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Non-nosocomial Healthcare-Associated Infective Endocarditis: A Distinct Entity? Data From the GAMES Series (2008-2021).
Alonso-Menchén, David; Bouza, Emilio; Valerio, Maricela; de Alarcón, Arístides; Gutiérrez-Carretero, Encarnación; Miró, José M; Goenaga-Sánchez, Miguel Ángel; Plata-Ciézar, Antonio; González-Rico, Claudia; López-Cortés, Luis Eduardo; Rodríguez Esteban, María Ángeles; Martínez-Marcos, Francisco Javier; Muñoz, Patricia.
Afiliación
  • Alonso-Menchén D; Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
  • Bouza E; Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
  • Valerio M; Medicine Department, Universidad Complutense de Madrid, Madrid, Spain.
  • de Alarcón A; CIBER (Centro de Investigación Biomédica en Red) de Enfermedades Respiratorias (CB06/06/0058), Instituto de Salud Carlos III, Madrid, Spain.
  • Gutiérrez-Carretero E; Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
  • Miró JM; Medicine Department, Universidad Complutense de Madrid, Madrid, Spain.
  • Goenaga-Sánchez MÁ; Unidad Clínica de Enfermedades Infecciosas, Microbiología y Parasitología, University Hospital Virgen del Rocío, Institute of Biomedicine of Seville, University of Seville/CSIC (Consejo Superior de Investigaciones Científicas), Seville, Spain.
  • Plata-Ciézar A; CIBER (Centro de Investigación Biomédica en Red) de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
  • González-Rico C; Cardiac Surgery Service, University Hospital Virgen del Rocío, Institute of Biomedicine of Seville, University of Seville/CSIC (Consejo Superior de Investigaciones Científicas), Seville, Spain.
  • López-Cortés LE; CIBER (Centro de Investigación Biomédica en Red) de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain.
  • Rodríguez Esteban MÁ; CIBER (Centro de Investigación Biomédica en Red) de Enfermedades Infecciosas, Instituto de Salud Carlos III, Madrid, Spain.
  • Martínez-Marcos FJ; Infectious Diseases Service, Hospital Clínic-IDIBAPS (Institut d'Investigacions Biomèdiques August Pi Sunyer), University of Barcelona, Barcelona, Spain.
  • Muñoz P; Servicio de Enfermedades Infecciosas, Hospital Universitario Donosti, San Sebastián, Spain.
Open Forum Infect Dis ; 10(8): ofad393, 2023 Aug.
Article en En | MEDLINE | ID: mdl-37564744
Background: Patients who acquire infective endocarditis (IE) following contact with the healthcare system, but outside the hospital, are classified as having non-nosocomial healthcare-associated IE (HCIE). Our aim was to characterize HCIE and establish whether its etiology, diagnosis, and therapeutic approach suggest it should be considered a distinct entity. Methods: This study retrospectively analyzes data from a nationwide, multicenter, prospective cohort including consecutive cases of IE at 45 hospitals across Spain from 2008 to 2021. HCIE was defined as IE detected in patients in close contact with the healthcare system (eg, patients receiving intravenous treatment, hemodialysis, or institutionalized). The prevalence and main characteristics of HCIE were examined and compared with those of community-acquired IE (CIE) and nosocomial IE (NIE) and with literature data. Results: IE was diagnosed in 4520 cases, of which 2854 (63%) were classified as CIE, 1209 (27%) as NIE, and 457 (10%) as HCIE. Patients with HCIE showed a high burden of comorbidities, a high presence of intravascular catheters, and a predominant staphylococcal etiology, Staphylococcus aureus being identified as the most frequent causative agent (35%). They also experienced more persistent bacteremia, underwent fewer surgeries, and showed a higher mortality rate than those with CIE (32.4% vs 22.6%). However, mortality in this group was similar to that recorded for NIE (32.4% vs 34.9%, respectively, P = .40). Conclusions: Our data do not support considering HCIE as a distinct entity. HCIE affects a substantial number of patients, is associated with a high mortality, and shares many characteristics with NIE.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Open Forum Infect Dis Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Open Forum Infect Dis Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: Estados Unidos