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Infective Endocarditis: What Is New in the Clinical Research?
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Infective Endocarditis: What Is New in the Clinical Research?

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (31 May 2023) | Viewed by 11647

Special Issue Editor

Dr. Petros Ioannou

E-Mail Website
Guest Editor
Department of Internal Medicine & Infectious Diseases, University Hospital of Heraklion, 71110 Heraklion, Crete, Greece
Interests: clinical microbiology; infectious diseases; endocarditis; mycoses; fungal infections
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Infective endocarditis (IE) is a rare disease that still poses significant challenges. Despite significant advances made in medical knowledge and technology that have improved the diagnosis and treatment of infectious diseases in the last few decades, IE is still associated with significant morbidity and mortality, while its epidemiology is changing. Patients are older in age, the microbiology has changed due to the increase in healthcare-associated infection, leading to the more frequent identification of Gram-negative microorganisms as causes of IE. On the other hand, the increasing rates of antimicrobial resistance have resulted in the more frequent diagnosis of IE caused by microorganisms with few therapeutic options. Finally, the increasing use of immunosuppression in patients with cancer, autoimmune diseases, and transplantation has led to an increase in the diagnosis of IE caused by rare pathogens. This Special Issue will focus on the current clinical research on IE and present the latest data on the changing epidemiology, microbiology, diagnostic methods, and treatment of IE as well as its outcomes.

Dr. Petros Ioannou
Guest Editor

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Keywords

  • infective endocarditis
  • vegetation
  • native valve
  • prosthetic valve
  • cardiac device
  • bloodstream infection

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Related Special Issue

Published Papers (6 papers)

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Editorial

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3 pages, 190 KiB  
Editorial
Special Issue “Infective Endocarditis: What Is New in the Clinical Research?”
by Petros Ioannou
J. Clin. Med. 2023, 12(15), 5064; https://doi.org/10.3390/jcm12155064 - 1 Aug 2023
Cited by 1 | Viewed by 1085
Abstract
Infective Endocarditis (IE) is a disease that carries high morbidity and mortality risks and involves the infection of the endocardium, and more commonly of the cardiac valves and prosthetic material, like implantable defibrillators or pacemakers [...] Full article
(This article belongs to the Special Issue Infective Endocarditis: What Is New in the Clinical Research?)

