학술논문
Evolution of epidemiological characteristics of infective endocarditis in Greece
Document Type
article
Author
Efthymia Giannitsioti; Angelos Pefanis; Charalampos Gogos; Alexandra Lekkou; Georgios N. Dalekos; Nikolaos Gatselis; Sara Georgiadou; Paraskevas Nikou; Agathi Vrettou; Angelos Rigopoulos; Christos Tryfonopoulos; Thomas Tsaganos; Emmanouil Karofilakis; Christos Psarrakis; Michail Argyriou; Panagiotis Gargalianos-Kakolyris; Georgios Adamis; Panagiota Lourida; Diamantis Kofteridis; Aggeliki Andrianaki; Chariclia Loupa; Evangelos Kostis; Dimitris Sinapidis; Styliani Sympardi; Nikolaos Alexiou; Ilias Karaiskos; Aikaterini Masgala; Efstratios Maltezos; Periklis Panagopoulos; Vasileios Sachpekidis; Constantinos Evdoridis; Nikolaos V. Sipsas; Georgios Daikos; Helen Giamarellou; Konstantinos Pontikis; Ioannis Lioris; Moysis Lelekis; Athanasios Trikkas; Dimitrios Aggouras; Vasilios Kolias; Chris Rokkas; Maria Nana-Anastasiou; Spiros Miyakis
Source
International Journal of Infectious Diseases, Vol 106, Iss , Pp 213-220 (2021)
Subject
Language
English
ISSN
1201-9712
Abstract
Objective: The clinical profile, management and outcome of infective endocarditis (IE) may be influenced by socioeconomic issues. Methods: A nationwide prospective study evaluated IE during the era of deep economic crisis in Greece. Epidemiological data and factors associated with 60-day mortality were analyzed through descriptive statistics, logistic and Cox-regression models. Results: Among 224 patients (male 72.3%, mean age 62.4 years), Staphylococcus aureus (n = 62; methicillin-resistant S. aureus (MRSA) 33.8%) predominated in the young without impact on mortality (p = 0.593), whilst Enterococci (n = 36) predominated in the elderly. Complications of IE were associated with mortality: heart failure [OR 2.415 (95% CI: 1.159–5.029), p = 0.019], stroke [OR 3.206 (95% CI: 1.190–8.632), p = 0.018] and acute kidney injury [OR 2.283 (95% CI: 1.085–4.805), p = 0.029]. A 60-day survival benefit was solely related to cardiac surgery for IE during hospitalization [HR 0.386 (95% CI: 0.165–0.903), p = 0.028] and compliance with antimicrobial treatment guidelines [HR 0.487 (95% CI: 0.259–0.916), p = 0.026]. Compared with a previous country cohort study, history of rheumatic fever and native valve predisposition had declined, whilst underlying renal disease and right-sided IE had increased (p < 0.0001); HIV infection had emerged (p = 0.002). No difference in rates of surgery and outcome was assessed. Conclusions: A country-wide survey of IE highlighted emergence of HIV, right-sided IE and predominance of MRSA in the youth during a severe socioeconomic crisis. Compliance with treatment guidelines promoted survival.