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National Temporal Trend Analysis of Infective Endocarditis among Patients Infected with HIV in Spain (1997–2014): A Retrospective Study

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Research Support Unit, University Clinical Hospital, 47003 Valladolid, Spain
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Internal Medicine Service, University Hospital Infanta Leonor, Madrid, 28031 Madrid, Spain
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Gregorio Marañón Health Research Institute (IiSGM), 28007 Madrid, Spain
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School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
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Department of Preventive Medicine and Public Health, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
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Harm Reduction Unit “SMASD”, Subdirectorate General for Addictions, 28020 Madrid, Spain
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Department of Anesthesiology and Resuscitation, University Clinical Hospital, 47003 Valladolid, Spain
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Unit of Viral Infection and Immunity, National Center for Microbiology—Carlos III Health Institute, Majadahonda, 28222 Madrid, Spain
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Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(8), 1167; https://doi.org/10.3390/jcm8081167
Received: 9 July 2019 / Revised: 31 July 2019 / Accepted: 2 August 2019 / Published: 4 August 2019
(This article belongs to the Section Epidemiology & Public Health)
Background: People living with human immunodeficiency virus (HIV) (PLWH) form a vulnerable population for the onset of infective endocarditis (IE). We aimed to analyze the epidemiological trend of IE, as well as its microbiological characteristics, in PLWH during the combined antiretroviral therapy era in Spain. Methods: We performed a retrospective study (1997–2014) in PLWH with data obtained from the Spanish Minimum Basic Data Set. We selected 1800 hospital admissions with an IE diagnosis, which corresponded to 1439 patients. Results: We found significant downward trends in the periods 1997–1999 and 2008–2014 in the rate of hospital admissions with an IE diagnosis (from 21.8 to 3.8 events per 10,000 patients/year; p < 0.001), IE incidence (from 18.2 to 2.9 events per 10,000 patients/year; p < 0.001), and IE mortality (from 23.9 to 5.5 deaths per 100,000 patient-years; p < 0.001). The most frequent microorganisms involved were staphylococci (50%; 42.7% Staphylococcus aureus and 7.3% coagulase-negative staphylococci (CoNS)), followed by streptococci (9.3%), Gram-negative bacilli (8.3%), enterococci (3%), and fungus (1.4%). During the study period, we found a downward trend in the rates of CoNS (p < 0.001) and an upward trends in streptococci (p = 0.001), Gram-negative bacilli (p < 0.001), enterococci (p = 0.003), and fungus (p < 0.001) related to IE, mainly in 2008–2014. The rate of community-acquired IE showed a significant upward trend (p = 0.001), while the rate of health care-associated IE showed a significant downward trend (p < 0.001). Conclusions: The rates of hospital admissions, incidence, and mortality related to IE diagnosis in PLWH in Spain decreased from 1997 to 2014, while other changes in clinical characteristics, mode of acquisition, and pathogens occurred over this time. View Full-Text
Keywords: HIV/AIDS; infective endocarditis; etiology; epidemiology; ICD9CM codes HIV/AIDS; infective endocarditis; etiology; epidemiology; ICD9CM codes
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MDPI and ACS Style

Muñoz-Moreno, M.F.; Ryan, P.; Alvaro-Meca, A.; Valencia, J.; Tamayo, E.; Resino, S. National Temporal Trend Analysis of Infective Endocarditis among Patients Infected with HIV in Spain (1997–2014): A Retrospective Study. J. Clin. Med. 2019, 8, 1167.

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