Men's more frequent predisposing factors in infectious endocarditis facilitate improvement of outcomes by shortening of diagnostic delay

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 11

Published: Feb. 12, 2025

Introduction Despite growing evidence for sex-specific differences in cardiovascular disease, sex is poorly considered the management of infectious endocarditis (IE). Purpose This study aimed to assess aspects diagnosing IE. Methods All consecutive patients admitted at Ulm University Heart Center with suspected IE between 2009 and 2019 were included. was diagnosed using Duke criteria. Risk factors, clinical presentation in-hospital outcomes along impact diagnostic delay compared male female patients. Results 96 118 men (81.4%) 33 45 women (73.3%) ( p = 0.121). Time diagnosis similar groups 0.598). Regarding patient characteristics, younger (65.5 vs. 74.3 years, 0.006). Men exhibited a higher prevalence predisposing cardiac conditions 0.012) due frequency history implantable cardioverter defibrillator implantation 0.004), more likely have poor dental status 0.001), coronary artery disease 0.002). The incidence complications heart failure reduced ejection fraction 0.007) new-onset dialysis higher, time intensive care unit longer. Male only independent risk factor mortality [ 0.036, HR 4.127 (95%-CI 1.096-15.538)]. Notably, cohort, shorter associated lower rate 0.035, optimal cut-point 3.5 days). within days had 13.5% 31.8% those later 0.028). Conclusion are younger, factors experience complicated course while benefiting from early diagnosis. Therefore, recognizing heightened profile specific during can help address their poorer prognosis.

Language: Английский

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Early oral stepdown therapy for infective endocarditis: an international cross-sectional survey on current use in clinical practice

CMI Communications, Journal Year: 2025, Volume and Issue: unknown, P. 105063 - 105063

Published: Feb. 1, 2025

Language: Английский

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Rethinking risk stratification for infective endocarditis in adults with congenital heart disease: Lessons for emergency medicine

International Journal of Cardiology, Journal Year: 2025, Volume and Issue: unknown, P. 133187 - 133187

Published: March 1, 2025

Language: Английский

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Management of Staphylococcus aureus Bacteremia

JAMA, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

Importance Staphylococcus aureus , a gram-positive bacterium, is the leading cause of death from bacteremia worldwide, with case fatality rate 15% to 30% and an estimated 300 000 deaths per year. Observations causes metastatic infection in more than one-third cases, including endocarditis (≈12%), septic arthritis (7%), vertebral osteomyelitis (≈4%), spinal epidural abscess, psoas splenic pulmonary emboli, seeding implantable medical devices. Patients S commonly present fever or symptoms infection, such as pain back, joints, abdomen extremities, and/or change mental status. Risk factors include intravascular devices cardiac dialysis vascular catheters, recent surgical procedures, injection drug use, diabetes, previous infection. detected blood cultures. Prolonged (≥48 hours) associated 90-day mortality risk 39%. All patients should undergo transthoracic echocardiography; transesophageal echocardiography be performed at high for endocarditis, those persistent bacteremia, fever, foci, Other imaging modalities, computed tomography magnetic resonance imaging, based on localizing signs categorized methicillin-susceptible (MSSA) methicillin-resistant (MRSA) susceptibility β-lactam antibiotics. Initial treatment typically includes antibiotics active against MRSA vancomycin daptomycin. Once antibiotic results are available, adjusted. Cefazolin antistaphylococcal penicillins used MSSA vancomycin, daptomycin, ceftobiprole MRSA. Phase 3 trials demonstrated noninferiority daptomycin standard care (treatment success, 53/120 [44%] vs 48/115 [42%]) 132/189 [70%] 136/198 [69%]). Source control critical component treating may removal infected implanted devices, drainage abscesses, debridement. Conclusions relevance has year worldwide. Empirical which susceptibilities known, treated cefazolin penicillin. Additional clinical management consists identifying sites pursuing source identified foci

Language: Английский

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Switch to oral antibiotics in Gram-negative bacteraemia: a randomized, open-label, clinical trial

Clinical Microbiology and Infection, Journal Year: 2023, Volume and Issue: 30(4), P. 492 - 498

Published: Oct. 18, 2023

To evaluate the safety and efficacy of switching from intravenous (IV) to oral antimicrobial therapy in patients with Enterobacterales bacteraemia, after completion 3-5 days microbiologically active IV therapy.

