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Clinical Challenges in 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 (18 August 2023) | Viewed by 10626

Special Issue Editors


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Guest Editor
1. Division of Cardiac Surgery, Ospedale Policlinico San Martino, University of Genoa, Genova, Italy
2. Department of Integrated Surgical and Diagnostic Sciences (DISC), University of Genoa, Genova, Italy
Interests: cardiovascular surgery; infective endocarditis; heart valves pathology; infections after surgery
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Guest Editor
Department of Health Sciences (DISSAL), Università degli Studi di Genova, Genoa, Italy
Interests: antimicrobial resistance; carbapenem resistance; antimicrobial stewardship
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infectious endocarditis (IE) is a fatal and debilitating disease, a growing problem in the last decade. It is estimated that IE affects 3–7.5 people per 100,000 person-years, and its incidence is reported to be increasing in some parts of the world. IE more frequently affects men around 60 years of age. Staphylococcal and enterococcal IE are the most frequent. Oral streptococcal endocarditis is less frequent, and its frequency has not increased since implementation of the 2009 and 2015 recommendations restricting indications for antibiotic prophylaxis. Much attention is paid to new methods of early diagnosis such as PET or CT scan, now used in several countries worldwide. The prognosis of IE is still unacceptably poor, and more aggressive management of this deadly disease remains necessary. With this Special Issue, we encourage submissions of studies, including clinical challenges involving IE.

Dr. Antonio Salsano
Dr. Daniele Roberto Giacobbe
Guest Editors

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Keywords

  • cardiovascular surgery
  • infective endocarditis
  • heart valves pathology
  • diagnosis
  • management
  • therapy

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Related Special Issue

Published Papers (4 papers)

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Editorial

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2 pages, 183 KiB  
Editorial
Antibiotics and Missed Etiological Diagnosis of Infective Endocarditis: A Dangerous Duo
by Daniele Roberto Giacobbe, Antonio Salsano, Francesco Santini and Matteo Bassetti
J. Clin. Med. 2022, 11(15), 4533; https://doi.org/10.3390/jcm11154533 - 3 Aug 2022
Cited by 1 | Viewed by 1166
Abstract
The etiological diagnosis of infective endocarditis (IE) still remains a challenge [...] Full article
(This article belongs to the Special Issue Clinical Challenges in Endocarditis)

Research

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11 pages, 1037 KiB  
Article
Sex Differences in Characteristics of Patients with Infective Endocarditis: A Multicenter Study
by Ruchi Bhandari, Shabnam Tiwari, Talia Alexander, Frank H. Annie, Umar Kaleem, Affan Irfan, Sudarshan Balla, R. Constance Wiener, Chris Cook, Aravinda Nanjundappa, Mark Bates, Ellen Thompson, Gordon S. Smith, Judith Feinberg and Melanie A. Fisher
J. Clin. Med. 2022, 11(12), 3514; https://doi.org/10.3390/jcm11123514 - 18 Jun 2022
Cited by 3 | Viewed by 2538
Abstract
Infectious diseases like infective endocarditis (IE) may manifest or progress differently between sexes. This study sought to identify the differences in demographic and clinical characteristics among male and female patients with IE. Data were obtained from a newly developed registry comprising all adult [...] Read more.
Infectious diseases like infective endocarditis (IE) may manifest or progress differently between sexes. This study sought to identify the differences in demographic and clinical characteristics among male and female patients with IE. Data were obtained from a newly developed registry comprising all adult patients with first IE admission at the four major tertiary cardiovascular centers in West Virginia, USA during 2014–2018. Patient characteristics were compared between males and females using Chi-square test, Fisher’s exact test, and Wilcoxon rank-sum test. A secondary analysis was restricted to IE patients with drug use only. Among 780 unique patients (390 males, 390 females), significantly more women (a) were younger than males (median age 34.9 vs. 41.4, p < 0.001); (b) reported drug use (77.7% vs. 64.1%, p < 0.001); (c) had tricuspid valve endocarditis (46.4% vs. 30.8%, p < 0.001); and (d) were discharged against medical advice (20% vs. 9.5%, p < 0.001). These differences persisted even within the subgroup of patients with drug use-associated IE. In a state with one of the highest incidences of drug use and overdose deaths, the significantly higher incident IE cases in younger women and higher proportion of women leaving treatment against medical advice are striking. Differential characteristics between male and female patients are important to inform strategies for specialized treatment and care. Full article
(This article belongs to the Special Issue Clinical Challenges in Endocarditis)
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12 pages, 1193 KiB  
Article
Surgery for Aortic Prosthetic Valve Endocarditis in the Transcatheter Era
by Shekhar Saha, Ahmad Ali, Philipp Schnackenburg, Konstanze Maria Horke, Andreas Oberbach, Nadine Schlichting, Sebastian Sadoni, Konstantinos Rizas, Daniel Braun, Maximilian Luehr, Erik Bagaev, Christian Hagl and Dominik Joskowiak
J. Clin. Med. 2022, 11(12), 3418; https://doi.org/10.3390/jcm11123418 - 14 Jun 2022
Cited by 5 | Viewed by 4091
Abstract
Objectives: As surgical experience with infective endocarditis following transcatheter aortic valve replacement is scarce, this study compared the perioperative and short-term outcomes of patients suffering from endocarditis following surgical aortic valve replacement and transcatheter aortic valve replacement. Methods: Between January 2013 [...] Read more.
Objectives: As surgical experience with infective endocarditis following transcatheter aortic valve replacement is scarce, this study compared the perioperative and short-term outcomes of patients suffering from endocarditis following surgical aortic valve replacement and transcatheter aortic valve replacement. Methods: Between January 2013 and December 2020, 468 consecutive patients were admitted to our center for surgery for IE. Among them, 98 were operated on for endocarditis following surgical aortic valve replacement and 22 for endocarditis following transcatheter aortic valve replacement. Results: The median EuroSCORE II (52.1 (40.6–62.0) v/s 45.4 (32.6–58.1), p = 0.207) and STS-PROM (1.8 (1.6–2.1) v/s 1.9 (1.4–2.2), p = 0.622) were comparable. Endocarditis following transcatheter aortic valve replacement accounted for 13.7% of the aortic prosthetic valve endocarditis between 2013 and 2015; this increased to 26.9% in the years 2019 and 2020.Concomitant procedures were performed in 35 patients (29.2%). The operative mortality was 26.5% in the endocarditis following surgical aortic valve replacement group and 9.1% in the endocarditis following transcatheter aortic valve replacement group (p = 0.098). Upon follow-up, survival at 6 months was found to be 98% in the group with endocarditis following surgical aortic valve replacement and 89% in the group with endocarditis following transcatheter aortic valve replacement (p = 0.081). Conclusions: Patients suffering from endocarditis following surgical aortic valve replacement and transcatheter aortic valve replacement present with comparable risk profiles and can be surgically treated with comparable results. Surgery as a curative option should not be rejected even in this intermediate-risk cohort. Full article
(This article belongs to the Special Issue Clinical Challenges in Endocarditis)
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Review

