title: Comparison of prognoses of Staphylococcus aureus left-sided prosthetic endocarditis and prosthetic endocarditis caused by other pathogens.
abstract: BACKGROUND
  Staphylococcus aureus prosthetic valve endocarditis (SAPIE) is a serious disease.
  
  
  OBJECTIVE
  Our 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).
  
  
  METHODS
  This 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).
  
  
  RESULTS
  SAPIE 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%).
  
  
  CONCLUSIONS
  SAPIE 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.
authors.affiliation: Département de cardiologie, CHU d'Amiens-Picardie, 80054 Amiens, France.
authors.forename: Layal
authors.initials: L
authors.lastname: Abdallah
authors.affiliation: Département de cardiologie, hôpital de la Timone, Aix-Marseille université, CHU de Marseille, 13385 Marseille, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Habib
authors.affiliation: Département de cardiologie, CHU d'Amiens-Picardie, 80054 Amiens, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Remadi
authors.affiliation: Département de cardiologie, hôpital de la Timone, Aix-Marseille université, CHU de Marseille, 13385 Marseille, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Salaun
authors.affiliation: Département de cardiologie, hôpital de la Timone, Aix-Marseille université, CHU de Marseille, 13385 Marseille, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Casalta
authors.affiliation: Département de cardiologie, CHU d'Amiens-Picardie, 80054 Amiens, France. Electronic address: Tribouilloy.Christophe@chu-amiens.fr.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tribouilloy
mesh_terms: D000368:Aged; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects* / Q000382:microbiology; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*
keywords: Endocardite infectieuse; Infective endocarditis; Left-sided prosthetic valve; Prognosis; Pronostic; Prothèse du cœur gauche; Sepsis; Staphylococcus aureus