• Eur. J. Intern. Med. · May 2021

    Infective endocarditis in patients with solid organ transplantation. A nationwide descriptive study.

    • Manuel Martínez-Sellés, Maricela Valerio-Minero, María Carmen Fariñas, Hugo Rodríguez-Abella, María Luisa Rodríguez, Aristides de Alarcón, Encarnación Gutiérrez-Carretero, Manuel Cobo-Belaustegui, Miguel Ángel Goenaga, Asunción Moreno-Camacho, Fernando Domínguez, Laura García-Pérez, Laura Domínguez-Pérez, Patricia Muñoz, and Spanish Collaboration on Endocarditis—Grupo de Apoyo al Manejo de la Endocarditis infecciosa en ESpaña (GAMES).
    • Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV. Universidad Europea. Universidad Complutense. Madrid, Spain. Electronic address: mmselles@secardiologia.es.
    • Eur. J. Intern. Med. 2021 May 1; 87: 59-65.

    BackgroundSolid organ transplantation (SOT) implies immunosuppression and frequent health care contact. Our aim was to compare the characteristics of patients with infective endocarditis (IE) and SOT against those without SOT.MethodsWe used data from the Spanish Collaboration on Endocarditis during the period 2008-2018.ResultsWe identified 4794 cases of IE, 85 (1.8%) in SOT (56 kidney, 18 liver, 8 heart, 3 lung). Thirteen patients with other transplantation types (bone marrow, hematopoietic precursors, and cornea) were excluded from the analysis. Compared with patients without SOT, patients with SOT had lower median age (61 vs. 69 years, p<0.001), more comorbidities (mean age-adjusted Charlson index 5.7±2.9 vs. 4.9±2.9, p=0.004), a lower prevalence of native valvular heart disease (29.4 vs. 45.4%, p=0.003), more in-hospital and healthcare-related IE (70.5% vs. 36.3%, p<0.001) and staphylococcal etiology (57.7% vs. 39.7%, p=0.001). Patients with SOT had more frequent kidney function worsening (47.1% vs. 34.6%, p=0.02), septic shock (25.9% vs. 12.1 %, p<0.001), sepsis (27.1% vs. 17.2%, p=0.02), and less surgery indication (54.1% vs 66.3%, p=0.02) and surgery (32.9% vs. 46.3%, p=0.01) than patients without SOT. There were no significant differences in mortality: inhospital (30.6% SOT vs. 25.6% without SOT, p=0.31), 1-year (38.8% SOT vs. 31.9% without SOT, p=0.18).ConclusionsMost IE in SOT recipients are nosocomial and over 70% are health care-related. Half have previously normal heart valves and almost 60% are due to Staphylococcus spp. infections. Mortality seems to be similar to non-SOT counterparts.Copyright © 2021. Published by Elsevier B.V.

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