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Current Trends and Outcomes of Infective Endocarditis
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Current Trends and Outcomes of Infective Endocarditis

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

Deadline for manuscript submissions: closed (1 February 2022) | Viewed by 10111

Special Issue Editors

Dr. Petros Ioannou

E-Mail Website
Guest Editor
Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece
Interests: clinical microbiology; infectious diseases; endocarditis; mycoses; fungal infections
Special Issues, Collections and Topics in MDPI journals
Dr. Diamantis Kofteridis

E-Mail Website
Co-Guest Editor
Faculty of Medicine, University of Crete, Heraklion, Greece
Interests: clinical microbiology; infectious diseases; endocarditis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infective endocarditis (IE) is a rare but challenging disease. Even though rapidly growing medical knowledge and the development of medical technology have provided us with the tools to diagnose and treat infectious diseases better than ever before, the challenges associated with IE are greater than in the previous decades. The patients are older and, thus, have more comorbidities; the microbiology has changed since an increasing proportion of IE is now healthcare-associated, leading to the more frequent development of IE due to Gram-negative microorganisms, while the evolving problem of antimicrobial resistance has led to frequent diagnosis of IE by microorganisms with fewer therapeutic options. Lastly, the increasing use of immunosuppressive therapy in patients with autoimmune diseases and cancer as well as transplantation has led to the occurrence of IE by less commonly encountered pathogens, such as fungi. With this Special Issue, we hope to encourage submissions discussing the current knowledge on the changing epidemiology, microbiology, diagnostic modalities, and treatment of IE as well as the current data on outcomes in this challenging infection.

Dr. Petros Ioannou
Prof. Dr. Diamantis Kofteridis
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
  • vegetation
  • cardiac valve
  • native valve
  • prosthetic valve
  • cardiac device
  • bloodstream infection

Published Papers (4 papers)

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Research

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12 pages, 867 KiB  
Article
Etiology, Risk Factors and Clinical Outcomes in Infective Endocarditis Patients Requiring Cardiac Surgery
by Kristians Meidrops, Franziska Johanna Burkhardt, Janis Davis Osipovs, Eva Petrosina, Valerija Groma and Peteris Stradins
J. Clin. Med. 2022, 11(7), 1957; https://doi.org/10.3390/jcm11071957 - 1 Apr 2022
Cited by 2 | Viewed by 1775
Abstract
Background: Infective endocarditis, which may be caused by various microbial agents, severely affects the innermost layer of the heart and often leads to poor clinical outcomes. The purpose of this study was to investigate the etiology, risk factors and short and long-term outcomes [...] Read more.
Background: Infective endocarditis, which may be caused by various microbial agents, severely affects the innermost layer of the heart and often leads to poor clinical outcomes. The purpose of this study was to investigate the etiology, risk factors and short and long-term outcomes of infective endocarditis caused by various bacterial agents in patients requiring cardiac surgery. Methods: One hundred and forty-four patients aged 18 years or above with indications for cardiac surgery due to S. aureus, Streptococcus spp., E. faecalis or coagulase-negative staphylococci caused infective endocarditis were included in this study. Results: S. aureus, Streptococcus spp., E. faecalis and coagulase-negative staphylococci were the causative agents of infective endocarditis in 44 (30.6%), 35 (24.3%), 33 (22.9%) and 32 (22.2%) patients, respectively. The presence of bicuspid aortic valve was the most common predisposing factor confirmed in 19 (23.5%), whereas intravenous drug usage was the most common in 17 (11.8%) patients. No significant differences in intrahospital mortality due to infective endocarditis caused by various bacterial agents were found, however, the worsening of long-term prognosis of endocarditis caused by S. aureus when compared to E. faecalis was confirmed (p = 0.03). The presence of S. aureus was associated with significantly higher rates of embolic complications (p = 0.003). The presence of coagulase-negative staphylococci was associated with prosthetic valve endocarditis (p = 0.015) and perivalvular complications (p = 0.024). Conclusions: In contrast to E. faecalis, the presence of S. aureus determines the worsening of the long-term mortality from infective endocarditis. Perivalvular complications are associated with the presence of coagulase-negative staphylococci. Full article
(This article belongs to the Special Issue Current Trends and Outcomes of Infective Endocarditis)
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11 pages, 1995 KiB  
Article
The Impact of the FilmArray-Based Detection of Microbial Pathogens from Positive Blood Culture Vials on the Time to Optimal Antimicrobial Regimen in Intensive Care Units of the Helios University Clinic Wuppertal, Germany
by Jannik Schumann, Ulrike Johanns, Parviz Ahmad-Nejad, Beniam Ghebremedhin and Gabriele Woebker
J. Clin. Med. 2021, 10(24), 5880; https://doi.org/10.3390/jcm10245880 - 15 Dec 2021
Cited by 6 | Viewed by 2015
Abstract
The role of empirical therapy and time to first effective treatment, including the antimicrobial stewardship program, are decisive in patients presenting with bloodstream infections (BSI). The FilmArray® Blood Culture Identification Panel (FA BCID 1.0) detects 24 bacterial and fungal pathogens as well [...] Read more.
The role of empirical therapy and time to first effective treatment, including the antimicrobial stewardship program, are decisive in patients presenting with bloodstream infections (BSI). The FilmArray® Blood Culture Identification Panel (FA BCID 1.0) detects 24 bacterial and fungal pathogens as well as 3 resistance genes from positive blood cultures in approximately 70 min. In this paper, we evaluate the impact of the additional FA BCID analysis on the time to an optimal antimicrobial therapy and on the length of stay in the ICU, ICU mortality, and PCT level reduction. This retro-/prospective trial was conducted in BSI patients in the ICU at a German tertiary care hospital. A total of 179 individual patients with 200 episodes of BSI were included in the prospective intervention group, and 150 patients with 170 episodes of BSI in the retrospective control group. In the intervention group, BSI data were analyzed including the MALDI-TOF MS (matrix assisted laser desorption ionization time-of-flight mass spectrometry) and FA BCID results from January 2019 to August 2020; the data from the control group, including the MALDI-TOF results, were collected retrospectively from the year 2018. The effective and appropriate antimicrobial regimen occurred in a median of 17 hours earlier in the intervention versus control group (p = 0.071). Furthermore, changes in the antimicrobial regimens of the intervention group that did not immediately lead to an optimal therapy occurred significantly earlier by a median of 24 hours (p = 0.029). Surrogate markers, indicating an earlier recovery of the patients from the intervention group, such as length of stay at the ICU, duration of mechanical ventilation, or an earlier reduction in PCT level, were not significantly affected. However, mortality did not differ between the patient groups. A postulated reduction of the antimicrobial therapy, in those cases in which coagulase-negative Staphylococcus species were identified, did occur in the control group, but not in the intervention group (p = 0.041). The implementation of FA BCID into the laboratory workflow can improve patient care by optimizing antimicrobial regimen earlier in BSI patients as it provides rapid and accurate results for key pathogens associated with BSI, as well as important antimicrobial resistance markers, e.g., mecA or vanA. Full article
(This article belongs to the Special Issue Current Trends and Outcomes of Infective Endocarditis)
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Review

