Commentary: Goals of surgical therapy in tricuspid valve endocarditis
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.
Morbidity and mortality from opioid use disorder (OUD) remain at epidemic levels in the United States. In the 12-month period ending July 2018, approximately 46,000 people died from opioid overdose in the United States, approximately five deaths every hour. The harms of OUD extend beyond the well-publicized overdose deaths. Aside from the tragic toll on families, patients experience social and medical sequelae of drug use. Among the medical sequelae is drug use-associated infective endocarditis, whose incidence has risen dramatically where opioid use disorder (OUD) is endemic; at least one state experienced a tenfold in...
Intravenous drug use has increased substantially over the past decade, with heroin abuse more than doubling. Injection drug use-related infective endocarditis hospitalizations have similarly increased over the same period. Right-sided infective endocarditis is strongly associated with intravenous drug use, and 90% of right-sided endocarditis involves the tricuspid valve. During the period of the opioid epidemic, tricuspid-related endocarditis rates have increased, while the incidence of surgery for tricuspid endocarditis has increased as much as five-fold.
ConclusionsOur data reflect high rates of postvalve surgery morbidity and mortality in people with SUD-IE at a tertiary care center. The midterm postoperative period is a vulnerable period for people with SUD-IE worthy of further investigation.
CONCLUSIONS: Our data reflect high rates of postvalve surgery morbidity and mortality in people with SUD-IE at a tertiary care center. The midterm postoperative period is a vulnerable period for people with SUD-IE worthy of further investigation. PMID: 31630767 [PubMed - as supplied by publisher]
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...
(MedPage Today) --'Alarming'increase prompts call to improve the related'cascade of care '
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]