4.3 Review

Endocarditis in the intensive care unit: an update

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Article Cardiac & Cardiovascular Systems

[18F]FDG-PET CT for the evaluation of native valve endocarditis

Gad Abikhzer et al.

Summary: This study examined the use of [F-18]FDG-PET/CT for diagnosing native valve endocarditis (NVE). The results showed that using [F-18]FDG-PET/CT as a major criterion in the modified Duke criteria improved the diagnostic performance, particularly in patients with Possible IE.

JOURNAL OF NUCLEAR CARDIOLOGY (2022)

Review Anesthesiology

Anesthesia Considerations in Infective Endocarditis

Henning Hermanns et al.

Summary: The management of infective endocarditis requires multidisciplinary cooperation and a thorough understanding of specific characteristics in the perioperative period. This review summarizes the current knowledge on infective endocarditis relevant for the clinical anesthesiologist and advocates for their involvement as an important member of the endocarditis team.

ANESTHESIOLOGY (2022)

Article Cardiac & Cardiovascular Systems

Trends in aortic valve replacement for aortic stenosis: a French nationwide study

Virginia Nguyen et al.

Summary: The number of aortic valve replacements has doubled in a decade and TAVR became the dominant form of AVR in 2018. The improvement in patient profiles seems to have anticipated the demonstrated benefit of TAVR in intermediate and low-risk patients. For patients 75 years or older, TAVR should be considered as the first option.

EUROPEAN HEART JOURNAL (2022)

Review Immunology

Potential Advances of Adjunctive Hyperbaric Oxygen Therapy in Infective Endocarditis

Christian Johann Lerche et al.

Summary: Patients with infective endocarditis require different levels of treatment, including potential surgical intervention. Hyperbaric oxygen therapy (HBOT) could be an adjunctive therapeutic option to decrease complications and improve long-term outcomes for IE patients. Although supported by preclinical studies, there is currently a lack of clinical research evaluating the feasibility of HBOT in IE.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY (2022)

Article Infectious Diseases

Predictors of Complications Secondary to Infective Endocarditis and Their Associated Outcomes: A Large Cohort Study from the National Emergency Database (2016-2018)

Tanveer Mir et al.

Summary: Analysis of data from 255,838 adult IE patients showed that 38.2% developed one or more major complications, including cardiovascular, neurologic, and renal complications. Patients with complicated IE had a higher risk of mortality, with septic shock, cardiogenic shock, DIC, and STE strongly associated with mortality.

INFECTIOUS DISEASES AND THERAPY (2022)

Review Hematology

Staphylococcus aureus and Neutrophil Extracellular Traps: The Master Manipulator Meets Its Match in Immunothrombosis

Severien Meyers et al.

Summary: Neutrophil extracellular traps (NETs) play a crucial role in immunothrombosis and have complex interactions with pathogens and the coagulation system. While the release of NETs is an attempt by neutrophils to trap pathogens, it can also have negative effects on the host, such as inducing uncontrolled thrombosis, inflammation, and tissue damage. Staphylococcus aureus (S. aureus) has evolved mechanisms to overcome NET formation and evade the host's defense mechanisms. Understanding the mechanisms of NET formation and its interactions with platelets and the coagulation system is important for studying immunothrombotic disorders.

ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY (2022)

Article Cardiac & Cardiovascular Systems

Very early infective endocarditis after transcatheter aortic valve replacement

Vassili Panagides et al.

Summary: This study aimed to evaluate the characteristics, management, and outcomes of very early infective endocarditis (VE-IE) after trans-catheter aortic valve replacement (TAVR). The results showed that a significant proportion of VE-IE occurs within a few weeks following the procedure and is associated with dismal outcomes. Some baseline and TAVR procedural factors were associated with VE-IE, and Staphylococcus aureus and enterococci were the main causative pathogens.

CLINICAL RESEARCH IN CARDIOLOGY (2022)

Article Infectious Diseases

Risk Factors Associated with Poor Outcome in Patients with Infective Endocarditis: An Italian Single-Center Experience

Claudio Ucciferri et al.

