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Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis
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Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 11701

Special Issue Editors

Prof. Dr. Manuel Martínez-Sellés

E-Mail Website
Guest Editor
1. Cardiology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 16, 28007 Madrid, Spain
2. Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
Interests: coronary artery disease; heart failure; heart transplant; endocarditis; aortic stenosis; sex influence in cardiovascular conditions
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Patricia Muñoz

E-Mail Website
Guest Editor
Microbiology Department, Hospital General Universitario Gregorio Marañón, Calle Doctor Esquerdo, 16, 28007 and Universidad Complutense de Madrid, Spain
Interests: infection endocarditis; nosocomial infections

Special Issue Information

Dear Colleagues,

Infective endocarditis (IE) is an inflammatory cardiovascular disease usually caused by microbes, primarily bacteria, entering the bloodstream and settling in the heart lining valves or blood vessels. It is an uncommon condition occurring every 5 per 100,000 person-years, but it is a serious infection with a wide array of manifestations and sequelae that carries high morbidity and mortality, with an estimated inpatient mortality rate of 25%.

In recent years, there have been important changes in the epidemiology of IE due to population aging and the greater frequency of risk factors. Among the risk factors for IE, some are particularly important as prosthetic heart valves, previous cardiac surgeries, implantable cardiac devices, percutaneous treatment of structural heart diseases, and solid organ transplantation. For instance, solid organ transplantation implies immunosuppression and frequent healthcare contact.

These changes have decreased the rate of community-acquired IE and of Streptococcus viridians etiology. On the other hand, Staphylococcus aureus is the most frequently identified pathogen, and healthcare-associated infection has become increasingly common.

In addition, new developments in the diagnosis and treatment of IE have changed the approach of this condition in recent years. Some examples are fluorodeoxyglucose (FDG)-positron emission tomography (PET) that has been included into the workup for patients with suspected IE, serum troponin detection as a prognostic marker, new antimicrobial classes that are now available, and innovative surgical techniques that have been developed recently.

The correct management of IE requires an interprofessional approach that should assess the need for possible surgical intervention as almost half of the patients with IE will require a surgical intervention.

The present Special Issue aims to address IE by assembling significant contributions in the following categories:

1)   Epidemiology
2)   Pathophysiology
3)   Diagnostic techniques
4)   Antimicrobials
5)   Surgery
6)   Special populations.
7)   Logistics and multidisciplinary approach

Prof. Dr. Manuel Martínez-Sellés
Prof. Dr. Patricia Muñoz 
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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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 2600 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 infection
  • prognosis
  • cardiac surgery

Published Papers (5 papers)

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Editorial

Jump to: Research, Review, Other

4 pages, 219 KiB  
Editorial
Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis
by Manuel Martínez-Sellés and Patricia Muñoz
J. Clin. Med. 2023, 12(17), 5705; https://doi.org/10.3390/jcm12175705 - 1 Sep 2023
Viewed by 1127
Abstract
Infective endocarditis (IE) has experienced enormous changes in recent decades [...] Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis)

