Microbiological etiology in prosthetic valve endocarditis : A nationwide registry study
(2022) In Journal of Internal Medicine 292(3). p.428-437- Abstract
Background: Prosthetic valve endocarditis (PVE) is a feared complication after heart valve surgery. Studies on differences in bacteriology in various types of PVE are limited. Objectives: This study aimed to investigate the microbiology of PVE depending on the type of prosthetic valve and timing of diagnosis. Methods: A retrospective study based on the Swedish Registry on Infective Endocarditis focusing on PVE was conducted. The cohort was divided into mechanical and bioprosthetic valves; into endocarditis localization in the aortic, mitral, or tricuspid valve; and into early and late PVE. The microbiology in these groups was compared. Predictors of Staphylococcus aureus as the cause of PVE were examined by multivariable logistic... (More)
Background: Prosthetic valve endocarditis (PVE) is a feared complication after heart valve surgery. Studies on differences in bacteriology in various types of PVE are limited. Objectives: This study aimed to investigate the microbiology of PVE depending on the type of prosthetic valve and timing of diagnosis. Methods: A retrospective study based on the Swedish Registry on Infective Endocarditis focusing on PVE was conducted. The cohort was divided into mechanical and bioprosthetic valves; into endocarditis localization in the aortic, mitral, or tricuspid valve; and into early and late PVE. The microbiology in these groups was compared. Predictors of Staphylococcus aureus as the cause of PVE were examined by multivariable logistic regression. Results: A total of 780 episodes of PVE in 749 patients were compared regarding the distribution of causative microbiological agents. The most common agents included alpha-hemolytic streptococci (29%), S. aureus (22%), enterococci (14%), coagulase-negative staphylococci (CoNS) (12%), and Cutibacterium acnes (6%). S. aureus was more commonly found on mechanical valves compared to bioprosthetic ones (36% vs. 17%, p < 0.001) whereas alpha-hemolytic streptococci, enterococci, and CoNS were more common on bioprosthetic valves. There were no significant differences in the microbiology of PVE affecting mitral or aortic valves or in cases of early and late PVE. Predictors for S. aureus as the cause of PVE were end-stage renal disease, intravenous drug use, mechanical valve, and tricuspid localization of endocarditis. Conclusions: The type of prosthetic heart valve is associated with the causative pathogen. Patients with mechanical valves are more likely to have PVE caused by S. aureus.
(Less)
- author
- Berisha, Blerand ; Ragnarsson, Sigurdur LU ; Olaison, Lars and Rasmussen, Magnus LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- microbiological etiology, prosthetic valve endocarditis, registry study, Staphylococcus aureus, valve prosthesis
- in
- Journal of Internal Medicine
- volume
- 292
- issue
- 3
- pages
- 428 - 437
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:35373870
- scopus:85128337369
- ISSN
- 0954-6820
- DOI
- 10.1111/joim.13491
- language
- English
- LU publication?
- yes
- id
- bdf01140-e3c6-417e-ac9c-85210dead2c3
- date added to LUP
- 2022-07-01 15:09:26
- date last changed
- 2024-05-02 13:55:15
@article{bdf01140-e3c6-417e-ac9c-85210dead2c3,
abstract = {{<p>Background: Prosthetic valve endocarditis (PVE) is a feared complication after heart valve surgery. Studies on differences in bacteriology in various types of PVE are limited. Objectives: This study aimed to investigate the microbiology of PVE depending on the type of prosthetic valve and timing of diagnosis. Methods: A retrospective study based on the Swedish Registry on Infective Endocarditis focusing on PVE was conducted. The cohort was divided into mechanical and bioprosthetic valves; into endocarditis localization in the aortic, mitral, or tricuspid valve; and into early and late PVE. The microbiology in these groups was compared. Predictors of Staphylococcus aureus as the cause of PVE were examined by multivariable logistic regression. Results: A total of 780 episodes of PVE in 749 patients were compared regarding the distribution of causative microbiological agents. The most common agents included alpha-hemolytic streptococci (29%), S. aureus (22%), enterococci (14%), coagulase-negative staphylococci (CoNS) (12%), and Cutibacterium acnes (6%). S. aureus was more commonly found on mechanical valves compared to bioprosthetic ones (36% vs. 17%, p < 0.001) whereas alpha-hemolytic streptococci, enterococci, and CoNS were more common on bioprosthetic valves. There were no significant differences in the microbiology of PVE affecting mitral or aortic valves or in cases of early and late PVE. Predictors for S. aureus as the cause of PVE were end-stage renal disease, intravenous drug use, mechanical valve, and tricuspid localization of endocarditis. Conclusions: The type of prosthetic heart valve is associated with the causative pathogen. Patients with mechanical valves are more likely to have PVE caused by S. aureus.</p>}},
author = {{Berisha, Blerand and Ragnarsson, Sigurdur and Olaison, Lars and Rasmussen, Magnus}},
issn = {{0954-6820}},
keywords = {{microbiological etiology; prosthetic valve endocarditis; registry study; Staphylococcus aureus; valve prosthesis}},
language = {{eng}},
number = {{3}},
pages = {{428--437}},
publisher = {{Wiley-Blackwell}},
series = {{Journal of Internal Medicine}},
title = {{Microbiological etiology in prosthetic valve endocarditis : A nationwide registry study}},
url = {{http://dx.doi.org/10.1111/joim.13491}},
doi = {{10.1111/joim.13491}},
volume = {{292}},
year = {{2022}},
}