on surgically treated patients with INAAs in Sweden, between 1994 – 2016. Patients were grouped and analyzed according to culture results: 1) Staphylococcus aureus, 2) Streptococcus species (sp.), 3) Salmonella sp., 4) Enterococcus sp., 5) Gram-negative intestinal bacteria, 6) Other sp. (all other species found in culture), and 7) Negative cultures. Results: A sum of 182 patients were included, mean age 71 years (standard deviation; SD: 8.9). The median follow-up was 50.3 months... (More)
- Objective: The aim was to describe the microbiology of surgically treated infective native (mycotic) aortic aneurysms (INAAs), and associated survival and development of infection-related complications (IRCs). Methods: Data were pooled from 2 nationwide studies on surgically treated patients with INAAs in Sweden, between 1994 – 2016. Patients were grouped and analyzed according to culture results: 1) Staphylococcus aureus, 2) Streptococcus species (sp.), 3) Salmonella sp., 4) Enterococcus sp., 5) Gram-negative intestinal bacteria, 6) Other sp. (all other species found in culture), and 7) Negative cultures. Results: A sum of 182 patients were included, mean age 71 years (standard deviation; SD: 8.9). The median follow-up was 50.3 months (range 0 – 360). 128 (70.3%) patients had positive blood and/or tissue culture; Staphylococcus aureus n = 38 (20.9%), Streptococcus sp. n = 37 (20.3%), Salmonella sp. n = 19 (10.4%), Enterococcus sp. n = 16 (8.8%), Gram-negative intestinal bacteria n = 6, (3.3%), Other sp. n = 12 (6.6%) and Negative cultures n = 54 (29.7%). The estimated survival for the largest groups at 2-years after surgery was: Staphylococcus aureus 62% (95% Confidence interval 53.9 – 70.1), Streptococcus sp. 74.7% (67.4 – 82.0), Salmonella sp. 73.7% (63.6 – 83.8), Enterococcus sp. 61.9% (49.6 – 74.2), and Negative cultures 89.8% (85.5 – 94.1), P = .051. There were 37 IRCs (20.3%), and 19 (51.4%) were fatal, the frequency was insignificant between the groups. The majority of IRCs, 30/37 (81%), developed during the first postoperative year. Conclusion: In this assessment of microbiological findings of INAAs in Sweden, 50% of the pathogens were Staphylococcus aureus, Streptococcus sp., or Salmonella sp. The overall 20%-frequency of IRCs, and its association with high mortality, motivates long-term antibiotic treatment regardless of microbial findings. (Less)
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https://lup.lub.lu.se/record/2047445e-fde7-4719-b74c-3016d803a29b
- author
- Sörelius, Karl ; Wanhainen, Anders ; Furebring, Mia ; Mani, Kevin and Vaccarino, Roberta LU
- author collaboration
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Vascular Surgery
- volume
- 78
- pages
- 112 - 122
- publisher
- Springer
- external identifiers
-
- scopus:85116804424
- pmid:34537347
- ISSN
- 1615-5947
- DOI
- 10.1016/j.avsg.2021.06.039
- language
- English
- LU publication?
- no
- id
- 2047445e-fde7-4719-b74c-3016d803a29b
- date added to LUP
- 2021-11-18 10:54:17
- date last changed
- 2022-06-29 16:50:48
@article{2047445e-fde7-4719-b74c-3016d803a29b, abstract = {{Objective: The aim was to describe the microbiology of surgically treated infective native (mycotic) aortic aneurysms (INAAs), and associated survival and development of infection-related complications (IRCs). Methods: Data were pooled from 2 nationwide studies on surgically treated patients with INAAs in Sweden, between 1994 – 2016. Patients were grouped and analyzed according to culture results: 1) Staphylococcus aureus, 2) Streptococcus species (sp.), 3) Salmonella sp., 4) Enterococcus sp., 5) Gram-negative intestinal bacteria, 6) Other sp. (all other species found in culture), and 7) Negative cultures. Results: A sum of 182 patients were included, mean age 71 years (standard deviation; SD: 8.9). The median follow-up was 50.3 months (range 0 – 360). 128 (70.3%) patients had positive blood and/or tissue culture; Staphylococcus aureus n = 38 (20.9%), Streptococcus sp. n = 37 (20.3%), Salmonella sp. n = 19 (10.4%), Enterococcus sp. n = 16 (8.8%), Gram-negative intestinal bacteria n = 6, (3.3%), Other sp. n = 12 (6.6%) and Negative cultures n = 54 (29.7%). The estimated survival for the largest groups at 2-years after surgery was: Staphylococcus aureus 62% (95% Confidence interval 53.9 – 70.1), Streptococcus sp. 74.7% (67.4 – 82.0), Salmonella sp. 73.7% (63.6 – 83.8), Enterococcus sp. 61.9% (49.6 – 74.2), and Negative cultures 89.8% (85.5 – 94.1), P = .051. There were 37 IRCs (20.3%), and 19 (51.4%) were fatal, the frequency was insignificant between the groups. The majority of IRCs, 30/37 (81%), developed during the first postoperative year. Conclusion: In this assessment of microbiological findings of INAAs in Sweden, 50% of the pathogens were Staphylococcus aureus, Streptococcus sp., or Salmonella sp. The overall 20%-frequency of IRCs, and its association with high mortality, motivates long-term antibiotic treatment regardless of microbial findings.}}, author = {{Sörelius, Karl and Wanhainen, Anders and Furebring, Mia and Mani, Kevin and Vaccarino, Roberta}}, issn = {{1615-5947}}, language = {{eng}}, pages = {{112--122}}, publisher = {{Springer}}, series = {{Annals of Vascular Surgery}}, title = {{The Microbiology of Infective Native Aortic Aneurysms in a Population-Based Setting}}, url = {{http://dx.doi.org/10.1016/j.avsg.2021.06.039}}, doi = {{10.1016/j.avsg.2021.06.039}}, volume = {{78}}, year = {{2022}}, }