Research

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8 pages, 261 KiB  
Article
Ampicillin Plus Ceftriaxone Combined Therapy for Enterococcus faecalis Infective Endocarditis in OPAT
by Laura Herrera-Hidalgo, Jose Manuel Lomas-Cabezas, Luis Eduardo López-Cortés, Rafael Luque-Márquez, Luis Fernando López-Cortés, Francisco J. Martínez-Marcos, Javier de la Torre-Lima, Antonio Plata-Ciézar, Carmen Hidalgo-Tenorio, Maria Victoria García-López, David Vinuesa, Alicia Gutiérrez-Valencia, Maria Victoria Gil-Navarro and Arístides De Alarcón
J. Clin. Med. 2022, 11(1), 7; https://doi.org/10.3390/jcm11010007 - 21 Dec 2021
Cited by 10 | Viewed by 3747
Abstract
Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for Enterococcus faecalis infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple [...] Read more.
Ampicillin plus ceftriaxone (AC) is a well-recognized inpatient regimen for Enterococcus faecalis infective endocarditis (IE). In this regimen, ceftriaxone is usually administered 2 g every 2 h (AC12). The administration of AC in outpatient parenteral antibiotic treatment (OPAT) programs is challenging because multiple daily doses are required. AC regimens useful for OPAT programs include once-daily high-dose administration of ceftriaxone (AC24) or AC co-diluted and jointly administered in bolus every 4 h (ACjoined). In this retrospective analysis of prospectively collected cases, we aimed to assess the clinical effectivity and safety of three AC regimens for the treatment of E. faecalis IE. Fifty-nine patients were treated with AC combinations (AC12 n = 32, AC24 n = 17, and ACjoined n = 10). Six relapses occurred in the whole cohort: five (29.4%) treated with AC24 regimen and one (10.0%) with ACjoined. Patients were cured in 30 (93.3%), 16 (94.1%), and eight (80.0%) cases in the AC12, AC24 and ACjoined groups, respectively. Unplanned readmission occurred in eight (25.0%), six (35.3%), and two (20.0%) patients in the AC12, AC24 and ACjoined groups, respectively. The outcome of patients with E. faecalis IE treated with AC in OPAT programs relies on an optimization of the delivery of the combination. AC24 exhibit an unexpected rate of failures, however, ACjoined might be an effective alternative which clinical results should corroborate in further studies. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis)

Review

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22 pages, 648 KiB  
Review
Optimal Timing for Cardiac Surgery in Infective Endocarditis with Neurological Complications: A Narrative Review
by Joan Siquier-Padilla, Guillermo Cuervo, Xabier Urra, Eduard Quintana, Marta Hernández-Meneses, Elena Sandoval, Pau Lapeña, Carles Falces, Carlos A. Mestres, Alfredo Paez-Carpio, Asunción Moreno and José María Miro
J. Clin. Med. 2022, 11(18), 5275; https://doi.org/10.3390/jcm11185275 - 7 Sep 2022
Cited by 5 | Viewed by 2835
Abstract
In patients with infective endocarditis and neurological complications, the optimal timing for cardiac surgery is unclear due to the varied risk of clinical deterioration when early surgery is performed. The aim of this review is to summarize the best evidence on the optimal [...] Read more.
In patients with infective endocarditis and neurological complications, the optimal timing for cardiac surgery is unclear due to the varied risk of clinical deterioration when early surgery is performed. The aim of this review is to summarize the best evidence on the optimal timing for cardiac surgery in the presence of each type of neurological complication. An English literature search was carried out from June 2018 through July 2022. The resulting selection, comprising observational studies, clinical trials, systematic reviews and society guidelines, was organized into four sections according to the four groups of neurological complications: ischemic, hemorrhagic, infectious, and asymptomatic complications. Cardiac surgery could be performed without delay in cases of ischemic vascular neurological complication (provided the absence of severe damage, which can be avoided with the performance of mechanical thrombectomy in cases of major stroke), as well as infectious or asymptomatic complications. In the presence of intracranial hemorrhage, a delay of four weeks is recommended for most cases, although recent studies have suggested that performing cardiac surgery within four weeks could be a suitable option for selected cases. The findings of this review are mostly in line with the recommendations of the current European and American infective endocarditis guidelines. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis)
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9 pages, 615 KiB  
Review
Healthcare-Associated Infective Endocarditis—Surgical Perspectives
by Tatjana Musci and Herko Grubitzsch
J. Clin. Med. 2022, 11(17), 4957; https://doi.org/10.3390/jcm11174957 - 24 Aug 2022
Cited by 5 | Viewed by 1754
Abstract
Health-care-associated infective endocarditis (HCA-IE), a disease with a poor prognosis, has become increasingly important. As surgical treatment is frequently required, this review aims to outline surgical perspectives on HCA-IE. We searched PubMed to identify publications from January 1980 to March 2022. Reports were [...] Read more.
Health-care-associated infective endocarditis (HCA-IE), a disease with a poor prognosis, has become increasingly important. As surgical treatment is frequently required, this review aims to outline surgical perspectives on HCA-IE. We searched PubMed to identify publications from January 1980 to March 2022. Reports were evaluated by the authors against a priori inclusion/exclusion criteria. Studies reporting on surgical treatment of HCA-IE including outcome were selected. Currently, HCA-IE accounts for up to 47% of IE cases. Advanced age, cardiac implants, and comorbidity are important predispositions, and intravascular catheters or frequent vascular access are significant sources of infection. Staphylococci and enterococci are the leading causative microorganisms. Surgery, although frequently indicated, is rejected in 24–69% because of prohibitive risk. In-hospital mortality is significant after surgery (29–50%) but highest in patients rejected for operation (52–83%). Furthermore, the length of hospital stay is prolonged. With aging populations, age-dependent morbidity, increasing use of cardiac implants, and growing healthcare utilization, HCA-IE is anticipated to gain further importance. A better understanding of pathogenesis, clinical profile, and outcomes is paramount. Further research on surgical treatment is needed to provide more comprehensive information for defining the most suitable treatment option, finding the optimal time for surgery, and reducing morbidity and mortality. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis)
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Other