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9 pages, 260 KiB  
Review
Ampicillin Plus Ceftriaxone Regimen against Enterococcus faecalis Endocarditis: A Literature Review
by Andrea Marino, Antonio Munafò, Aldo Zagami, Manuela Ceccarelli, Rosaria Di Mauro, Giuseppina Cantarella, Renato Bernardini, Giuseppe Nunnari and Bruno Cacopardo
J. Clin. Med. 2021, 10(19), 4594; https://doi.org/10.3390/jcm10194594 - 6 Oct 2021
Cited by 24 | Viewed by 3686
Abstract
Enterococcus faecalis infective endocarditis (EFIE) continues to represent a potentially fatal infectious disease characterized by elevated morbidity and mortality. Despite advances in antimicrobial therapy, changing demographics and the reduced availability of useful antibiotics combined with the dissemination of multi-drug resistant strains, the mortality [...] Read more.
Enterococcus faecalis infective endocarditis (EFIE) continues to represent a potentially fatal infectious disease characterized by elevated morbidity and mortality. Despite advances in antimicrobial therapy, changing demographics and the reduced availability of useful antibiotics combined with the dissemination of multi-drug resistant strains, the mortality rate remained unchanged in the last decades. Nowadays, optimizing the antibiotic regimen is still of paramount importance. Historically, aminoglycosides were considered as a cornerstone for treatment even though their use is associated with a high risk of kidney failure. It is against this background that, in recent years, several studies have been carried in order to assess the validity of alternative therapeutic approaches, including combinations of beta-lactams, that, acting synergistically, have yielded useful results in different clinical settings. In this scenario, we searched and critically report clinical studies assessing the efficacy and safety of double beta-lactam therapy in treating EFIE. Full article
(This article belongs to the Special Issue Current Trends and Outcomes of Infective Endocarditis)
11 pages, 875 KiB  
Review
Endocarditis in Liver Transplant Recipients: A Systematic Review
by Petros Ioannou, Konstantinos Alexakis and Diamantis P Kofteridis
J. Clin. Med. 2021, 10(12), 2660; https://doi.org/10.3390/jcm10122660 - 16 Jun 2021
Cited by 4 | Viewed by 1565
Abstract
Infective Endocarditis (IE) is associated with significant mortality. Interestingly, IE in patients with liver transplantation has not been adequately described. The aim of this review was to systematically review all published cases of IE in liver transplant recipients and describe their epidemiology, microbiology, [...] Read more.
Infective Endocarditis (IE) is associated with significant mortality. Interestingly, IE in patients with liver transplantation has not been adequately described. The aim of this review was to systematically review all published cases of IE in liver transplant recipients and describe their epidemiology, microbiology, clinical characteristics, treatment and outcomes. A systematic review of PubMed, Scopus and Cochrane Library (through 2 January 2021) for studies providing epidemiological, clinical, microbiological, treatment data and outcomes of IE in liver transplant recipients was conducted. A total of 39 studies, containing data for 62 patients, were included in the analysis. The most common causative pathogens were gram-positive microorganisms in 69.4%, fungi in 25.8%, and gram-negative microorganisms in 9.7% of cases, while in 9.3% IE was culture-negative. The aortic valve was the most commonly infected valve followed by mitral, tricuspid and the pulmonary valve. Aminoglycosides, vancomycin and aminopenicillins were the most commonly used antimicrobials, and surgical management was performed in half of the cases. Clinical cure was noted in 57.4%, while overall mortality was 43.5%. To conclude, this systematic review thoroughly describes IE in liver transplant recipients and provides information on epidemiology, clinical presentation, treatment and outcomes. Full article
(This article belongs to the Special Issue Current Trends and Outcomes of Infective Endocarditis)
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