1. Infective Endocarditis Caused by Staphylococcus Aureus after Transcatheter Aortic Valve Replacement
- Author
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Fernando Alfonso, Marco Barbanti, Oliver Husser, Harindra C. Wijeysundera, Jean-Bernard Masson, Ignacio J. Amat-Santos, Samir R. Kapadia, Marina Urena, Francisco Campelo-Parada, Vinicius Esteves, Roger R. Godinho, Tarun Chakravarty, Marcos Antonio Marino, Stamatios Lerakis, Alexandre Siciliano Colafranceschi, Marouane Boukhris, Chekrallah Chamandi, Lisa Crusius, Tomasz Gasior, Azeem Latib, Norman Mangner, Utz Kappert, Josep Rodés-Cabau, José Armando Mangione, Francesco Rosato, Axel Linke, Sandro Sponga, Erika Muñoz-García, Valter Corriea de Lima, Susheel Kodali, Asim N. Cheema, Lars Søndergaard, Igor Vendramin, Alexandre Abizaid, Antonio L. Bartorelli, Annapoorna Kini, Rosana Hernández-Antolín, John G. Webb, Costanza Pellegrini, Didier Tchetche, Howard C. Herrmann, John Lisko, Claudia Fiorina, Mohamed Abdel-Wahab, Kim Won-Keun, Hélène Eltchaninoff, Alberto Alperi, Martin Landt, Dominique Himbert, Frédéric Maes, Victoria Vilalta, Luca Testa, Isaac Pascual, Luisa Salido, Jan Malte Sinning, Vicenç Serra, Guglielmo Mario Actis Dato, Antonio Miceli, Clement Servoz, David del Val, Rafael Romaguera, Maria-Cristina Ferreira, Eric Durand, Julio Andrea, Fabio Sandoli de Brito, Vincent Auffret, Philippe Gervais, Stefan Stortecky, Paolo Olivares, Francesco Giannini, Enrique Gutiérrez-Ibañes, Raj Makkar, Nikolaj Ihlemann, Wojtek Wojakowski, Hervé Le Breton, Abdullah Alkhodair, Juan C. Castillo, Ander Regueiro, David Holzhey, Luis Nombela-Franco, Henrique Barbosa Ribeiro, Saif Siddiqui, Université Laval [Québec] (ULaval), Universität Leipzig [Leipzig], Endothélium, valvulopathies et insuffisance cardiaque (EnVI), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Toulouse [Toulouse], Clinique Pasteur, Clinique Pasteur [Toulouse], Mount Sinai Hospital [Toronto, Canada] (MSH), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), University Hospital Leipzig, Edwards Lifesciences, Fundación Alfonso Martín Escudero, Abbott Laboratories, Medtronic, Boston Scientific Corporation, UCL - (SLuc) Département cardiovasculaire, UCL - SSS/IREC/SLUC - Pôle St.-Luc, Hôpital de Rangueil, Universität Leipzig, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
- Subjects
Male ,medicine.medical_specialty ,Staphylococcus aureus ,Prosthesis-Related Infections ,Transcatheter aortic ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Global Health ,Prosthesis ,Sepsis ,Transcatheter Aortic Valve Replacement ,03 medical and health sciences ,0302 clinical medicine ,Valve replacement ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Risk Factors ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,medicine ,Endocarditis ,Humans ,030212 general & internal medicine ,Hospital Mortality ,Registries ,610 Medicine & health ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Incidence ,Aortic Valve Stenosis ,Endocarditis, Bacterial ,Staphylococcal Infections ,medicine.disease ,3. Good health ,Surgery ,Survival Rate ,Infective endocarditis ,Aortic Valve ,Heart Valve Prosthesis ,Etiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
International audience; Background - Staphylococcus aureus (SA) has been extensively studied as causative microorganism of surgical prosthetic-valve infective endocarditis (IE). However, scarce evidence exists on SA IE after transcatheter aortic valve replacement (TAVR). Methods - Data were obtained from the Infectious Endocarditis After TAVR International Registry, including patients with definite IE after TAVR from 59 centres in 11 countries. Patients were divided into 2 groups according to microbiologic etiology: non-SA IE vs SA IE. Results - SA IE was identified in 141 patients out of 573 (24.6%), methicillin-sensitive SA in most cases (115/141, 81.6%). Self-expanding valves were more common than balloon-expandable valves in patients presenting with early SA IE. Major bleeding and sepsis complicating TAVR, neurologic symptoms or systemic embolism at admission, and IE with cardiac device involvement (other than the TAVR prosthesis) were associated with SA IE (P < 0.05 for all). Among patients with IE after TAVR, the likelihood of SA IE increased from 19% in the absence of those risk factors to 84.6% if ≥ 3 risk factors were present. In-hospital (47.8% vs 26.9%; P < 0.001) and 2-year (71.5% vs 49.6%; P < 0.001) mortality rates were higher among patients with SA IE vs non-SA IE. Surgery at the time of index SA IE episode was associated with lower mortality at follow-up compared with medical therapy alone (adjusted hazard ratio 0.46, 95% CI 0.22-0.96; P = 0.038). Conclusions - SA IE represented approximately 25% of IE cases after TAVR and was associated with very high in-hospital and late mortality. The presence of some features determined a higher likelihood of SA IE and could help to orientate early antibiotic regimen selection. Surgery at index SA IE was associated with improved outcomes, and its role should be evaluated in future studies.
- Published
- 2022
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