Summary: This study found that the mortality rate of infective endocarditis (IE) patients was associated with factors such as age, estimated glomerular filtration rate, procalcitonin values, cerebral embolization, and inadequate antibiotic therapy. Procalcitonin values at the diagnosis of IE and 48-72 hours after starting antibiotics can be used as prognostic factors for stratifying patient risk and setting up personalized treatment.

INFECTIOUS DISEASE REPORTS (2022)

Review Infectious Diseases

A review of current treatment strategies for infective endocarditis

David Luque Paz et al.

Summary: This article focuses on the anti-infective treatment of infective endocarditis caused by main bacteria, including specific treatment strategies, such as empirical treatment and treatment duration. The use of aminoglycosides has decreased over the years, with emphasis on the role of anti-staphylococcal penicillins and vancomycin for staphylococcal endocarditis. The optimal duration of antibacterial treatment is discussed, with the oral switch being safe post intravenous course.

EXPERT REVIEW OF ANTI-INFECTIVE THERAPY (2021)

Article Medicine, General & Internal

Haemophilus parainfluenzae endocarditis presenting with symptoms of COVID-19

Laurie C. Finch et al.

Summary: A young man presented with symptoms during the second wave of the COVID-19 pandemic in the UK, eventually diagnosed with infective endocarditis. Blood cultures grew Haemophilus parainfluenzae, while COVID-19 tests were negative. He underwent urgent mitral valve repair surgery and recovered well.

BMJ CASE REPORTS (2021)

Article Medicine, General & Internal

Complex case of COVID-19 and infective endocarditis

Katrin Alizadeh et al.

Summary: The 50-year-old man presented with confusion and dyspnoea, tested positive for COVID-19, and subsequently developed severe sepsis, acute renal failure, bacteraemia, infective endocarditis, discitis, and thrombosis, leading to a prolonged hospitalization and elective forefoot amputation with a good recovery.

BMJ CASE REPORTS (2021)

Article Cardiac & Cardiovascular Systems

18F-fluorodeoxyglucose positron emission tomography/computed tomography for the diagnosis of native valve infective endocarditis: A prospective study

Mary Philip et al.

Summary: F-18-FDG PET/CT has poor sensitivity but high specificity in the diagnosis of NVE. The usefulness of F-18-FDG PET/CT is high for embolic detection. Diffuse splenic uptake represents a possible new diagnostic criterion for NVE.

ARCHIVES OF CARDIOVASCULAR DISEASES (2021)

Article Immunology

Use of Plasma Metagenomic Next-generation Sequencing for Pathogen Identification in Pediatric Endocarditis

Rachel K. To et al.

Summary: Pediatric infective endocarditis is associated with underlying heart disease, and accurate identification of pathogens is crucial for treatment. Plasma next-generation sequencing showed a high detection rate in this case series.

PEDIATRIC INFECTIOUS DISEASE JOURNAL (2021)

Review Critical Care Medicine

A Review of Pathophysiology, Clinical Features, and Management Options of COVID-19 Associated Coagulopathy

Julie Goswami et al.

Summary: COVID-19 is associated with significant coagulopathy, leading to increased rates of venous and arterial thromboembolic events. Inflammatory response in COVID-19 is linked to coagulopathy, posing challenges for diagnosis, prevention, and treatment of thrombotic complications. Endothelial injury and augmented innate immune response play a role in the development of thrombosis in COVID-19.
Article Critical Care Medicine

Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021

Laura Evans et al.

INTENSIVE CARE MEDICINE (2021)

Article Pediatrics

Case Report: Comparison of Plasma Metagenomics to Bacterial PCR in a Case of Prosthetic Valve Endocarditis

Joshua A. Lieberman et al.

Summary: Molecular assays, such as metagenomic next-generation sequencing, are important for infectious disease diagnosis; however, their clinical impact and cost-effectiveness may vary depending on the type of infection and anatomical location. This case study highlights the limitations and challenges of using clinical metagenomics in infectious disease diagnosis.

FRONTIERS IN PEDIATRICS (2021)

Review Cardiac & Cardiovascular Systems

Infective endocarditis complicated by embolic events: Pathogenesis and predictors

Wangling Hu et al.

