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      Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis—The ESCAPE Study

      1 , 2 , 3 , 4 , 5 , 6 , 1 , 6 , 7 , 8 , 4 , 5 , 9 , 1 , 10 , 2 , 3 , 4 , 5 , 11 , 12 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,   , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , French Mycoses Study Group and Grupo de Apoyo al Manejo de las Endocarditis en España (GAMES)

      Clinical Infectious Diseases

      Oxford University Press (OUP)

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          Most cited references 16

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          Executive Summary: Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.

          It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
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            Fungal endocarditis: evidence in the world literature, 1965-1995.

            We analyzed 270 cases of fungal endocarditis (FE) that occurred over 30 years. Vascular lines, non-cardiac surgery, immunocompromise and injection drug abuse are increasing risk factors. Delayed or mistaken diagnosis (82% of patients), long duration of symptoms before hospitalization (mean +/- standard deviation, 32+/-39 days) and extracardiac manifestations were characteristic. From 1988 onwards, 72% of patients were diagnosed preoperatively, compared with 43% before 1988 (P=.0001). The fungi most commonly isolated were Candida albicans (24% of patients), non-albicans species of Candida (24%), Apergillus species (24%), and Histoplasma species (6%); recently-emerged fungi accounted for 25% of cases. The mortality rate was 72%. Survival rates were better among patients who received combined surgical-antifungal treatment, were infected with Candida, and had univalvular involvement. Improvement in the survival rate (from or =4 years while on prophylactic antifungal therapy.
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              Is Open Access

              Current Epidemiology and Outcome of Infective Endocarditis

              Abstract The aim of the study was to describe the epidemiologic and clinical characteristics and identify the risk factors of short-term and 1-year mortality in a recent cohort of patients with infective endocarditis (IE). From January 2008, multidisciplinary teams have prospectively collected all consecutive cases of IE, diagnosed according to the Duke criteria, in 25 Spanish hospitals. Overall, 1804 patients were diagnosed. The median age was 69 years (interquartile range, 55–77), 68.0% were men, and 37.1% of the cases were nosocomial or health care-related IE. Gram-positive microorganisms accounted for 79.3% of the episodes, followed by Gram-negative (5.2%), fungi (2.4%), anaerobes (0.9%), polymicrobial infections (1.9%), and unknown etiology (9.1%). Heart surgery was performed in 44.2%, and in-hospital mortality was 28.8%. Risk factors for in-hospital mortality were age, previous heart surgery, cerebrovascular disease, atrial fibrillation, Staphylococcus or Candida etiology, intracardiac complications, heart failure, and septic shock. The 1-year independent risk factors for mortality were age (odds ratio [OR], 1.02), neoplasia (OR, 2.46), renal insufficiency (OR, 1.59), and heart failure (OR, 4.42). Surgery was an independent protective factor for 1-year mortality (OR, 0.44). IE remains a severe disease with a high rate of in-hospital (28.9%) and 1-year mortality (11.2%). Surgery was the only intervention that significantly reduced 1-year mortality.
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                Author and article information

                Journal
                Clinical Infectious Diseases
                Oxford University Press (OUP)
                1058-4838
                1537-6591
                March 15 2018
                March 05 2018
                October 25 2017
                March 15 2018
                March 05 2018
                October 25 2017
                : 66
                : 6
                : 825-832
                Affiliations
                [1 ]Université Paris Descartes, Service de Maladies Infectieuses et Tropicales, Centre d’Infectiologie Necker Pasteur, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique–Hôpitaux de Paris, France
                [2 ]Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Spain
                [3 ]Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Universidad Complutense de Madrid, Spain
                [4 ]CIBER de Enfermedades Respiratorias (CIBERES), Universidad Complutense de Madrid, Spain
                [5 ]Medicine Department, School of Medicine, Universidad Complutense de Madrid, Spain
                [6 ]Unit of Epidemiology of Emerging Diseases, Institut Pasteur, Paris, France
                [7 ]PACRI Unit, Conservatoire National des Arts et Métiers, Paris, France
                [8 ]Hospices Civils de Lyon, Université Claude Bernard Lyon 1, France
                [9 ]Hospital General Universitario Gregorio Marañón, Madrid Spain
                [10 ]Institut Pasteur, Unité de Mycologie Moléculaire, Centre National de Référence Mycoses Invasives et Antifongiques, CNRS URA3012, Clichy, France
                [11 ]IAME, UMR1137, Université Paris-Diderot, Sorbonne Paris Cité, Clichy, France
                [12 ]Service de Médecine Interne, Hôpital Beaujon, Hôpitaux Universitaires Paris Nord Val-de-Seine, Assistance Publique–Hôpitaux de Paris, Clichy, France
                Article
                10.1093/cid/cix913
                29077791
                © 2017

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