[Associated factors and descriptive analysis of healthcare-related infective endocarditis in a tertiary reference hospital].
OBJECTIVE
The primary aim of this study was to evaluate associated factors, clinical features and prognosis of healthcare-related infective endocarditis cases compared with community-acquired and intravenous drug user-related episodes. Changes in the distribution of healthcare-related infective endocarditis were also analysed over time in our setting.


METHODS
A prospective, observational, comparative study was performed. We included all the cases of infective endocarditis from January 2003 to June 2010, which were then classified into 2 groups: group 1: community-acquired and intravenous drug user origin, and group 2: nosocomial and non-nosocomial healthcare-related cases. The episodes were classified into 2 periods: period I: January/2003-June/2006 and period II: July/2006-June 2010. Univariate and multivariate analyses were performed.


RESULTS
A total of 212 cases were included (group 1: 138, group 2: 74). The variables of age (risk ratio 1.026; 95%CI, 1.003 to 1.049), Charlson index (risk radio 1.242; 95%CI, 1.067 to 1.445), and previous heart surgery (risk ratio 2.522; 95%CI, 1.353 to 4.701) were independently associated with healthcare-related infective endocarditis on multivariate analysis. A non-significant increase was observed in healthcare-related cases of infective endocarditis in period II (40/104; 38.4% vs. 34/108; 31.4%).


CONCLUSIONS
The recent increase in healthcare-related infective endocarditis seems to be associated with the use of invasive procedures in elderly patients with prosthetic cardiac valve, and those with a greater number of underlying diseases, especially patients with chronic renal failure on haemodialysis.
Unidad de Enfermedades Infecciosas, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
Raquel
R
Núñez Aragón
Maria Luisa
ML
Pedro-Botet Montoya
Lourdes
L
Mateu Pruñonosa
Nuria
N
Vallejo Camazón
Nieves
N
Sopena Galindo
Irma
I
Casas García
Sonia
S
Molinos Arbós
Miquel
M
Sabrià Leal
D000368:Aged; D017714:Community-Acquired Infections / Q000150:complications / Q000453:epidemiology; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology; D004696:Endocarditis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012017:Referral and Consultation; D015819:Substance Abuse, Intravenous / Q000150:complications; D062606:Tertiary Care Centers