Summary: Infective endocarditis (IE) presents a significant challenge due to its frequent and life-threatening embolic events. Accurate prediction of embolization is crucial for early identification and treatment of at-risk patients. Echocardiographic characteristics are the most powerful predictors of embolic events, while blood biomarkers and clinical characteristics also show promise in predicting embolic events.

CLINICAL CARDIOLOGY (2021)

Review Pharmacology & Pharmacy

Key Challenges in Providing Effective Antibiotic Therapy for Critically Ill Patients with Bacterial Sepsis and Septic Shock

Cornelia B. Landersdorfer et al.

Summary: Early initiation of effective antibiotic therapy is essential for critically ill patients with sepsis or septic shock, but current guidelines are lacking. Renal function is a key determinant for achieving the required antibiotic exposure. Model-informed approaches are suggested to individualize treatment regimens and adjust them based on monitoring antibiotic concentrations and other clinical data during treatment.

CLINICAL PHARMACOLOGY & THERAPEUTICS (2021)

Article Radiology, Nuclear Medicine & Medical Imaging

The role of cardiac computed tomography in the diagnosis of prosthetic valve endocarditis - A comparison with transthoracic and transesophageal echocardiography and intra-operative findings

Ilona Michalowska et al.

Summary: In patients with PVE, cardiac CT was found to be more accurate in diagnosing valvular and perivalvular abscesses, vegetations, and inflammatory infiltration compared to echocardiography. However, echocardiography had a higher diagnostic value in evaluating paravalvular leakage. The combination of cardiac CT and echocardiography improves the diagnostic accuracy of PVE and both examinations should be performed in these patients.

EUROPEAN JOURNAL OF RADIOLOGY (2021)

Article Medicine, General & Internal

Linezolid for infective endocarditis A structured approach based on a national database experience

P. Munoz et al.

Summary: This study evaluated the effectiveness of linezolid in infective endocarditis using a national database. The results suggest that the use of linezolid as definitive treatment in infective endocarditis may be associated with higher in-hospital mortality.

MEDICINE (2021)

Review Cardiac & Cardiovascular Systems

Cardiac computed tomography in the contemporary evaluation of infective endocarditis

Omar K. Khalique et al.

Summary: CCT plays a crucial role in infective endocarditis, providing high accuracy for large vegetations and perivalvular complications, and excluding coronary artery disease. It can help clarify the etiology of infective prosthetic valve dysfunction and has seen increased relevance in valvular heart disease with structural interventions.

JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY (2021)

Review Cardiac & Cardiovascular Systems

Cardiac troponin and infective endocarditis prognosis: a systematic review and meta-analysis

Andrea Postigo et al.

Summary: Elevation of cardiac troponin in patients with infective endocarditis is associated with poor prognosis, leading to higher in-hospital mortality, surgery rates, and more frequent complications such as central nervous system events and cardiac abscesses. Troponin determination may provide additional help in prognostic assessment of these patients.

EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE (2021)

Article Cardiac & Cardiovascular Systems

Temporal Changes in Mortality After Transcatheter and Surgical Aortic Valve Replacement: Retrospective Analysis of US Medicare Patients (2012-2019)

Sandra B. Lauck et al.

Summary: This study retrospectively compared 30-day mortality, readmission rates, and length of stay differences between patients undergoing SAVR and TAVR in the United States from 2012 to 2019. TAVR had lower mortality rates, readmission rates, and shorter length of stay compared to SAVR, with TAVR surpassing SAVR in terms of improvement rate until 2016.

JOURNAL OF THE AMERICAN HEART ASSOCIATION (2021)

Article Immunology

Ticagrelor Increases Platelet-Mediated Staphylococcus aureus Killing, Resulting in Clearance of Bacteremia

Erlinda R. Ulloa et al.

Summary: Research has shown that ticagrelor can effectively prevent damage to platelets by Staphylococcus aureus, helping restore platelet count and clear bacteremia.

