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- Title
Infective endocarditis in pregnant women without intravenous drug use: a multicentre retrospective case series.
- Authors
Escolà-Vergé, Laura; Rello, Pau; Declerck, Charles; Dubée, Vincent; Rouleau, Fréderic; Duval, Xavier; Habib, Gilbert; Lavie-Badie, Yoan; Martin-Blondel, Guillaume; Porte, Lydie; Bouiller, Kevin; Goehringer, François; Selton-Suty, Christine; Lamas, Cristiane da Cruz; Nacinovich, Francisco; Issa, Nahema; Richaud, Clémence; Hammoudi, Nadjib; Barranco, Francisco José; Almirante, Benito
- Abstract
<bold>Objectives: </bold>To describe the clinical features and outcomes of infective endocarditis (IE) in pregnant women who do not inject drugs.<bold>Methods: </bold>A multinational retrospective study was performed at 14 hospitals. All definite IE episodes between January 2000 and April 2021 were included. The main outcomes were maternal mortality and pregnancy-related complications.<bold>Results: </bold>Twenty-five episodes of IE were included. Median age at IE diagnosis was 33.2 years (IQR 28.3-36.6) and median gestational age was 30 weeks (IQR 16-32). Thirteen (52%) patients had no previously known heart disease. Sixteen (64%) were native IE, 7 (28%) prosthetic and 2 (8%) cardiac implantable electronic device IE. The most common aetiologies were streptococci (n = 10, 40%), staphylococci (n = 5, 20%), HACEK group (n = 3, 12%) and Enterococcus faecalis (n = 3, 12%). Twenty (80%) patients presented at least one IE complication; the most common were heart failure (n = 13, 52%) and symptomatic embolism other than stroke (n = 4, 16%). Twenty-one (84%) patients had surgery indication and surgery was performed when indicated in 19 (90%). There was one maternal death and 16 (64%) patients presented pregnancy-related complications (11 patients ≥1 complication): 3 pregnancy losses, 9 urgent Caesarean sections, 2 emergency Caesarean sections, 1 fetal death, and 11 preterm births. Two patients presented a relapse during a median follow-up of 3.1 years (IQR 0.6-7.4).<bold>Conclusions: </bold>Strict medical surveillance of pregnant women with IE is required and must involve a multidisciplinary team including obstetricians and neonatologists. Furthermore, the potential risk of IE during pregnancy should never be underestimated in women with previously known underlying heart disease.
- Subjects
RESEARCH; ENDOCARDITIS; RETROSPECTIVE studies; PREGNANT women; EVALUATION research; INFECTIVE endocarditis; COMPARATIVE studies; STAPHYLOCOCCUS; RESEARCH funding
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2022, Vol 77, Issue 10, p2701
- ISSN
0305-7453
- Publication type
journal article
- DOI
10.1093/jac/dkac258