title: [Infective endocarditis in adult patients with congenital heart disease. Experience from a reference centre].
abstract: BACKGROUND
  A growing number of patients with congenital heart disease (CHD) will reach adulthood. Infective endocarditis (IE) is a major complication in this population. The aim of this study was to describe the features of IE in adults with CHD treated in a reference centre.
  
  
  METHODS
  A retrospective review was performed on a cohort of patients over 16 years of age with CHD who presented with IE (defined by the modified Duke criteria) between 1996 and 2014. Only the first episode from each patient was considered for the descriptive analysis.
  
  
  RESULTS
  IE was observed in 27 patients. The median age at diagnosis of IE was 27.7 years, and 63% were male. Comorbidity was low (median Charlson index was 0). IE was mostly community-acquired (78%). The most frequent CHD were ventricular septal defect (33%). A repair was performed in 48% of patients, and 19% received palliative treatment. Forty-one percent of patients had some type of prosthesis. A residual defect was observed in 81%. The IE was detected in the right side of 44% of the patients. The most frequent aetiological agents were viridans group streptococci (41%) and Staphylococcus epidermidis (30%). Surgery was required to treat IE in 37% of patients. There were five re-infections and three relapses. Two patients died, both as a result of recurrence.
  
  
  CONCLUSIONS
  IE in adults with CHD occurred in young patients, and almost all of them carried some prosthetic material or a residual defect. The IE is frequently right-sided. Although surgical treatment was required in many cases, mortality was low, except in the case of relapses.
authors: Servicio de Medicina Interna, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors: Jose
authors: J
authors: Loureiro-Amigo
authors: Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, Barcelona, España. Electronic address: nufernan@gmail.com.
authors: Nuria
authors: N
authors: Fernández-Hidalgo
authors: Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Unidad Integrada de Cardiopatías Congénitas del Adolescente y del Adulto Vall d'Hebron-Sant Pau, Barcelona, España.
authors: Antonia
authors: A
authors: Pijuan-Domènech
authors: Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España; Unidad Integrada de Cardiopatías Congénitas del Adolescente y del Adulto Vall d'Hebron-Sant Pau, Barcelona, España.
authors: Laura
authors: L
authors: Dos-Subirà
authors: Universitat Autònoma de Barcelona, Barcelona, España; Unidad Integrada de Cardiopatías Congénitas del Adolescente y del Adulto Vall d'Hebron-Sant Pau, Barcelona, España; Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors: Teresa
authors: T
authors: Subirana-Domènech
authors: Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors: Teresa
authors: T
authors: Gonzàlez-Alujas
authors: Servicio de Microbiología, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors: Juan José
authors: JJ
authors: González-López
authors: Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors: Pilar
authors: P
authors: Tornos-Mas
authors: Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Cardiología, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors: David
authors: D
authors: García-Dorado
authors: Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Enfermedades Infecciosas, Hospital Universitario Vall d'Hebron, Barcelona, España.
authors: Benito
authors: B
authors: Almirante
mesh_terms: D000293:Adolescent; D000328:Adult; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000382:microbiology; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D034363:Viridans Streptococci
keywords: Cardiopatías congénitas; Congenital heart disease; Endocarditis infecciosa; Infective endocarditis; Prognosis; Pronóstico