| Clinical characteristics of infective endocarditis caused by Staphylococcus aureus: A 12-year experience in a tertiary-care hospital |
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Eun Seok Kim, Eun-Jeong Joo, Young Eun Ha, Yu mi Wi, Hae Suk Cheong, Jin Seo Lee, Cheol-In Kang, Doo Ryeon Chung, Seung-Woo Park, Pyo-Won Park, Nam-Yong Lee, Kyong Ran Peck, Jae-Hoon Song |
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| 황색포도알균에 의한 감염성 심내막염의 임상적 특성 |
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김은석, 주은정, 하영은, 위유미, 정혜숙, 이진서, 강철인, 정두련, 박승우, 박표원, 이남용, 백경란, 송재훈 |
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| Abstract |
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Background/Aims: The risk factors and clinical outcome of infective endocarditis (IE) have changed over the past few decades. Recently, the incidence of Staphylococcus aureus IE (SAIE) has increased. We investigated the clinical and microbiological characteristics and clinical outcomes of SAIE.
Methods: All patient cases that were diagnosed as IE according to the modified Duke criteria in Samsung Medical Center during the period of January 1995 to December 2006 were reviewed retrospectively. The clinical and microbiological characteristics of patients with SAIE were compared to those of non-SAIE patients with IE.
Results: We enrolled 304 patients with IE. Of these, 240 cases were IE culture-positive, including 73 cases of SAIE. The mean age of patients with SAIE was 48.15±19.87 years, with male patients accounting for 71.2% of our study group. Congenital heart disease (8.2%) was less common among SAIE patients. Hospital-acquired IE was significantly more common in SAIE than in non-SAIE cohorts (p<0.05). Surgical treatment was performed in 33 cases (45.2%). Valvular regurgitation with heart failure was the most frequent cause of surgery (39.3%). Twenty-three cases exhibited complications, including extra cardiac embolization (16.4%) and heart failure (5.6%). Fever persisting for a period longer than seven days was more common among those in the SAIE group. Twelve patients (16.4%) died and four patients (5.4%) were discharged without hope of improvement. The in-hospital mortality rate was higher among SAIE patients (17.3%) compared to that among non-SAIE patients (11%), although this comparison was not statistically distinct (p>0.05). Methicillin resistance and non-surgical treatment were significant risk factors for in-hospital mortality.
Conclusions: SAIE is more strongly associated with systemic embolization, persistent fever, and longer hospital stays compared to non-SAIE. Further studies are warranted to evaluate adequate treatment and to improve the outcome of patients with SAIE.
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| Key Words:
Infective endocarditis; Methicillin-resistance; Outcome; Staphylococcus aureus |
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