JOURNAL OF INFECTIOUS DISEASES (2021)

Review Cell Biology

Aspirin or Ticagrelor in Staphylococcus aureus Infective Endocarditis: Where Do We Stand?

Kirsten Leeten et al.

Summary: Infective endocarditis is a challenging disease with high mortality and morbidity rates. Antibiotic prophylaxis is recommended in high-risk patients but faces challenges of low efficacy and antibiotic resistance. Platelets play a crucial role in the disease, but there are still many unanswered questions about their antimicrobial activities in infective endocarditis.

FRONTIERS IN CELL AND DEVELOPMENTAL BIOLOGY (2021)

Article Oncology

The clinical value of valve metagenomic next-generation sequencing when applied to the etiological diagnosis of infective endocarditis

Sishi Cai et al.

Summary: This study demonstrated the high sensitivity and specificity of valve mNGS in diagnosing infective endocarditis (IE), especially in culture-negative IE patients. The results showed that the SMRNG, relative abundance, SMRN, relative abundance, and coverage rate of valve mNGS were significantly higher in culture-positive IE participants than in culture-negative IE participants, indicating its potential value in guiding precise antibiotic treatment after surgery. Valve mNGS is a promising technology for the etiological diagnosis of IE.

ANNALS OF TRANSLATIONAL MEDICINE (2021)

Article Cell Biology

Repurposed drugs block toxin-driven platelet clearance by the hepatic Ashwell-Morell receptor to clear Staphylococcus aureus bacteremia

Josh Sun et al.

Summary: The study found that decreased platelet count in patients with Staphylococcus aureus infection is associated with increased mortality and increased expression of pathogen toxins. Platelet-derived antibacterial peptides are important in defense against S. aureus, but bacterial toxin can harm platelets and accelerate their clearance.

SCIENCE TRANSLATIONAL MEDICINE (2021)

Article Cardiac & Cardiovascular Systems

Escalating incidence of infective endocarditis in Europe in the 21st century

Khawaja M. Talha et al.

Summary: The systematic review on infective endocarditis (IE) in Europe over the past two decades showed a doubling of incidence, with elderly men being the predominant demographic. The annual incidence of IE increased by 4.1%, and Staphylococci and streptococci were the most commonly identified pathogens. Surgical intervention rates ranged from 10.2% to 60.0%, with inpatient mortality rates between 14.3% to 17.5%.

OPEN HEART (2021)

Article Medicine, General & Internal

Impact of Operative Timing in Infective Endocarditis with Cerebral Embolism-The Risk of Intermediate Deterioration

Alexey Dashkevich et al.

Summary: Surgical timing in infective endocarditis (IE) patients with preoperative symptomatic cerebral embolism (CE) is crucial for outcomes. Large vegetations and patient age are identified as independent risk factors for in-hospital mortality, rather than operative timing. Delaying surgery may lead to deterioration and increased in-hospital mortality within 3 weeks after CE.

JOURNAL OF CLINICAL MEDICINE (2021)

Article Immunology

Outcomes and Risk Factors of Septic Shock in Patients With Infective Endocarditis: A Prospective Cohort Study

Juan M. Pericas et al.

Summary: Septic shock and sepsis occurred in a significant proportion of patients with infective endocarditis, with septic shock associated with higher mortality rates. Cardiac surgery was found to be associated with lower mortality in patients with septic shock.

OPEN FORUM INFECTIOUS DISEASES (2021)

Article Medicine, General & Internal

Accuracy and Prognosis Value of the Sequential Organ Failure Assessment Score Combined With C-Reactive Protein in Patients With Complicated Infective Endocarditis

Yaowang Lin et al.

Summary: This study evaluated the accuracy and prognostic value of the SOFA score combined with CRP in patients with complicated IE. High SOFA score and high CRP levels were associated with in-hospital mortality, while SOFA score, but not CRP, predicted long-term mortality in complicated IE.

FRONTIERS IN MEDICINE (2021)

Article Cardiac & Cardiovascular Systems

Prognostic value of D-dimer for adverse outcomes in patients with infective endocarditis: an observational study

Ying-Wen Lin et al.

