• Layal Abdallah, Gilbert Habib, Jean-Paul Remadi, Erwan Salaun, Jean-Paul Casalta, and Christophe Tribouilloy.
• Département de cardiologie, CHU d'Amiens-Picardie, 80054 Amiens, France.
• Arch Cardiovasc Dis. 2016 Oct 1; 109 (10): 542-549.

BackgroundStaphylococcus aureus prosthetic valve endocarditis (SAPIE) is a serious disease.AimsOur objective was to study the clinical, echocardiographic and prognostic characteristics of left-sided SAPIE, and to compare these characteristics with those of left-sided non-S. aureus prosthetic infective endocarditis (NSAPIE) (i.e. left-sided prosthetic infective endocarditis caused by another germ).MethodsThis was a retrospective analysis of 35 cases of SAPIE among 247 cases of left-sided prosthetic valve endocarditis hospitalized at two university hospitals (Amiens and Marseille, France).ResultsSAPIE accounted for 14.1% of the cases of left-sided prosthetic valve endocarditis. SAPIE complications included heart failure (in 42.8% of cases), acute renal failure (in 51.4%), sepsis (in 51.4%), neurological events (in 31.4%), systemic embolic event (in 34.2%) and abscess (in 60.0%). In-hospital mortality occurred in 48.5% of SAPIE cases compared with 16% of NSAPIE cases. A comparison of the SAPIE and NSAPIE groups showed a significant difference in terms of 4-year survival (31.8±7.3% vs 60.1±4.1%; P=0.001). Severe sepsis was the only prognostic factor associated with in-hospital mortality (odds ratio 5.7; P=0.03) and long-term mortality (odds ratio 3.7; P=0.01) in cases of SAPIE. Sepsis-induced multiple organ dysfunction syndrome was the main cause of in-hospital mortality (70.5%).ConclusionsSAPIE is a very serious disease, with elevated in-hospital mortality resulting from sepsis-induced multiple organ dysfunction syndrome. Emergency surgery is recommended in these cases, when possible, before the occurrence of complications, especially severe sepsis.Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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