Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020
Microbiological etiology has been associated with surgery for infective endocarditis (IE) during admission, especially <i>Staphylococcus aureus</i>. We aimed to compare patient characteristics, microbiological characteristics, and outcomes by treatment choice (surgery or not). We identif...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-09-01
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| Series: | Microorganisms |
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| Online Access: | https://www.mdpi.com/2076-2607/11/10/2403 |
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| author | Peter Laursen Graversen Lauge Østergaard Marianne Voldstedlund Malthe Faurschou Wandall-Holm Morten Holdgaard Smerup Lars Køber Emil Loldrup Fosbøl |
| author_facet | Peter Laursen Graversen Lauge Østergaard Marianne Voldstedlund Malthe Faurschou Wandall-Holm Morten Holdgaard Smerup Lars Køber Emil Loldrup Fosbøl |
| author_sort | Peter Laursen Graversen |
| collection | DOAJ |
| description | Microbiological etiology has been associated with surgery for infective endocarditis (IE) during admission, especially <i>Staphylococcus aureus</i>. We aimed to compare patient characteristics, microbiological characteristics, and outcomes by treatment choice (surgery or not). We identified patients with first-time IE between 2010 and 2020 and examined the microbiological etiology of IE according to treatment choice. To identify factors associated with surgery during initial admission, we used the Aalen–Johansen estimator and an adjusted cause-specific Cox model. One-year mortality stratified by microbiological etiology and treatment choice was assessed using unadjusted Kaplan–Meier estimates and an adjusted Cox proportional hazard model. A total of 6255 patients were included, of which 1276 (20.4%) underwent surgery during admission. Patients who underwent surgery were younger (65 vs. 74 years) and less frequently had cerebrovascular disease, cardiovascular disease, diabetes, and chronic kidney disease. Patients with <i>Staphylococcus aureus</i> IE were less likely to undergo surgery during admission (13.6%) compared to all other microbiological etiologies. One-year mortality according to microbiological etiology in patients who underwent surgery was 7.0%, 5.3%, 5.5%, 9.6%, 13.2, and 11.2% compared with 24.2%, 19.1%, 27,6%, 25.2%, 21%, and 16.9% in patients who received medical therapy for <i>Staphylococcus aureus</i>, <i>Streptococcus</i> spp., <i>Enterococcus</i> spp., coagulase-negative Staphylococci, “other microbiological etiologies”, and blood culture-negative infective endocarditis, respectively. Patients with IE who underwent surgery differed in terms of microbiology, more often having Streptococci than those who received medical therapy. Contrary to expectations, <i>Staphylococcus aureus</i> was more common among patients who received medical therapy only. |
| first_indexed | 2024-03-10T21:02:19Z |
| format | Article |
| id | doaj.art-22d654c319144699bb0c0612ff47fdae |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-10T21:02:19Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-22d654c319144699bb0c0612ff47fdae2023-11-19T17:26:12ZengMDPI AGMicroorganisms2076-26072023-09-011110240310.3390/microorganisms11102403Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020Peter Laursen Graversen0Lauge Østergaard1Marianne Voldstedlund2Malthe Faurschou Wandall-Holm3Morten Holdgaard Smerup4Lars Køber5Emil Loldrup Fosbøl6Department of Cardiology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Data Integration and Analysis, Statens Serum Institut, 2300 Copenhagen, DenmarkDanish Multiple Sclerosis Registry, Department of Neurology, University of Copenhagen—Rigshospitalet, 2600 Glostrup, DenmarkDepartment of Cardiothoracic Surgery, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkDepartment of Cardiology, Copenhagen University Hospital—Rigshospitalet, 2100 Copenhagen, DenmarkMicrobiological etiology has been associated with surgery for infective endocarditis (IE) during admission, especially <i>Staphylococcus aureus</i>. We aimed to compare patient characteristics, microbiological characteristics, and outcomes by treatment choice (surgery or not). We identified patients with first-time IE between 2010 and 2020 and examined the microbiological etiology of IE according to treatment choice. To identify factors associated with surgery during initial admission, we used the Aalen–Johansen estimator and an adjusted cause-specific Cox model. One-year mortality stratified by microbiological etiology and treatment choice was assessed using unadjusted Kaplan–Meier estimates and an adjusted Cox proportional hazard model. A total of 6255 patients were included, of which 1276 (20.4%) underwent surgery during admission. Patients who underwent surgery were younger (65 vs. 74 years) and less frequently had cerebrovascular disease, cardiovascular disease, diabetes, and chronic kidney disease. Patients with <i>Staphylococcus aureus</i> IE were less likely to undergo surgery during admission (13.6%) compared to all other microbiological etiologies. One-year mortality according to microbiological etiology in patients who underwent surgery was 7.0%, 5.3%, 5.5%, 9.6%, 13.2, and 11.2% compared with 24.2%, 19.1%, 27,6%, 25.2%, 21%, and 16.9% in patients who received medical therapy for <i>Staphylococcus aureus</i>, <i>Streptococcus</i> spp., <i>Enterococcus</i> spp., coagulase-negative Staphylococci, “other microbiological etiologies”, and blood culture-negative infective endocarditis, respectively. Patients with IE who underwent surgery differed in terms of microbiology, more often having Streptococci than those who received medical therapy. Contrary to expectations, <i>Staphylococcus aureus</i> was more common among patients who received medical therapy only.https://www.mdpi.com/2076-2607/11/10/2403microorganisminfective endocarditissurgerymicrobiological etiologymicrobiological characteristics |
| spellingShingle | Peter Laursen Graversen Lauge Østergaard Marianne Voldstedlund Malthe Faurschou Wandall-Holm Morten Holdgaard Smerup Lars Køber Emil Loldrup Fosbøl Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020 Microorganisms microorganism infective endocarditis surgery microbiological etiology microbiological characteristics |
| title | Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020 |
| title_full | Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020 |
| title_fullStr | Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020 |
| title_full_unstemmed | Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020 |
| title_short | Microbiological Etiology in Patients with IE Undergoing Surgery and for Patients with Medical Treatment Only: A Nationwide Study from 2010 to 2020 |
| title_sort | microbiological etiology in patients with ie undergoing surgery and for patients with medical treatment only a nationwide study from 2010 to 2020 |
| topic | microorganism infective endocarditis surgery microbiological etiology microbiological characteristics |
| url | https://www.mdpi.com/2076-2607/11/10/2403 |
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