Associated factors and descriptive analysis of healthcare-related infective endocarditis in a tertiary reference hospital

作者：Nunez Aragon Raquel; Pedro Botet Montoya Maria Luisa; Mateu Prunonosa Lourdes; Vallejo Camazon Nuria; Sopena Galindo Nieves; Casas Garcia Irma; Molinos Arbos Sonia; Sabria Leal Miquel

来源：Enfermedades Infecciosas y Microbiologia Clinica, 2013, 31(1): 15-22.

DOI：10.1016/j.eimc.2012.03.014

• Infective endocarditis
• Community-acquired infection
• Healthcare-related infection
• Hospital-acquired infection

Introduction and objectives: The primary aim of this study was to evaluate associated factors, clinical features and prognosis of healthcare-related infective endocarditis cases compared with community-acquired and intravenous drug user-related episodes. Changes in the distribution of healthcare-related infective endocarditis were also analysed over time in our setting.
Methods: A prospective, observational, comparative study was performed. We included all the cases of infective endocarditis from January 2003 to June 2010, which were then classified into 2 groups: group 1: community-acquired and intravenous drug user origin, and group 2: nosocomial and non-nosocomial healthcare-related cases. The episodes were classified into 2 periods: period I: January/2003-June/2006 and period II: July/2006-June 2010. Univariate and multivariate analyses were performed.
Results: A total of 212 cases were included (group 1: 138, group 2: 74). The variables of age (risk ratio 1.026; 95% CI, 1.003 to 1.049), Charlson index (risk radio 1.242; 95% CI, 1.067 to 1.445), and previous heart surgery (risk ratio 2.522; 95% Cl, 1.353 to 4.701) were independently associated with healthcare-related infective endocarditis on multivariate analysis. A non-significant increase was observed in healthcare-related cases of infective endocarditis in period II (40/104; 38.4% vs. 34/108; 31.4%).
Conclusions: The recent increase in healthcare-related infective endocarditis seems to be associated with the use of invasive procedures in elderly patients with prosthetic cardiac valve, and those with a greater number of underlying diseases, especially patients with chronic renal failure on haemodialysis.

• 出版日期2013-1