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Infective endocarditis in paediatric patients from Andalusia (Spain), 2008-2020
Walter Alfredo Goycochea-Valdivia1, Marta Aboza-García1, Reyes Moreno-Pérez de Tudela2
1Unidad de Infectología e Inmunopatologías Pediátricas, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Insights
Paediatric infective endocarditis (IE) is a serious condition. This study found prosthetic material and high CRP levels predict complicated IE in children, with a 9% mortality rate.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Paediatric infective endocarditis (IE) presents a significant mortality risk.
- Limited regional data exists for paediatric IE in Spain.
Purpose of the Study:
- To describe the epidemiology, clinical characteristics, microbiology, and outcomes of paediatric IE in Andalusia.
- To identify risk factors for complicated paediatric IE.
Main Methods:
- Multi-centre, descriptive, observational, retrospective study.
- Inclusion of patients under 18 years old diagnosed with IE admitted to six Andalusian hospitals (2008-2020).
Main Results:
- 44 IE episodes in 41 patients were identified; median age 103 months.
- Congenital heart disease (CHD) was the primary predisposing factor (77%); 48% of episodes involved prosthetic material.
- Staphylococcus aureus was the most common pathogen (25%); mortality was 9%.
- Prosthetic material and CRP > 140 mg/L independently predicted complicated IE.
Conclusions:
- Paediatric IE is associated with high morbidity.
- Findings aid in identifying epidemiological and clinical profiles of children with IE and complicated forms.
Introduction:
Paediatric infective endocarditis (IE) is a serious condition associated with significant mortality. Information in Spain is limited and comes from case series from single centres. The aim was to describe the epidemiology, clinical features, microbiology and outcome of paediatric IE in Andalusia.
Patients And Methods:
Multi-centre descriptive observational retrospective study of patients <18 years old with a diagnosis of IE who were admitted to six Andalusian hospitals during 2008-2020.
Results:
44 episodes of IE (41 patients) with a median age of 103 months (IQR 37-150 months) were identified. Congenital heart disease (CHD) was the main predisposing factor, identified in 34 cases (77%). A total of 21 (48%) episodes of IE occurred in patients with prosthetic material. These had higher rate of CHD (p = 0.002) and increased end organ dysfunction (p = 0.04) compared to those with native valve. Fever was an almost universal symptom, associated in 23% of the episodes with heart failure. Staphylococcus aureus (25%) followed by coagulase-negative staphylococci (18%) and Streptococcus viridans (14%) were the most frequently isolated microorganisms, and three (7%) patients with central venous catheters had a fungal infection. Thromboembolic events were observed in 30% of the episodes, surgical intervention was required in 48% of cases. Mortality rate was 9%. Prosthetic material and CRP > 140 mg/L were independent predictors of complicated IE.
Conclusions:
Our findings emphasize the high morbidity of paediatric IE. The information provided could be useful for the identification of epidemiological and clinical profiles of children with IE and complicated forms.
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