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Is Rifampin Use Associated With Better Outcome in Staphylococcal Prosthetic Valve Endocarditis? A Multicenter Retrospective Study
- Source :
- Clinical Infectious Diseases, Clinical Infectious Diseases, Oxford University Press (OUP), 2020, pp.ciaa1040. ⟨10.1093/cid/ciaa1040⟩, Clinical Infectious Diseases, 2021, 72 (9), pp.e249-e255. ⟨10.1093/cid/ciaa1040⟩, Clinical Infectious Diseases, Oxford University Press (OUP), 2021, 72 (9), pp.e249-e255. ⟨10.1093/cid/ciaa1040⟩
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- Background International guidelines recommend rifampin-based combinations for staphylococcal prosthetic valve endocarditis (PVE). However, no robust clinical data support this recommendation, and rifampin tolerability is an issue. We aimed to evaluate the impact of rifampin for the treatment of staphylococcal PVE. Methods An observational retrospective cohort study of all adults with staphylococcal PVE (modified Duke criteria) was conducted in 3 referral centers for endocarditis, during years 2000–2018. Primary outcome measurement was 1-year mortality. Results We enrolled 180 patients with PVE due to Staphylococcus aureus (n = 114, 63.3%), or coagulase-negative staphylococci (n = 66, 36.7%), on bioprosthesis (n = 111, 61.7%), mechanical valve (n = 67, 37.2%), or both (n = 2). There were 132 males (73.3%), and mean age was 70.4 ± 12.4 years. Valvular surgery was performed in 51/180 (28.3%) cases. Despite all isolates were susceptible to rifampin, only 101 (56.1%) were treated with rifampin, for a median duration of 33.0 days, whereas 79 (43.9%) received no rifampin. Baseline characteristics were similar in both groups. One-year mortality was, respectively, 37.6% (38/101), and 31.6% (25/79), in patients treated with, or without, rifampin (P = .62). Relapse rates were 5.9% (6/101), and 8.9% (7/79), P = .65. Patients treated with rifampin had longer hospital length-of-stay: 42.3 ± 18.6 vs 31.3 ± 14.0 days (P < .0001). On multivariate analysis, only cerebral emboli (odds ratio [OR] 2.95, 95% confidence interval [CI], 1.30–6.70, P = .009), definite endocarditis (OR 7.15, 95% CI, 1.47–34.77, P = .018), and methicillin-resistant S. aureus (OR 6.04, 95% CI, 1.34–27.26, P = .019), were associated with 1-year mortality. Conclusions A large proportion (43.9%) of staphylococcal PVE received no rifampin. One-year survival and relapse rates were similar in patients treated with or without rifampin.
- Subjects :
- Adult
Male
Methicillin-Resistant Staphylococcus aureus
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Prosthesis-Related Infections
[SDV]Life Sciences [q-bio]
030106 microbiology
030204 cardiovascular system & hematology
medicine.disease_cause
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases
Internal medicine
medicine
Humans
Endocarditis
In patient
Prosthetic valve endocarditis
Aged
Retrospective Studies
Aged, 80 and over
relapse
business.industry
Retrospective cohort study
Endocarditis, Bacterial
Odds ratio
Middle Aged
Staphylococcal Infections
medicine.disease
mortality
Confidence interval
prosthetic valve
3. Good health
[SDV] Life Sciences [q-bio]
Infectious Diseases
Tolerability
Staphylococcus aureus
Heart Valve Prosthesis
[SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases
endocarditis
Rifampin
business
Subjects
Details
- Language :
- English
- ISSN :
- 10584838 and 15376591
- Database :
- OpenAIRE
- Journal :
- Clinical Infectious Diseases, Clinical Infectious Diseases, Oxford University Press (OUP), 2020, pp.ciaa1040. ⟨10.1093/cid/ciaa1040⟩, Clinical Infectious Diseases, 2021, 72 (9), pp.e249-e255. ⟨10.1093/cid/ciaa1040⟩, Clinical Infectious Diseases, Oxford University Press (OUP), 2021, 72 (9), pp.e249-e255. ⟨10.1093/cid/ciaa1040⟩
- Accession number :
- edsair.doi.dedup.....73a01a375375053dcaf4be1328703c34