Language: Английский

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Inflammation and arrhythmogenesis: a narrative review of the complex relationship

International Journal of Arrhythmia, Journal Year: 2024, Volume and Issue: 25(1)

Published: Feb. 7, 2024

Abstract Background A biological mechanism called inflammation is necessary for reacting to damaging stimuli, but it can also, ironically, play a role in the formation of arrhythmias, or group disorders known as arrhythmogenesis. This review delves into intricate relationship that exists between localized and systemic electrophysiological changes result abnormal heart rhythms. Main body Through oxidative stress, autonomic dysfunction, electrolyte imbalances, coagulation activation, may impact arrhythmogenicity. Similar neuropathic alterations, direct cellular damage, structural remodeling, also predisposes arrhythmias. Studies demonstrating cytokines on ion channel expression function, along with clinical associations inflammatory indicators arrhythmia incidence, offer molecular insights. Immune cells like macrophages alter cardiac conduction are involved interaction electrophysiology, which further complicates situation. Clinical ramifications include use anti-inflammatory drugs treat arrhythmic episodes possible adjustment treatment based condition. Even yet, thorough study fully understand efficacy these medicines. Conclusions Arrhythmogenesis inherently linked by number mechanisms change electrical characteristics heart. Arrhythmia prevention benefit from therapeutic approaches reduce processes. The difficulties still exist applying this information settings highlight necessity continuing studies better comprehend subtleties inflammation-induced alterations. Progress identifying biomarkers developing tailored therapies will be crucial enhancing prognosis individuals suffering arrhythmogenic aggravated inflammation.

Language: Английский

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Aprepitant ameliorates vancomycin-induced kidney injury: Role of GPX4/system Xc− and oxidative damage

Food and Chemical Toxicology, Journal Year: 2025, Volume and Issue: unknown, P. 115264 - 115264

Published: Jan. 1, 2025

Language: Английский

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A case of stroke as a unique sign of subclinical infective endocarditis by Abiotrophia defectiva: a case report

International Journal of Emergency Medicine, Journal Year: 2025, Volume and Issue: 18(1)

Published: Jan. 17, 2025

Here we describe a patient admitted for stroke that was unexpectedly correlated with subclinical infective endocarditis attributable to rarely opportunistic pathogen, Abiotrophia defectiva. A 75-year-old man presented stroke. Transesophageal echocardiography suggested vegetation on all aortic valve cusps, despite the absence of clinical or laboratory signs infection. Surprisingly, three sets blood cultures collected without fever were positive A. Although did not exhibit classic infection during hospitalization, severity condition necessitated replacement bioprosthesis. This case underscores importance investigating origin endocarditis, even in evidence. Physicians should maintain high level suspicion, especially patients highly suggestive anamnestic characteristics.

Language: Английский

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Benchmarking antimicrobial use to antimicrobial resistance: a comparative study of two hospitals using current National Healthcare Safety Network (NHSN) metrics

Infection Control and Hospital Epidemiology, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 8

Published: Jan. 27, 2025

Abstract Objective: We aimed to determine whether benchmarking antimicrobial use (AU) resistance (AR) using select AU/AR ratios is more informative than AU metrics in isolation. Design: retrospectively measured (antimicrobial therapy days per 1,000 present) and (specific corresponding AR event) two hospitals during 2020 through 2022. then had stewardship committee members evaluate each value indicate they believed it represented potential overuse, appropriate use, or underuse of the antimicrobials, could not provide an assessment. Setting: Two acute-care hospitals. Patients: Hospitalized patients. Results: In semi-annual facility-wide analyses, echinocandins a median ratio 658.5 fluconazole-resistant Candida event Hospital A, IV vancomycin 114.9 108.2 methicillin-resistant Staphylococcus aureus A B, respectively, linezolid 33.8 88.0 vancomycin-resistant Enterococcus respectively. When values were evaluated by committees, respondents able assess based on compared values. Based ratios, most identified overuse B. Conclusion: Select provided personnel, which can be used motivate audits administration appropriateness.

Language: Английский

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Diagnosis of Coxiella burnetii endocarditis by using nanopore targeted sequencing: a case report

BMC Infectious Diseases, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 5, 2025

Language: Английский

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