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16 pages, 3320 KiB  
Review
Infective Endocarditis among Pediatric Patients with Prosthetic Valves and Cardiac Devices: A Review and Update of Recent Emerging Diagnostic and Management Strategies
by Mohamed Dardari, Eliza Cinteza, Corina Maria Vasile, Paul Padovani and Radu Vatasescu
J. Clin. Med. 2023, 12(15), 4941; https://doi.org/10.3390/jcm12154941 - 27 Jul 2023
Cited by 4 | Viewed by 1980
Abstract
Infective endocarditis (IE) is a disease of the endocardium, which leads to the appearance of vegetation on the valves, cardiac structures, or, potentially, vascular endothelium of the heart. The risk of IE can be increased more than 140 times by congenital heart disease [...] Read more.
Infective endocarditis (IE) is a disease of the endocardium, which leads to the appearance of vegetation on the valves, cardiac structures, or, potentially, vascular endothelium of the heart. The risk of IE can be increased more than 140 times by congenital heart disease (50–59% of all IE), particularly if cyanotic. An increase in mortality may result from IE in patients with a complex cardiac pathology or patients with an implanted prosthetic material, most frequently conduits in a pulmonary position. Cardiac implantable electronic devices (CIED) infective endocarditis is a life-threatening complication representing 10% of all cases of endocarditis. Common signs of presentation are often fever and chills; redness and swelling at the pocket of the pacemaker, including the erosion and exteriorization of the device; and life-threatening sepsis. The use of intracardiac echocardiography for the diagnosis of IE is an innovative method. This may be needed, especially in older children undergoing complex cardiac surgery, when transthoracic echocardiography (TTE) and transesophageal echocardiography (TOE) failed to provide a reliable diagnosis. The 2018 European Heart Rhythm Association (EHRA) experts’ consensus statement on transvenous lead extraction recommends complete device removal and antimicrobial therapy for any device-related infection, including CIED-IE. The most detected microorganism was Staphylococcus Aureus. In addition, cardiac surgery and interventional cardiology associated with the placement of prostheses or conduits may increase the risk of IE up to 1.6% for Melody valve implantation. Our manuscript presents a comprehensive review of infective endocarditis associated with cardiac devices and prostheses in the pediatric population, including recent advances in diagnosis and management. Full article
(This article belongs to the Special Issue Clinical Challenges in Endocarditis)
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