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Resultados del estudio EIRA 3. - Archivo PPCT

Endocarditis Infecciosa en la República Argentina. Resultados del estudio EIRA 3.;
Infective Endocarditis in Argentina. Results of the EIRA 3 Study

Creators:Avellana, Patricia; Htal. Gral. de Agudos Dr. Cosme Argerich, Garcia Aurelio, Mauro; Area de Investigación - SAC, Swieszkowski, Sandra; Hospital de Clínicas José de San Martín., Nacinovich, Francisco; Instituto Cardiovascular de Buenos Aires, Kazelian, Lucia; Htal. Gral. de Agudos Dr. Cosme Argerich, Spennato, Mario; Area de Investigación - SAC, Casabé, J. Horacio; Fundación Favaloro, Varini, Sergio, Zylbersztejn, Horacio; Area de Investigación - SAC, Gagliardi, Juan; Htal. Gral. de Agudos Dr. Cosme Argerich
2018-05-31

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Descripción

La endocarditis infecciosa (EI) es una enfermedad compleja con elevada morbimortalidad, cuyas características clínicas y epidemiológicas han variado. Desde la realización de los Estudios EIRA 1 y 2 (1992 y 2002) no se dispone de información nacional actualizada. OBJETIVO: Analizar la epidemiología, características clínicas, microbiológicas y evolución hospitalaria de los pacientes con EI. METODOS: Estudio observacional prospectivo multicéntrico de EI definidas según los criterios de Duke modificados. RESULTADOS: En 48 centros, (69.5% Área Metropolitana Buenos Aires), se registraron 502 pacientes; edad 60,7 ± 19,3 años, hombres 69,9%. Tenían enfermedad cardíaca previa el 52,4% (9,6% congénita, 18,3% isquémico-necrótica, 3,8% reumática y 20,7% prótesis valvulares). El 38,1% tenía antecedentes de un procedimiento asociado al cuidado de la salud. En el 73,3% se realizó el diagnóstico dentro del mes de la primera manifestación clínica (76,5% en vávula nativa). La localización fue aórtica (55,6%), mitral (33,6%), catéter endocavitario (10,8%) y tricúspide (19,3%). Los gérmenes más frecuentes fueron: Staphylococcus spp 46,3%, Streptococcus spp 28,2% y Enterococcus spp 12,8%. En 8,6% de los casos los hemocultivos fueron negativos. Complicaciones: insuficiencia cardíaca (30,9%), embolias periféricas (19,6%) y absceso (15,5%). El 62,4% recibió tratamiento antibiótico empírico adecuado y el 43,6% tratamiento quirúrgico. Mortalidad hospitalaria global: 25,5%. La edad, el antecedente de insuficiencia renal, la afección de la válvula mitral y la presencia de insuficiencia cardíaca fueron predictores de mortalidad hospitalaria. CONCLUSIONES: El 47,6% de los pacientes con EI no tenía enfermedad cardíaca previa conocida. El Staphylococcus spp fue el germen causal más frecuente. La mortalidad se mantiene elevada, y similar a la de los estudios EIRA 1 y 2.

Introduction: The clinical and epidemiological characteristics of infective endocarditis (IE), a complex disease with high morbidity and mortality, have been changing over the time. Our country lacks updated information since the publication of the EIRA 1 and 2 studies. Objective: The aim of this study is to analyze the epidemiology, clinical and microbiological characteristics and hospital outcome of IE. Methods: We conducted a prospective multicenter observational study of patients with definite IE according to the modified Duke criteria. Results: A total of 502 patients [mean age 60.7±19.3 years, 69.9% (n=351) were men] were recruited from 48 centers; 54.64% of the patients (n = 274) did not present underlying heart disease and 37.1% (n=191) had history of a healthcare-related procedure. The diagnosis was made within one month after the first clinical manifestation in 73.3% (n=368). The aortic valve was most commonly affected in native and prosthetic valves (48.24%; n=233), followed by mitral valve involvement (25.88%; n=125). The most common germs found were Staphylococcus spp 46.3% (n=210), Streptococcus spp 28.2% (n=128) and Enterococcus 12.8% (n=58). Blood cultures were negative in 48 patients (9.76%). Complications: heart failure (30.9%; n=155), peripheral embolism (19.6%; n = 98) and abscess (15.5%; n = 78). Adequate empirical antibiotic treatment was administered to 62.4% of the patients and 43.3% received surgical treatment (n=218). Overall hospital mortality was 25.5% (n=128). Age, history of chronic kidney failure, mitral valve affection and heart failure were independent predictors of hospital mortality. Conclusions: A high percentage of patients with IE do not present known prior heart disease. Staphylococcus spp was the most common microorganism. Mortality remains high and similar to the one observed in the EIRA 1 and 2 studies.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 86, No 1 (2018); 20-28, Argentine Journal of Cardiology; Vol 86, No 1 (2018); 20-28

Citación

Avellana, Patricia; Htal. Gral. de Agudos Dr. Cosme Argerich et al., “Endocarditis Infecciosa en la República Argentina. Resultados del estudio EIRA 3.,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/9354.

Dublin Core

Materia

Autor

Avellana, Patricia; Htal. Gral. de Agudos Dr. Cosme Argerich
Garcia Aurelio, Mauro; Area de Investigación - SAC
Swieszkowski, Sandra; Hospital de Clínicas José de San Martín.
Nacinovich, Francisco; Instituto Cardiovascular de Buenos Aires
Kazelian, Lucia; Htal. Gral. de Agudos Dr. Cosme Argerich
Spennato, Mario; Area de Investigación - SAC
Casabé, J. Horacio; Fundación Favaloro
Varini, Sergio
Zylbersztejn, Horacio; Area de Investigación - SAC
Gagliardi, Juan; Htal. Gral. de Agudos Dr. Cosme Argerich

Fuente

Revista Argentina de Cardiología; Vol 86, No 1 (2018); 20-28
Argentine Journal of Cardiology; Vol 86, No 1 (2018); 20-28

Editor

Sociedad Argentina de Cardiología

Fecha

2018-05-31

Derechos

Los que firman al pié, certificamos que tenemos total responsabilidad por la conducción de este estudio y por el diseño y la interpretación de los datos. Nosotros escribimos el manuscrito y somos responsables por la decisión acerca del mismo. Cada uno de nosotros cumple la definición de autor como se afirma en el Comité Internacional de Editores de Revistas Médicas (International Committee of Medical Journal Editors, ver www.icmje.org). Nosotros hemos visto y aprobado el manuscrito final. Ni el artículo, ni ninguna parte esencial del mismo, incluido las tablas y las figuras, será publicado o admitido para arbitrar a otra parte antes de aparecer en la Revista.También notificamos haber leído la sección “conflicto de intereses”, y revelaríamos cualquiera que existiera. Dejamos constancia que si nuestro artículo se publicara en la RAC, cederíamos los derechos (copyright) a la Revista.Los documentos publicados en esta revista están bajo la licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.
Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

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Idioma

eng
spa

Tipo

info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion