المؤلفون: Seminari, E.¹ e.seminari@smatteo.pv.it, Silvestri, A.², Ravasio, V.³, Ludovisi, S.¹, Utili, R.⁴, Petrosillo, N.⁵, Castelli, F.⁶, Bassetti, M.⁷, Barbaro, F.⁸, Grossi, P.⁹, Barzaghi, N.¹⁰, Rizzi, M.³, Minoli, L.¹

المصدر: European Journal of Clinical Microbiology & Infectious Diseases. Feb2016, Vol. 35 Issue 2, p279-284. 6p.

مصطلحات موضوعية: *LIVER failure, *LIVER diseases, *LIVER disease diagnosis, *INPATIENT care, *ENDOCARDIUM diseases, *INFECTIVE endocarditis, *PATIENTS, *GENETICS

مستخلص: Few data have been published regarding the epidemiology and outcome of infective endocarditis (IE) in patients with chronic hepatic disease (CHD). A retrospective analysis of the Studio Endocarditi Italiano (SEI) database was performed to evaluate the epidemiology and outcome of CHD+ patients compared with CHD− patients. The diagnosis of IE was defined in accordance with the modified Duke criteria. Echocardiography, diagnosis, and treatment procedures were in accordance with current clinical practice. Among the 1722 observed episodes of IE, 300 (17.4 %) occurred in CHD+ patients. The cause of CHD mainly consisted of chronic viral infection. Staphylococcus aureus was the most common bacterial species in CHD+ patients; the frequency of other bacterial species ( S. epidermidis, streptococci, and enterococci) were comparable among the two groups. The percentage of patients undergoing surgery for IE was 38.9 in CHD+ patients versus 43.7 in CHD− patients ( p = 0.06). Complications were more common among CHD+ patients (77 % versus 65.3 %, p < 0.001); embolization (43.3 % versus 26.1 %, p < 0.001) and congestive heart failure (42 % versus 34.1 %, p = 0.01) were more frequent among CHD+ patients. Mortality was comparable (12.5 % in CHD− and 15 % in CHD+ patients). At multivariable analysis, factors associated with hospital-associated mortality were having an infection sustained by S. aureus, a prosthetic valve, diabetes and a neoplasia, and CHD. Being an intravenous drug user (IVDU) was a protective factor and was associated with a reduced death risk. CHD is a factor worsening the prognosis in patients with IE, in particular in patients for whom cardiac surgery was required. [ABSTRACT FROM AUTHOR]

المؤلفون: Durante-Mangoni, E.^1,2 emanuele.durante@unina2.it, Casillo, R.^1,2, Pinto, D.^1,2, Caianiello, C.^1,2, Albisinni, R.^1,2, Caprioli, V.³, Maiello, C.³, Utili, R.^1,2

المصدر: Transplantation Proceedings. Jan2011, Vol. 43 Issue 1, p304-306. 3p.

مصطلحات موضوعية: *HEART transplant recipients, *INFECTIVE endocarditis, *BACTERIAL diseases, *CARDIOMYOPATHIES, *STAPHYLOCOCCUS, *SURGICAL complications, *LITERATURE reviews

مستخلص: Abstract: Bacterial infections are a contraindication to organ transplantation, but infective endocarditis may require heart transplantation when otherwise untreatable. We describe a heart transplant patient with cardiomyopathy and ongoing defibrillator endocarditis due to Staphylococcus epidermidis. An initial attempt at percutaneous extraction of the 5 implanted leads was unable to eradicate the infection and was complicated by severe decompensation, requiring a new implant for biventricular pacing. Despite continuing bactericidal treatment, the patient showed persistent infection on the implanted leads with further hemodynamic deterioration. The decision was therefore made to list the patient for heart transplantation. The procedure was successful in removing all of the hardware. No recurrence of infection was observed despite persistence of large vegetations on the removed defibrillator leads. The patient had an uneventful postoperative course, remaining free of symptoms with negative blood cultures at 3 months'' follow-up. Our experience showed that active infection of defibrillator leads may not represent an absolute contraindication to heart transplantation when all other medical and surgical treatments have been proven to be ineffective. [Copyright &y& Elsevier]