Non-nosocomial Healthcare-Associated Infective Endocarditis : A Distinct Entity? Data From the GAMES Series (2008-2021)
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America..
Background: Patients who acquire infective endocarditis (IE) following contact with the healthcare system, but outside the hospital, are classified as having non-nosocomial healthcare-associated IE (HCIE). Our aim was to characterize HCIE and establish whether its etiology, diagnosis, and therapeutic approach suggest it should be considered a distinct entity.
Methods: This study retrospectively analyzes data from a nationwide, multicenter, prospective cohort including consecutive cases of IE at 45 hospitals across Spain from 2008 to 2021. HCIE was defined as IE detected in patients in close contact with the healthcare system (eg, patients receiving intravenous treatment, hemodialysis, or institutionalized). The prevalence and main characteristics of HCIE were examined and compared with those of community-acquired IE (CIE) and nosocomial IE (NIE) and with literature data.
Results: IE was diagnosed in 4520 cases, of which 2854 (63%) were classified as CIE, 1209 (27%) as NIE, and 457 (10%) as HCIE. Patients with HCIE showed a high burden of comorbidities, a high presence of intravascular catheters, and a predominant staphylococcal etiology, Staphylococcus aureus being identified as the most frequent causative agent (35%). They also experienced more persistent bacteremia, underwent fewer surgeries, and showed a higher mortality rate than those with CIE (32.4% vs 22.6%). However, mortality in this group was similar to that recorded for NIE (32.4% vs 34.9%, respectively, P = .40).
Conclusions: Our data do not support considering HCIE as a distinct entity. HCIE affects a substantial number of patients, is associated with a high mortality, and shares many characteristics with NIE.
| Errataetall: |
CommentIn: Open Forum Infect Dis. 2024 Mar 27;11(3):ofae167. - PMID 38545441 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:10 |
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| Enthalten in: |
Open forum infectious diseases - 10(2023), 8 vom: 27. Aug., Seite ofad393 |
| Sprache: |
Englisch |
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| Links: |
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| Themen: |
Healthcare-related infections |
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| Anmerkungen: |
Date Revised 28.03.2024 published: Electronic-eCollection CommentIn: Open Forum Infect Dis. 2024 Mar 27;11(3):ofae167. - PMID 38545441 Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1093/ofid/ofad393 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM360642780 |
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| 100 | 1 | |a Alonso-Menchén, David |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Non-nosocomial Healthcare-Associated Infective Endocarditis |b A Distinct Entity? Data From the GAMES Series (2008-2021) |
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| 500 | |a CommentIn: Open Forum Infect Dis. 2024 Mar 27;11(3):ofae167. - PMID 38545441 | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. | ||
| 520 | |a Background: Patients who acquire infective endocarditis (IE) following contact with the healthcare system, but outside the hospital, are classified as having non-nosocomial healthcare-associated IE (HCIE). Our aim was to characterize HCIE and establish whether its etiology, diagnosis, and therapeutic approach suggest it should be considered a distinct entity | ||
| 520 | |a Methods: This study retrospectively analyzes data from a nationwide, multicenter, prospective cohort including consecutive cases of IE at 45 hospitals across Spain from 2008 to 2021. HCIE was defined as IE detected in patients in close contact with the healthcare system (eg, patients receiving intravenous treatment, hemodialysis, or institutionalized). The prevalence and main characteristics of HCIE were examined and compared with those of community-acquired IE (CIE) and nosocomial IE (NIE) and with literature data | ||
