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Infective endocarditis in patients with solid organ transplantation. A nationwide descriptive study

Abstract: Background. Solid organ transplantation (SOT) implies immunosuppression and frequent health care contact. Our aim was to compare the characteristics of patients with infective endocarditis (IE) and SOT against those without SOT. Methods. We used data from the Spanish Collaboration on Endocarditis during the period 2008-2018. Results. We identified 4794 cases of IE, 85 (1.8%) in SOT (56 kidney, 18 liver, 8 heart, 3 lung). Thirteen patients with other transplantation types (bone marrow, hematopoietic precursors, and cornea) were excluded from the analysis. Compared with patients without SOT, patients with SOT had lower median age (61 vs. 69 years, p<0.001), more comorbidities (mean age-adjusted Charlson index 5.7±2.9 vs. 4.9±2.9, p=0.004), a lower prevalence of native valvular heart disease (29.4 vs. 45.4%, p=0.003), more in-hospital and healthcare-related IE (70.5% vs. 36.3%, p<0.001) and staphylococcal etiology (57.7% vs. 39.7%, p=0.001). Patients with SOT had more frequent kidney function worsening (47.1% vs. 34.6%, p=0.02), septic shock (25.9% vs. 12.1 %, p<0.001), sepsis (27.1% vs. 17.2%, p=0.02), and less surgery indication (54.1% vs 66.3%, p=0.02) and surgery (32.9% vs. 46.3%, p=0.01) than patients without SOT. There were no significant differences in mortality: inhospital (30.6% SOT vs. 25.6% without SOT, p=0.31), 1-year (38.8% SOT vs. 31.9% without SOT, p=0.18). Conclusions. Most IE in SOT recipients are nosocomial and over 70% are health care-related. Half have previously normal heart valves and almost 60% are due to Staphylococcus spp. infections. Mortality seems to be similar to non-SOT counterparts.

 Fuente: European Journal of Internal Medicine 87 (2021) 59-65

 Editorial: Elsevier

 Fecha de publicación: 01/05/2021

 Tipo de publicación: Artículo de Revista

 DOI: doi.org/10.1016/j.ejim.2021.02.017

 ISSN: 0953-6205,1879-0828

 Url de la publicación: https://doi.org/10.1016/j.ejim.2021.02.017

Autoría

MARTÍNEZ SELLÉS, MANUEL

VALERIO MINERO, MARICELA

RODRÍGUEZ ABELLA, HUGO

RODRÍGUEZ, MARÍA LUISA

ALARCÓN, ARISTIDES DE

GUTIÉRREZ CARRETERO, ENCARNACIÓN

COBO BELAUSTEGUI, MANUEL

GOENAGA, MIGUEL ÁNGEL

MORENO CAMACHO, ASUNCIÓN

DOMÍNGUEZ, FERNANDO

GARCÍA PÉREZ, LAURA

DOMÍNGUEZ PÉREZ, LAURA

MUÑOZ, PATRICIA