Clinical Factors Associated with Reinfection versus Relapse in Infective Endocarditis: Prospective Cohort Study.
J Clin Med
; 10(4)2021 Feb 13.
Article
in En
| MEDLINE
| ID: mdl-33668597
ABSTRACT
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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Language:
En
Journal:
J Clin Med
Year:
2021
Document type:
Article
Affiliation country:
Spain