| 520 | |a Results: IE was diagnosed in 4520 cases, of which 2854 (63%) were classified as CIE, 1209 (27%) as NIE, and 457 (10%) as HCIE. Patients with HCIE showed a high burden of comorbidities, a high presence of intravascular catheters, and a predominant staphylococcal etiology, Staphylococcus aureus being identified as the most frequent causative agent (35%). They also experienced more persistent bacteremia, underwent fewer surgeries, and showed a higher mortality rate than those with CIE (32.4% vs 22.6%). However, mortality in this group was similar to that recorded for NIE (32.4% vs 34.9%, respectively, P = .40) | ||
| 520 | |a Conclusions: Our data do not support considering HCIE as a distinct entity. HCIE affects a substantial number of patients, is associated with a high mortality, and shares many characteristics with NIE | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a healthcare-related infections | |
| 650 | 4 | |a infective endocarditis | |
| 650 | 4 | |a nosocomial infections | |
| 700 | 1 | |a Bouza, Emilio |e verfasserin |4 aut | |
| 700 | 1 | |a Valerio, Maricela |e verfasserin |4 aut | |
| 700 | 1 | |a de Alarcón, Arístides |e verfasserin |4 aut | |
| 700 | 1 | |a Gutiérrez-Carretero, Encarnación |e verfasserin |4 aut | |
| 700 | 1 | |a Miró, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Goenaga-Sánchez, Miguel Ángel |e verfasserin |4 aut | |
| 700 | 1 | |a Plata-Ciézar, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a González-Rico, Claudia |e verfasserin |4 aut | |
| 700 | 1 | |a López-Cortés, Luis Eduardo |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez Esteban, María Ángeles |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-Marcos, Francisco Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Muñoz, Patricia |e verfasserin |4 aut | |
| 700 | 0 | |a Grupo de Apoyo al Manejo de la Endocarditis Infecciosa en España (GAMES) Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Adán, Iván |e investigator |4 oth | |
| 700 | 1 | |a Alonso, David |e investigator |4 oth | |
| 700 | 1 | |a Alonso, Juan Carlos |e investigator |4 oth | |
| 700 | 1 | |a Álvarez-Uría, Ana |e investigator |4 oth | |
| 700 | 1 | |a Bermejo, Javier |e investigator |4 oth | |
| 700 | 1 | |a Bouza, Emilio |e investigator |4 oth | |
| 700 | 1 | |a Caballero, Gregorio Cuerpo |e investigator |4 oth | |
| 700 | 1 | |a Montero, Antonia Delgado |e investigator |4 oth | |
| 700 | 1 | |a Estévez, Agustín |e investigator |4 oth | |
| 700 | 1 | |a Ribas, Ramón Fortuny |e investigator |4 oth | |
| 700 | 1 | |a Gargallo, Esther |e investigator |4 oth | |
| 700 | 1 | |a Mansilla, Ana González |e investigator |4 oth | |
| 700 | 1 | |a Leoni, María Eugenia García |e investigator |4 oth | |
| 700 | 1 | |a Moraga, Francisco Javier González |e investigator |4 oth | |
| 700 | 1 | |a Ramallo, Víctor González |e investigator |4 oth | |
| 700 | 1 | |a Hernández, Martha Kestler |e investigator |4 oth | |
| 700 | 1 | |a Hualde, Amaia Mari |e investigator |4 oth | |
| 700 | 1 | |a Machado, Marina |e investigator |4 oth | |
| 700 | 1 | |a Marín, Mercedes |e investigator |4 oth | |
| 700 | 1 | |a Martínez-Sellés, Manuel |e investigator |4 oth | |
| 700 | 1 | |a Melero, Rosa |e investigator |4 oth | |
| 700 | 1 | |a Muñoz, Patricia |e investigator |4 oth | |
| 700 | 1 | |a Monzón, Diego |e investigator |4 oth | |
| 700 | 1 | |a Olmedo, María |e investigator |4 oth | |
| 700 | 1 | |a Pedraz, Álvaro |e investigator |4 oth | |
| 700 | 1 | |a Pinilla, Blanca |e investigator |4 oth | |
| 700 | 1 | |a Pinto, Ángel |e investigator |4 oth | |
| 700 | 1 | |a Rincón, Cristina |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez-Abella, Hugo |e investigator |4 oth | |
| 700 | 1 | |a Rodríguez-Créixems, Marta |e investigator |4 oth | |
| 700 | 1 | |a Sánchez-Pérez, Eduardo |e investigator |4 oth | |
| 700 | 1 | |a Segado, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Toledo, Neera |e investigator |4 oth | |
| 700 | 1 | |a Valerio, Maricela |e investigator |4 oth | |
| 700 | 1 | |a Vázquez, Pilar |e investigator |4 oth | |
| 700 | 1 | |a Moreno, Eduardo Verde |e investigator |4 oth | |
| 700 | 1 | |a de la Villa, Sofía |e investigator |4 oth | |
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