Infective Endocarditis: Spike in N.C. Linked to Opioid Epidemic (CME/CE)
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There is a rising trend in incidence of infective endocarditis [1,2]. The injection drug use (IDU) epidemic and the aging population with associated use of intracardiac implantable electronic devices are contributing factors. The 2007 American Heart Association, 2008 National Institute for Health and Clinical Excellence (UK) and 2009 European Society of Cardiology restricted the antibiotic prophylaxis guidelines to high-risk patients and to certain invasive procedures. This may also have had an impact, although there is conflicting data to support this notion [1,3].
This study identified prophages as mediators of bacterial virulence in a model of infectious endocarditis, probably through promotion of interaction with extracellular matrix components. Further studies are needed to identify mechanisms leading to promotion of intrinsic virulence. Introduction Challenges related to Staphylococcus aureus infections in the human and veterinary clinics mobilized important human and technical resources. S. aureus can colonize 20–30% of the general population asymptomatically but is also capable of causing a wide spectrum of diseases ranging from benign infections, to particularly...
In conclusion, we unraveled the secretome of G. adiacens, an oral bacterium well-documented in infective endocarditis, but also recently shown to be involved in oral infections. Importantly, the secretome of G. adiacens comprised of a large number of putative virulence factors. Of particular importance is the finding that the G. adiacens secretome comprised of a number of “moonlighting” proteins, which in other species are shown to enhance bacterial colonization and virulence through their multifunctional roles (Pavkova et al., 2017; Graf et al., 2019). Thus, our results provide a basis for investigating the ro...
The incidence of infective endocarditis is on the rise, and this condition remains associated with high rates of morbidity and mortality, despite advances in diagnosis and treatment.1 The worsening epidemic of intravenous drug abuse (IVDA) and the increasing rates of indwelling chronic venous lines and implantable cardiac devices have resulted in a recent surge of cases of tricuspid valve endocarditis. Right-sided infective endocarditis occurs far less frequently (5%-10% of total infective endocarditis cases) than does left-sided infective endocarditis, with most cases primarily affecting the tricuspid valve.
A'staggering increase'in the occurrence of drug use-associated infective endocarditis is reported in a new study.Medscape Medical News
Conclusion: DUA-IE hospitalizations and valve surgeries increased more than 12-fold, and nearly half of all IE valve surgeries were performed in patients with DUA-IE. The swell of patients with DUA-IE is reshaping the scope, type, and financing of health care resources needed to effectively treat IE. Primary Funding Source: National Institutes of Health. PMID: 30508432 [PubMed - as supplied by publisher]
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To study the mid-term survival in patients with infective endocarditis as a result of IV drug use undergoing aortic root replacement with cryopreserved aortic homograft.
The human immunodeficiency virus epidemic is a major health challenge of the twenty-first century as the transition from infectious complications to noncommunicable disease becomes more evident. These patients may present to the emergency department with a variety of cardiovascular diseases, such as acute coronary syndromes, heart failure, pericardial disease, infective endocarditis, venothromboembolism, and other conditions. Increased awareness is needed among health care professionals to enhance adequate identification and promote prompt management of these patients.
CONCLUSION: In this study of patients in a rural region of New York, an increase in the incidence of IE was seen over the study period with changes in patient characteristics and etiology over this time. We speculate that an increase in IV drug use could be a leading factor in the recent and future increased incidence of IE in the area. PMID: 28811851 [PubMed]