Research

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9 pages, 1135 KiB  
Article
A Gap of Patients with Infective Endocarditis between Clinical Trials and the Real World
by Nobuhiro Asai, Yuichi Shibata, Jun Hirai, Wataru Ohashi, Daisuke Sakanashi, Hideo Kato, Mao Hagihara, Hiroyuki Suematsu and Hiroshige Mikamo
J. Clin. Med. 2023, 12(4), 1566; https://doi.org/10.3390/jcm12041566 - 16 Feb 2023
Cited by 5 | Viewed by 1651
Abstract
Introduction: A randomized control trial (RCT) is considered to be the highest level in the Evidence-Based Medicine (EBM) pyramid. While EBM is essential to make a practical tool such as a prognostic guideline, it has been unclear how many patients in the real [...] Read more.
Introduction: A randomized control trial (RCT) is considered to be the highest level in the Evidence-Based Medicine (EBM) pyramid. While EBM is essential to make a practical tool such as a prognostic guideline, it has been unclear how many patients in the real world can be eligible for a randomized control trial (RCT). Patients and method: This study was performed to clarify if there is a difference in patients’ profiles and clinical outcomes between the patients eligible and not eligible for any RCT. We reviewed all IE patients at our institute between 2007 and 2019. The patients were divided into two groups: those eligible for RCTs (RCT appropriate group) and those who were not (RCT inappropriate group). Exclusion criteria for clinical trials were set based on previous clinical trials. Results: A total of 66 patients were enrolled in the study. The median age was 70 years (range 18 to 87 years), and 46 (70%) were male. Seventeen (26%) of the patients were eligible for RCTs. Comparing the two groups, patients in the RCT appropriate group were younger and had fewer comorbidities. The disease severity was milder in the RCT appropriate groups than in the RCT inappropriate groups. Patients in the RCT appropriate group showed significantly longer overall survival times than those in the RCT inappropriate group (Log-Rank test, p < 0.001). Conclusions: We found a significant gap in patients’ characteristics and clinical outcomes between the groups. Physicians should be aware that RCT can never reflect the real-world population. Full article
(This article belongs to the Special Issue Infective Endocarditis: What Is New in the Clinical Research?)
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13 pages, 1163 KiB  
Article
Risk of Infective Endocarditis Associated with Transcatheter Aortic Valve Implantation versus Surgical Aortic Valve Replacement: A Propensity Score-Based Analysis
by Jorge Calderón-Parra, Juan E. de Villarreal-Soto, Juan Francisco Oteo-Domínguez, María Mateos-Seirul, Elsa Ríos-Rosado, Laura Dorado, Beatriz Vera-Puente, Carlos Arellano-Serrano, Antonio Ramos-Martínez and Alberto Forteza-Gil
J. Clin. Med. 2023, 12(2), 586; https://doi.org/10.3390/jcm12020586 - 11 Jan 2023
Cited by 8 | Viewed by 1774
Abstract
Background: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE after SAVR/TAVI. Methods: We conducted an [...] Read more.
Background: Infective endocarditis (IE) is a feared complication after surgical aortic valve replacement (SAVR)/transcatheter aortic valve implantation (TAVI). It is not certain which procedure carries a higher risk. Our aim was to assess the risk of IE after SAVR/TAVI. Methods: We conducted an observational study of a prospective cohort, including patients with TAVI/SAVR, from March 2015 to December 2020. IE was defined according to the modified Duke’s criteria. IE occurring during the first 12 months of the procedure was considered early IE, and an episode occurring after 12 months was considered late IE. The propensity score was designed to include variables previously associated with TAVI/SAVR and IE. An inverse probability of treatment weight was generated. Results: In total, 355 SAVR and 278 TAVI were included. Median follow-up, 38 vs. 41 months, p = 0.550. IE occurred in 5 SAVR (1.41%, 95% CI 0.2–2.6) vs. 13 TAVI (4.65%, 95% CI 2.2–7.2), p = 0.016. TAVI patients had more frequent early IE (3.2% vs. 0.3%, p = 0.006). In the PS analyses, IE risk did not differ: OR 0.65, 95% CI 0.32–1.32. Factors associated with TAVI IE included younger age (74y vs. 83y, p = 0.030), complicated diabetes mellitus (38.5% vs. 6.8%, p = 0.002), COPD (46.2% vs. 16.3%, p = 0.015), advanced heart failure (100% vs. 52.9%, p < 0.001), and peripheral arteriopathy (61.5% vs. 26.7%, p = 0.011). Conclusions: Early IE was higher with TAVI, but in the PS analyses, the risk attributable to each procedure was similar. Studies are needed to identify and optimize the risk factors of IE prior to TAVI. Full article
(This article belongs to the Special Issue Infective Endocarditis: What Is New in the Clinical Research?)
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Review

