Infective Endocarditis at a Referral Children's Hospital During 19-Year Period: Trends and Outcomes.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pediatric Cardiology Pub Date : 2024-12-01 Epub Date: 2023-08-23 DOI:10.1007/s00246-023-03274-y

Nahed Abdel-Haq, Ahmed Shawaqfeh, Shipra Gupta, Jocelyn Y Ang, Ronald Thomas, Basim I Asmar

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引用次数: 0

Abstract

Background: We noted a recent increase in cases of infective endocarditis (IE) at our institution. The purpose of the study is to examine the incidence, risk factors, microbiology and outcome of IE in our pediatric population.

Methods: Retrospective review of IE cases during 2002-2020 at Children's Hospital of Michigan, Detroit.

Results: 68 patients with IE were identified. There was a 2-fold increase in incidence during the 2012-2020 (late period) compared to the 2002-2011 (early period). The most common predisposing conditions were congenital heart disease (CHD) in 39 (57.4%) and central venous catheter (CVC) in 19 (27.9%). CHD was more frequent in the late period (29/43, 67.4%) compared to early period (10/25, 40.0%) (p = 0.042). In CHD patients, palliative or corrective cardiac surgery was performed prior to IE diagnosis in 4/25 (16%) in early period and 23/43 (53.5%) in the late period (p = 0.004). S. aureus was the most common causative organism (35.3%) followed by streptococci (22.1%). Valve replacement or valvuloplasty was performed in 22.1% of patients. Complications occurred in 20 (29.4%). Mortality occurred in 7 (10.3%): 3 had CHD, 3 had CVC and underlying conditions and 1 had fulminant MRSA infection.

Conclusion(s): The higher incidence of IE during the late period is likely due to an increase in patients with CHD who had undergone prior cardiac surgery. S. aureus was the predominant pathogen in all patients including those with CHD, followed by streptococci. IE in children continues to be associated with high rates of morbidity and mortality.

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一家儿童转诊医院 19 年间发生的感染性心内膜炎：趋势和结果。

背景：我们注意到最近本院感染性心内膜炎（IE）病例有所增加。本研究的目的是调查本院儿科人群中 IE 的发病率、风险因素、微生物学和结果：方法：对底特律密歇根儿童医院 2002-2020 年期间的 IE 病例进行回顾性研究：结果：共发现 68 例 IE 患者。与 2002-2011 年（早期）相比，2012-2020 年（晚期）的发病率增加了 2 倍。最常见的致病因素是先天性心脏病（CHD）39例（57.4%）和中心静脉导管（CVC）19例（27.9%）。与早期（10/25，40.0%）相比，晚期（29/43，67.4%）先天性心脏病的发病率更高（P = 0.042）。在心脏病患者中，早期有 4/25 例（16%）和晚期有 23/43 例（53.5%）在确诊 IE 之前进行了姑息性或纠正性心脏手术（p = 0.004）。金黄色葡萄球菌是最常见的致病菌（35.3%），其次是链球菌（22.1%）。22.1%的患者接受了瓣膜置换或瓣膜成形术。20例（29.4%）患者出现并发症。7人（10.3%）死亡：3人患有心脏病，3人患有CVC和基础疾病，1人患有暴发性MRSA感染：结论：晚期 IE 发生率较高的原因可能是之前接受过心脏手术的心脏病患者增多。金黄色葡萄球菌是所有患者（包括先天性心脏病患者）的主要病原体，其次是链球菌。儿童 IE 的发病率和死亡率一直居高不下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Cardiology 医学-小儿科

CiteScore

3.30

自引率

6.20%

发文量

258

审稿时长

12 months

期刊介绍： The editor of Pediatric Cardiology welcomes original manuscripts concerning all aspects of heart disease in infants, children, and adolescents, including embryology and anatomy, physiology and pharmacology, biochemistry, pathology, genetics, radiology, clinical aspects, investigative cardiology, electrophysiology and echocardiography, and cardiac surgery. Articles which may include original articles, review articles, letters to the editor etc., must be written in English and must be submitted solely to Pediatric Cardiology.