Time-trend population analysis of the clinical and epidemiologic effect on pediatric infective endocarditis after change of antibiotic prophylaxis guidelines

Purpose In 2007, antibiotic prophylaxis (AP) guidelines for infective endocarditis (IE) changed, but the possible influence on the annual incidences of pediatric IE is unclear. Methods We studied the clinical and epidemiologic impact of AP change by comparing two time periods before and after change of AP guidelines in a tertiary care center as referral center for a total population of more than 4,500,000 inhabitants. Results After change of AP guidelines, twenty-five patients were diagnosed for IE at a median age of 6.9 years (range 0.1–19.4, female 48%). Modified Duke criteria were fulfilled for definite (12/25; 48%), or probable IE (13/25; 52%). The frequency of IE (cases per 1000 hospitalized patients) increased from 0.37% (1995–2005) to 0.59% (2006–2017) [p = 0.152], the annual incidence of IE (cases per 1000 CHD patients, < 20 years of age) increased from 0.195 ‰ to 0.399 ‰ [p = 0.072]. Postoperative IE (13/25; 52%), was associated mostly with prosthetic pulmonary valves (12/13; 92%). Pathogens were staphylococci spp. (8/25; 32%), streptococci spp. (7/25; 28%), HACEK (3/25; 12%), other (4/25; 16%), or culture-negative (3/25; 12%). Treatment included antibiotics (25/25; 100%), and cardiac surgery (16/25; 64%). The clinical findings and complications of pediatric IE including mortality (2/25; 8%) did not differ between the two time periods. Conclusions Pediatric IE remains a severe cardiac disease with a comparable clinical picture. Unless increasing absolute case numbers of IE, the relative case number of IE remains stable despite AP change. The high number of prosthetic pulmonary valve associated IE needs further evaluation and therapeutic alternatives..

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:48

Enthalten in:

Infection - 48(2020), 5 vom: 30. Apr., Seite 671-678

Sprache:

Englisch

Beteiligte Personen:

Knirsch, Walter [VerfasserIn]
Schuler, Stefanie Katharina [VerfasserIn]
Christmann, Martin [VerfasserIn]
Weber, Roland [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Child
Heart disease
Infective endocarditis
Prophylaxis

Anmerkungen:

© Springer-Verlag GmbH Germany, part of Springer Nature 2020. corrected publication 2020

doi:

10.1007/s15010-020-01433-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2119655804

Zugang & Verfügbarkeit




Zugehörige Publikationen/Bände

    Haven't found what you're looking for?