Infective endocarditis in an urban medical center: Association of individual drugs with valvular involvement - 08/08/11
Corresponding author. Department of Medicine, Division of Infectious Diseases. San Francisco General Hospital, 1001 Potrero Avenue, Room 5H22, San Francisco, CA 94110, USA. Tel.: +1 415 206 8703; fax: +1 415 206 8965.Summary |
Objectives |
Injection drug users (IDUs) develop more right-sided infective endocarditis (IE) than non-IDUs, but it is not known whether this risk is specific to any particular injected drug. This study reviews the clinical characteristics of IE in an urban population and examines the association of drug type with manifestations of IE.
Methods |
A retrospective cohort of 247 cases of IE was analyzed. Demographic, clinical, microbiologic, and echocardiographic data were collected.
Results |
Our cohort featured a 74% IDU rate, most with heroin. Staphylococcus aureus was the most prevalent organism. S. aureus IE was more likely to occur in IDUs versus non-IDUs (OR 5.5, p<0.0001). Enterococcus faecalis IE was less likely to occur in IDUs (OR 0.21, p=0.02). Tricuspid valve (TV) IE was more likely to occur in IDUs (OR 4.37, p=0.001), while mitral valve (MV) IE occurred less commonly in IDUs (OR 0.40, p=0.005). TV IE occurred more frequently in heroin users vs. IDUs not using heroin (OR 4.03, p=0.033).
Conclusions |
The epidemiology of IE in this cohort is different from that reported recently in other cohorts, likely due to the high prevalence of IDU. Heroin use may underlie the association between IDU and right-sided endocarditis.
Le texte complet de cet article est disponible en PDF.Keywords : Infective endocarditis, Epidemiology, Microbiology, Injection drug use, Heroin
Plan
Vol 57 - N° 2
P. 132-138 - août 2008 Retour au numéro
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