Clinical Factors Associated with Reinfection versus Relapse in Infective Endocarditis: Prospective Cohort Study



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Calderón Parra, Jorge and Kestler Hernández, Martha and Ramos Martínez, Antonio and Bouza, Emilio and Valerio Minero, Maricela and Alarcón, Arístides and Luque, Rafael and Goenaga, Miguel and Echeverría, Tomás and Fariñas, Mª and Pericàs, Juan and Ojeda Burgos, Guillermo and Fernández Cruz, Ana and Plata, Antonio and Vinuesa, David and Muñoz, Patricia (2021) Clinical Factors Associated with Reinfection versus Relapse in Infective Endocarditis: Prospective Cohort Study. Journal of Clinical Medicine, 10 (4). p. 748. ISSN 2077-0383

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We aimed to identify clinical factors associated with recurrent infective endocarditis (IE) episodes. The clinical characteristics of 2816 consecutive patients with definite IE (January 2008–2018) were compared according to the development of a second episode of IE. A total of 2152 out of 2282 (94.3%) patients, who were discharged alive and followed-up for at least the first year, presented a single episode of IE, whereas 130 patients (5.7%) presented a recurrence; 70 cases (53.8%) were due to other microorganisms (reinfection), and 60 cases (46.2%) were due to the same microorganism causing the first episode. Thirty-eight patients (29.2%), whose recurrence was due to the same microorganism, were diagnosed during the first 6 months of follow-up and were considered relapses. Relapses were associated with nosocomial endocarditis (OR: 2.67 (95% CI: 1.37–5.29)), enterococci (OR: 3.01 (95% CI: 1.51–6.01)), persistent bacteremia (OR: 2.37 (95% CI: 1.05–5.36)), and surgical treatment (OR: 0.23 (0.1–0.53)). On the other hand, episodes of reinfection were more common in patients with chronic liver disease (OR: 3.1 (95% CI: 1.65–5.83)) and prosthetic endocarditis (OR: 1.71 (95% CI: 1.04–2.82)). The clinical factors associated with reinfection and relapse in patients with IE appear to be different. A better understanding of these factors would allow the development of more effective therapeutic strategies.

Item Type:Article
Uncontrolled Keywords:endocarditis; bacterial; recurrence; Enterococcus; bacteremia; cardiac surgical procedures; liver disease
Subjects:Medical sciences > Medicine > Cardiology
Medical sciences > Medicine > Communicable diseases
ID Code:71301
Deposited On:22 Mar 2022 17:43
Last Modified:23 Mar 2022 10:21

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