Summary: D-dimer is a reliable prognostic biomarker independently associated with in-hospital adverse events and six-month mortality in patients with infective endocarditis (IE). Higher levels of D-dimer are correlated with increased risks of adverse events and death in these patients.

BMC CARDIOVASCULAR DISORDERS (2021)

Article Medicine, General & Internal

Predictors of long-term mortality in left-sided infective endocarditis: an historical cohort study in 414 patients

Emanuele Durante-Mangoni et al.

Summary: The study found that the long-term prognosis of left-sided IE patients is influenced by cardiovascular and metabolic risk signals. Factors such as peripheral arterial disease and hyperglycemia may increase the risk of long-term mortality in patients.

EUROPEAN JOURNAL OF INTERNAL MEDICINE (2021)

Article Infectious Diseases

Streptococcal and enterococcal endocarditis: time for individualized antibiotherapy?

Clara Flateau et al.

Summary: For the treatment of streptococcal and enterococcal endocarditis, it is suggested to maintain beta-lactam concentration higher than 4-6 times the bacteria MIC in the heart of the vegetation. However, the complete determination of the antibiotic concentration ratio between plasma and vegetation is still unknown, which is essential for personalized antibiotherapy.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2021)

Article Medicine, General & Internal

Evaluation of 16S rDNA Heart Tissue PCR as a Complement to Blood Cultures for the Routine Etiological Diagnosis of Infective Endocarditis

Raquel Rodriguez-Garcia et al.

Summary: The study demonstrates that 16S rDNA tissue PCR provides complementary information for the diagnosis of IE, especially when blood cultures are negative, with a higher reliability in identifying pathogens.

DIAGNOSTICS (2021)

Article Immunology

Host-pathogen interactions of clinical S. aureus isolates to induce infective endocarditis

Christian Schwarz et al.

Summary: The study revealed that the virulence profiles and cytotoxicity of S. aureus isolates in vitro were not accurate predictors of the severity of infective endocarditis, but there were differences in the activation and inhibition of pathways connected to the extracellular matrix and inflammatory response. Therefore, a comprehensive understanding of host-pathogen interactions and immune pathways is necessary to evaluate the pathogenic capacity of bacteria.

VIRULENCE (2021)

Article Cardiac & Cardiovascular Systems

Validity of SOFA score as a prognostic tool for critically ill elderly patients with acute infective endocarditis

Yaowang Lin et al.

Summary: A high SOFA score is associated with increased in-hospital and long-term mortality in critically ill elderly patients with acute infective endocarditis (IE). Age, SOFA >= 6, and surgical treatment are predictors of in-hospital mortality, while age, diabetes mellitus, SOFA=6, and surgical treatment are predictors of long-term mortality.

REVIEWS IN CARDIOVASCULAR MEDICINE (2021)

Review Critical Care Medicine

Initial antimicrobial management of sepsis

Michael S. Niederman et al.

Summary: Sepsis is a common consequence of infection with a mortality rate > 25%. Immediate, empiric, broad-spectrum therapy is necessary for severe sepsis and/or shock, but antimicrobial stewardship is important to prevent overuse and resistance. Biomarkers and newer antimicrobial agents can help guide antibiotic therapy.

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FDG-PET/CT in intensive care patients with bloodstream infection

Jordy P. Pijl et al.

Summary: This study evaluated the diagnostic yield of FDG-PET/CT in intensive care patients with BSI, showing a high sensitivity and specificity for identifying infection foci. Poor image quality was significantly associated with decreased likelihood of finding infection foci.

CRITICAL CARE (2021)

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Using surgical risk scores in nonsurgically treated infective endocarditis patients

Giuseppe Gatti et al.

HELLENIC JOURNAL OF CARDIOLOGY (2020)

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Ceftobiprole for the treatment of infective endocarditis: A case series

Carlo Tascini et al.

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Aminoglycosides for infective endocarditis: time to say goodbye?

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Acute Ischemic Stroke Treatment in Infective Endocarditis: Systematic Review

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Detection of Native and Prosthetic Valve Endocarditis: Incremental Attributes of Functional FDG PET/CT over Morphologic Imaging

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