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15 pages, 638 KiB  
Review
Infective Endocarditis by Pasteurella Species: A Systematic Review
by Angeliki Alifragki, Argyro Kontogianni, Ioanna Protopapa, Stella Baliou and Petros Ioannou
J. Clin. Med. 2022, 11(17), 5037; https://doi.org/10.3390/jcm11175037 - 27 Aug 2022
Cited by 5 | Viewed by 2077
Abstract
Pasteurella spp. are non-motile, facultative anaerobic, Gram-negative coccobacilli that are commonly found in the oral cavity and the gastrointestinal tract of some animals and are known to be the cause of infections. Usually, infections by Pasteurella spp. in humans is more common in [...] Read more.
Pasteurella spp. are non-motile, facultative anaerobic, Gram-negative coccobacilli that are commonly found in the oral cavity and the gastrointestinal tract of some animals and are known to be the cause of infections. Usually, infections by Pasteurella spp. in humans is more common in the context of an animal bite leading to a skin and soft tissue infection (SSTI). Infective endocarditis (IE) is rarely caused by Pasteurella spp.; however, it can pose diagnostic and therapeutic dilemmas due to its rarity. The aim of the present study was to systematically review all cases of IE by Pasteurella spp. in the literature. A systematic review was performed of PubMed, Scopus and the Cochrane Library (through 20 December 2021) for studies providing data on epidemiology and clinical and microbiological characteristics as well as data on treatment and outcomes of IE by Pasteurella spp. A total of 28 studies containing data for 28 patients were included. Prosthetic valve was present in 21.4% of patients. The aorta was the most commonly involved intracardiac site. Fever, sepsis, septic shock and heart failure were the most common clinical presentations. Cephalosporins, aminopenicillins and penicillin were the antimicrobials used most commonly. Overall mortality was 17.9%. Full article
(This article belongs to the Special Issue Infective Endocarditis: What Is New in the Clinical Research?)
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9 pages, 546 KiB  
Review
Blood Culture-Negative Infective Endocarditis by Mycoplasma hominis: Case Report and Literature Review
by Antonio Bustos-Merlo, Antonio Rosales-Castillo, Fernando Cobo and Carmen Hidalgo-Tenorio
J. Clin. Med. 2022, 11(13), 3841; https://doi.org/10.3390/jcm11133841 - 2 Jul 2022
Cited by 4 | Viewed by 2277
Abstract
Mycoplasma hominis is a habitual colonizing microorganism of the lower genital tract but can exceptionally be the causal agent of blood culture-negative infective endocarditis (IE). Only 11 cases of this entity have been published to date. The study objectives were to describe the [...] Read more.
Mycoplasma hominis is a habitual colonizing microorganism of the lower genital tract but can exceptionally be the causal agent of blood culture-negative infective endocarditis (IE). Only 11 cases of this entity have been published to date. The study objectives were to describe the first case diagnosed in our center of IE by M. hominis on pacemaker lead and to carry out a narrative review. Among published cases of IE by this microorganism, 72.7% were male, with a mean age of 45 years and a history of valve surgery; the diagnosis was by culture (54.5%) or molecular technique (45.5%), and the prognosis was favorable in 72.7% of cases. The most frequently prescribed antibiotics were doxycycline, quinolones, and clindamycin. Full article
(This article belongs to the Special Issue Infective Endocarditis: What Is New in the Clinical Research?)
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Other

4 pages, 1054 KiB  
Case Report
Implantable Cardiac Defibrillator-Related Culture-Negative Infection: A Case of Coxiella burnetii Infection
by Panteleimon E. Papakonstantinou, Victoria Georgiadou, Grigorios Doumanis, Vasiliki Bistola, Joseph Papaparaskevas, Gerasimos Filippatos and Sotirios Xydonas
J. Clin. Med. 2023, 12(8), 2817; https://doi.org/10.3390/jcm12082817 - 11 Apr 2023
Cited by 3 | Viewed by 1808
Abstract
Coxiella burnetii is one of the most common causes of blood culture-negative infective endocarditis (IE). However, only a few cases of cardiac implantable electronic devices (CIED) infection have been reported in the literature. Herein, we present a case of CIED-related blood culture-negative infection [...] Read more.
Coxiella burnetii is one of the most common causes of blood culture-negative infective endocarditis (IE). However, only a few cases of cardiac implantable electronic devices (CIED) infection have been reported in the literature. Herein, we present a case of CIED-related blood culture-negative infection attributed to C. burnetii. A 54-year-old male was admitted to our hospital due to prolonged fatigue, a low-grade fever lasting more than a month, and weight loss. Three years ago, he received an implantable cardiac defibrillator (ICD) as a primary prevention measure against sudden cardiac death. An initial transthoracic and transesophageal echocardiography showed a dilated left ventricle with severely impaired systolic function, while the ventricular pacing wire was inside the right ventricle with a large echogenic mass (2.2 × 2.5 cm) adherent to it. Repeated blood cultures were negative. The patient underwent transvenous lead extraction. A transesophageal echocardiography after the extraction revealed multiple vegetations on the tricuspid valve with moderate to severe valve regurgitation. A surgical replacement of the tricuspid valve was determined after a multidisciplinary heart team approach. Serology tests showed increased IgG antibodies in phase I (1:16,394) and phase II (1:8192), and a definite diagnosis of CIED infection was made based on the serological tests. Full article
(This article belongs to the Special Issue Infective Endocarditis: What Is New in the Clinical Research?)
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