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http://hdl.handle.net/2445/113884
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DC Field | Value | Language |
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dc.contributor.author | Egea, Viviana de | - |
dc.contributor.author | Muñoz, Patricia | - |
dc.contributor.author | Valerio, Maricela | - |
dc.contributor.author | Alarcón, Aristides de | - |
dc.contributor.author | Lepe, José Antonio | - |
dc.contributor.author | Miró Meda, José M. | - |
dc.contributor.author | Gálvez-Acebal, Juan | - |
dc.contributor.author | Garcia Pavia, Pablo | - |
dc.contributor.author | Navas Pérez, Enrique | - |
dc.contributor.author | Goenaga Sánchez, Miguel Ángel | - |
dc.contributor.author | Fariñas, María Carmen | - |
dc.contributor.author | García Vázquez, Elisa | - |
dc.contributor.author | Marín, Mercedes | - |
dc.contributor.author | Bouza, Emilio | - |
dc.contributor.author | Sitges Carreño, Marta | - |
dc.contributor.author | Moreno Camacho, Ma. Asunción | - |
dc.date.accessioned | 2017-07-17T10:39:53Z | - |
dc.date.available | 2017-07-17T10:39:53Z | - |
dc.date.issued | 2015-10-02 | - |
dc.identifier.issn | 0025-7974 | - |
dc.identifier.uri | http://hdl.handle.net/2445/113884 | - |
dc.description.abstract | Streptococcus pneumoniae is an infrequent cause of severe infectious endocarditis (IE). The aim of our study was to describe the epidemiology, clinical and microbiological characteristics, and outcome of a series of cases of S. pneumoniae IE diagnosed in Spain and in a series of cases published since 2000 in the medical literature. We prospectively collected all cases of IE diagnosed in a multicenter cohort of patients from 27 Spanish hospitals (n = 2539). We also performed a systematic review of the literature since 2000 and retrieved all cases with complete clinical data using a pre-established protocol. Predictors of mortality were identified using a logistic regression model. We collected 111 cases of pneumococcal IE: 24 patients from the Spanish cohort and 87 cases from the literature review. Median age was 51 years, and 23 patients (20.7%) were under 15 years. Men accounted for 64% of patients, and infection was community-acquired in 96.4% of cases. The most important underlying conditions were liver disease (27.9%) and immunosuppression (10.8%). A predisposing heart condition was present in only 18 patients (16.2%). Pneumococcal IE affected a native valve in 93.7% of patients. Left-sided endocarditis predominated (aortic valve 53.2% and mitral valve 40.5%). The microbiological diagnosis was obtained from blood cultures in 84.7% of cases. In the Spanish cohort, nonsusceptibility to penicillin was detected in 4.2%. The most common clinical manifestations included fever (71.2%), a new heart murmur (55%), pneumonia (45.9%), meningitis (40.5%), and Austrian syndrome (26.1%). Cardiac surgery was performed in 47.7% of patients. The in-hospital mortality rate was 20.7%. The multivariate analysis revealed the independent risk factors for mortality to be meningitis (OR, 4.3; 95% CI, 1.4-12.9; P < 0.01). Valve surgery was protective (OR, 0.1; 95% CI, 0.04-0.4; P < 0.01). Streptococcus pneumoniae IE is a community-acquired disease that mainly affects native aortic valves. Half of the cases in the present study had concomitant pneumonia, and a considerable number developed meningitis. Mortality was high, mainly in patients with central nervous system (CNS) involvement. Surgery was protective. | - |
dc.format.extent | 11 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Lippincott, Williams & Wilkins. Wolters Kluwer Health | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.1097/MD.0000000000001562 | - |
dc.relation.ispartof | Medicine, 2015, vol. 94, num. 39, p. e1562 | - |
dc.relation.uri | https://doi.org/10.1097/MD.0000000000001562 | - |
dc.rights | cc-by (c) de Egea, Viviana et al., 2015 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es | - |
dc.source | Articles publicats en revistes (Medicina) | - |
dc.subject.classification | Endocarditis | - |
dc.subject.classification | Pneumococs | - |
dc.subject.classification | Medicaments antibacterians | - |
dc.subject.classification | Comorbiditat | - |
dc.subject.classification | Espanya | - |
dc.subject.classification | Epidemiologia | - |
dc.subject.other | Endocarditis | - |
dc.subject.other | Streptococcus pneumonia | - |
dc.subject.other | Antibacterial agents | - |
dc.subject.other | Comorbidity | - |
dc.subject.other | Spain | - |
dc.subject.other | Epidemiology | - |
dc.title | Characteristics and outcome of Streptococcus pneumoniae endocarditis in the XXI Century: a systematic review of 111 cases (2000-2013) | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 657799 | - |
dc.date.updated | 2017-07-17T10:39:53Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 26426629 | - |
Appears in Collections: | Articles publicats en revistes (Medicina) |
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