dc.creator | Egea, Viviana de | es |
dc.creator | Muñoz, Patricia | es |
dc.creator | Valerio, Maricela | es |
dc.creator | Alarcón, Arístides de | es |
dc.creator | Lepe Jiménez, José Antonio | es |
dc.creator | Miró, José M. | es |
dc.creator | Gálvez-Acebal, Juan | es |
dc.creator | García-Pavía, Pablo | es |
dc.creator | Navas, Enrique | es |
dc.date.accessioned | 2021-05-26T11:55:27Z | |
dc.date.available | 2021-05-26T11:55:27Z | |
dc.date.issued | 2015 | |
dc.identifier.citation | Egea, V.d., Muñoz, P., Valerio, M., Alarcón, A.d., Lepe Jiménez, J.A., Miró, J.M.,...,Navas, E. (2015). Characteristics and Outcome of Streptococcus pneumoniae Endocarditis in the XXI Century. A Systematic Review of 111 Cases (2000–2013). Medicine, 94 (39), 1-11. | |
dc.identifier.issn | 1536-5964 | es |
dc.identifier.uri | https://hdl.handle.net/11441/110846 | |
dc.description.abstract | Streptococcus pneumoniae is an infrequent cause of severe infectious endocarditis (IE). The aim of our study was to describe the epidemiology, clinical and microbiological characteristics, and outcome of a series of cases of S. pneumoniae IE diagnosed in Spain and in a series of cases published since 2000 in the medical literature. We prospectively collected all cases of IE diagnosed in a multicenter cohort of patients from 27 Spanish hospitals (n¼2539). We also performed a systematic review of the literature since 2000 and retrieved all cases with complete clinical data using a pre-established protocol.
Predictors of mortality were identified using a logistic regression model. We collected 111 cases of pneumococcal IE: 24 patients from the Spanish cohort and 87 cases from the literature review. Median age was 51 years, and 23 patients (20.7%) were under 15 years. Men accounted for 64% of patients, and infection was community-acquired in 96.4% of
cases. The most important underlying conditions were liver disease (27.9%) and immunosuppression (10.8%). A predisposing heart condition was present in only 18 patients (16.2%). Pneumococcal IE affected a native valve in 93.7% of patients. Left-sided endocarditis predominated (aortic valve 53.2% and mitral valve 40.5%). The microbiological diagnosis was obtained from blood cultures in 84.7% of cases. In the Spanish cohort, nonsusceptibility to penicillin was detected in 4.2%. The most common clinical manifestations included fever (71.2%), a new heart murmur (55%), pneumonia (45.9%), meningitis (40.5%), and Austrian syndrome (26.1%). Cardiac surgery was performed in 47.7% of patients. The in-hospital mortality rate was 20.7%. The multivariate analysis revealed the independent risk factors for mortality to be meningitis (OR, 4.3; 95% CI, 1.4–12.9; P<0.01). Valve surgery was protective (OR, 0.1; 95% CI, 0.04–0.4; P<0.01).
Streptococcus pneumoniae IE is a community-acquired disease that mainly affects native aortic valves. Half of the cases in the present study had concomitant pneumonia, and a considerable number developed meningitis. Mortality was high, mainly in patients with central nervous system (CNS) involvement. Surgery was protective. | es |
dc.format | application/pdf | es |
dc.format.extent | 11 | es |
dc.language.iso | eng | es |
dc.publisher | Wolters Kluwer | es |
dc.relation.ispartof | Medicine, 94 (39), 1-11. | |
dc.rights | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Streptococcus pneumoniae | es |
dc.subject | Endocarditis | es |
dc.subject | Medical literature | es |
dc.title | Characteristics and Outcome of Streptococcus pneumoniae Endocarditis in the XXI Century. A Systematic Review of 111 Cases (2000–2013) | es |
dc.type | info:eu-repo/semantics/article | es |
dcterms.identifier | https://ror.org/03yxnpp24 | |
dc.type.version | info:eu-repo/semantics/publishedVersion | es |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | es |
dc.contributor.affiliation | Universidad de Sevilla. Departamento de Microbiología | es |
dc.identifier.doi | 10.1097/md.0000000000001562 | es |
dc.contributor.group | Universidad de Sevilla. CTS204: Biotecnología Aplicada al Estudio de Enf. Infecciosas | es |
dc.journaltitle | Medicine | es |
dc.publication.volumen | 94 | es |
dc.publication.issue | 39 | es |
dc.publication.initialPage | 1 | es |
dc.publication.endPage | 11 | es |