title: Clinical manifestations of infective endocarditis in relation to infectious agents: An 8-year retrospective study.
abstract: OBJECTIVE
  To compare clinical complications and outcomes of infective endocarditis (IE) episodes caused by Staphylococcus aureus (S. aureus) and other most frequent aetiological agents (streptococci, enterococci, coagulase-negative staphylococci, and culture-negative IE).
  
  
  METHODS
  A total of 117 IE episodes assessed by all internal medicine services of a major teaching institution in the Czech Republic over an eight-year period were identified.
  
  
  RESULTS
  We found that S. aureus IE episodes (n = 36) were significantly more associated with systemic embolism (41.7% vs 18.5%, P = 0.01), severe sepsis/septic shock (33.3% vs 3.7%, P < 0.0001), and in-hospital mortality (33% vs 12.3%, P = 0.01). No differences in local, structural, and/or functional complications (cardiac abscess formation, impaired integrity of the valvular apparatus, conduction disturbances, or incidence of heart failure) were observed between studied groups. Long-term survival estimates were significantly improved in patients with IE caused by agents other than S. aureus (13.78 median years vs 5.48 median years, P=0.03).
  
  
  CONCLUSIONS
  IE episodes caused by S. aureus are associated with both increased short-term and long-term mortality. Of all the studied parameters, only systemic embolism and severe sepsis/septic shock predicted in-hospital mortality.
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Pazdernik
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Sochman
authors.affiliation: Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kettner
authors.affiliation: 1st Department of Internal Medicine - Cardioangiology, Faculty Hospital in Hradec Kralove, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Vojacek
authors.affiliation: 1st Department of Internal Medicine - Cardioangiology, Faculty Hospital in Hradec Kralove, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Pelouch
mesh_terms: D000328:Adult; D000368:Aged; D018153:Czech Republic / Q000453:epidemiology; D004617:Embolism / Q000382:microbiology / Q000401:mortality; D004697:Endocarditis, Bacterial / Q000401:mortality*; D016983:Enterococcus; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000401:mortality; D006333:Heart Failure / Q000382:microbiology / Q000401:mortality; D006349:Heart Valve Diseases / Q000382:microbiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012772:Shock, Septic / Q000382:microbiology / Q000401:mortality; D013203:Staphylococcal Infections / Q000401:mortality*; D013290:Streptococcal Infections / Q000401:mortality*; D055815:Young Adult
keywords: Staphylococcus aureus; complications of infective endocarditis; infective endocarditis; mortality; septic shock; systemic embolism