7 pages, 230 KiB  
Brief Report
Infective Endocarditis in People Who Inject Drugs: Report from the Italian Registry of Infective Endocarditis
by Enrico Cecchi, Silvia Corcione, Tommaso Lupia, Ilaria De Benedetto, Nour Shbaklo, Fabio Chirillo, Antonella Moreo, Mauro Rinaldi, Pompilio Faggiano, Moreno Cecconi, Olivia Bargiacchi, Alessandro Cialfi, Stefano Del Ponte, Angelo Squeri, Oscar Gaddi, Maria Gabriella Carmina, Alessandro Lazzaro, Giovannino Ciccone, Anna Castiglione and Francesco Giuseppe De Rosa
J. Clin. Med. 2022, 11(14), 4082; https://doi.org/10.3390/jcm11144082 - 14 Jul 2022
Cited by 4 | Viewed by 1374
Abstract
Intravenous drug use is a predisposing condition for infective endocarditis (IE). We report the clinical features of IE, taken from the Italian Registry of IE, in people who inject drugs (PWIDs). The registry prospectively collected epidemiological, clinical, in-hospital, and follow-up data on patients [...] Read more.
Intravenous drug use is a predisposing condition for infective endocarditis (IE). We report the clinical features of IE, taken from the Italian Registry of IE, in people who inject drugs (PWIDs). The registry prospectively collected epidemiological, clinical, in-hospital, and follow-up data on patients with IE from 17 Italian centers. A total of 677 patients were enrolled, and 61 (9%) were intravenous drug users (IDUs). Most PWIDs were male (78.6%), and aged between 41 and 50 years old (50%). The most frequent comorbidities were HIV (34.4%) and chronic liver disease (32%). Predisposing factors for IE were present in 6.5% of the patients, and 10% had minor valvular abnormalities. IE had occurred previously in 16.4% of the patients, and 50% of them had undergone heart surgery. Overall mortality was 9.8% in IDUs and 20% in patients with recurrent IE. IE in PWIDs mostly affected the native valves (90%). The echocardiographic diagnosis of IE was based on the detection of vegetation in 91.82% of cases. Staphylococcus aureus was the main microorganism isolated (70%) from blood cultures. Thirty patients (49%) underwent heart surgery: thirteen had aortic valves, eleven had mitral valves, and six had tricuspid valve interventions. IE in PWIDs was relatively common, and patients with native valve right-sided IE had a better prognosis, with a low rate of surgical interventions. Full article
(This article belongs to the Special Issue Epidemiology, Diagnosis, Treatment, and Prognosis of Infective Endocarditis)
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