Heart-valve illness studied

[Roger Frank]

Heart-valve illness studied
The Press
Last updated 05:00 17/03/2009


Christchurch medics are shedding new light on a deadly heart condition that kills up to 40 per cent of sufferers within a year.

Endocarditis is an infection of the heart valve that requires hospitalisation, intravenous antibiotics and, in severe cases, replacement of the infected heart valve.

In Canterbury, there are about 30 new patients with endocarditis each year and an estimated 300 across New Zealand.

However, lead investigator, Professor David Murdoch, of the University of Otago, Christchurch, said mortality rates were lower in New Zealand.

Globally, 18 per cent of people die from endocarditis in hospital and up to 40 per cent will die within a year.

There are also risks of ongoing complications such as stroke, blood clots and heart failure.

The five-year study examined the presentation, causes and outcome of endocarditis.

It is the largest study of the infection and looked at 2781 patients from 58 hospitals in 25 countries.

"It's been a very successful study," Murdoch said. "We'd been using data that was 30, 40, 50 years old, so this will really update how we diagnose and treat the disease.

"This study enables us to be much more definitive about the contemporary causes of this serious disease; how to better treat it and reduce the stubbornly high mortality rates," Murdoch said.

Researchers discovered that a quarter of endocarditis patients contracted the infection after being exposed to invasive health care, such as having an IV line, dialysis or an operation.

This finding was relevant with New Zealand's ageing population, who would need more hospital care, he said.

Other factors linking endocarditis with in-hospital deaths were increasing age, pulmonary oedema and other heart-valve complications.

The most common cause of endocarditis is through the bacterium, Staphylococcus aureus.

The research was published this month in the Archives of Internal Medicine.

The New Zealand arm of the study involved hospitals in Auckland, Wellington and Christchurch.

http://www.stuff.co.nz/the-press/news/christchurch/2267436/Heart-valve-illness-studied

 

[Adrienne]

That is really scary! I'm assuming that the high mortality rates are from the staph infections and not the strep infections (I had strep). I know that mine was called sub-acute bacterial endocarditis, whereas I think that the staph causes acute bacterial endocarditis. Anyhow, it is very scary!

 

[Lynlw]

That is really scary! I'm assuming that the high mortality rates are from the staph infections and not the strep infections (I had strep). I know that mine was called sub-acute bacterial endocarditis, whereas I think that the staph causes acute bacterial endocarditis. Anyhow, it is very scary!

"Globally, 18 per cent of people die from endocarditis in hospital and up to 40 per cent will die within a year."

Since this covers 25 countries, I wonder what the stats are in the countries with better medical care?

 

[Roger Frank]

I guess the good news (if there is any)...they've identified what particular bug is causing all the trouble.

 

[Adrienne]

"Globally, 18 per cent of people die from endocarditis in hospital and up to 40 per cent will die within a year."

Since this covers 25 countries, I wonder what the stats are in the countries with better medical care?

That's a good question and a good point.

I guess the good news (if there is any)...they've identified what particular bug is causing all the trouble.

Where in or on the body is that particular staph bacteria located?

 

[Lynlw]

Where in or on the body is that particular staph bacteria located?

http://en.wikipedia.org/wiki/Staphylococcus_aureus
Staphylococcus aureus (pronounced /ˌstæfɨləˈkɒkəs ˈɔriəs/, literally the "golden cluster seed" or "the seed gold" and also known as golden staph) is the most common cause of staph infections. It is a spherical bacterium, frequently found in the nose and skin of a person. About 20% of the population are long-term carriers of S. aureus.[1] S. aureus can cause a range of illnesses from minor skin infections, such as pimples, impetigo (may also be caused by Streptococcus pyogenes), boils, cellulitis folliculitis, furuncles, carbuncles, scalded skin syndrome and abscesses, to life-threatening diseases such as pneumonia, meningitis, osteomyelitis, endocarditis, Toxic shock syndrome (TSS), and septicemia. Its incidence is from skin, soft tissue, respiratory, bone, joint, endovascular to wound infections. It is still one of the four most common causes of nosocomial infections, often causing postsurgical wound infections.

 

[Adrienne]

http://en.wikipedia.org/wiki/Staphylococcus_aureus
Staphylococcus aureus (pronounced /ˌstæfɨləˈkɒkəs ˈɔriəs/, literally the "golden cluster seed" or "the seed gold" and also known as golden staph) is the most common cause of staph infections. It is a spherical bacterium, frequently found in the nose and skin of a person. About 20% of the population are long-term carriers of S. aureus.[1] S. aureus can cause a range of illnesses from minor skin infections, such as pimples, impetigo (may also be caused by Streptococcus pyogenes), boils, cellulitis folliculitis, furuncles, carbuncles, scalded skin syndrome and abscesses, to life-threatening diseases such as pneumonia, meningitis, osteomyelitis, endocarditis, Toxic shock syndrome (TSS), and septicemia. Its incidence is from skin, soft tissue, respiratory, bone, joint, endovascular to wound infections. It is still one of the four most common causes of nosocomial infections, often causing postsurgical wound infections.

OMG, why did I ask? It seems to be just about everywhere in the body!

 

[Lynlw]

OMG, why did I ask? It seems to be just about everywhere in the body!

Which is probably why it is one of the more common infections

 

[Bryan B]

When I had IE (infectious endocarditis) I researched and found that the mortality rate was 25% overall. I assume this figure included all types of endocarditis and the figures were calculated from statistics globally. I also assumed that this statistic included mortality directly from endocarditis as well as complications from endocarditis. However they came up with that figure it scared the crap out of me. I had a streptococcal strain of endocarditis which my infectious disease doctor determined came from chronic bronchitis.

Survival

In the preantibiotic era, survival after infective endocarditis was unlikely. With effective antimicrobial therapy and surgical intervention, the outcome is no longer bleak. However, despite striking advances in management, mortality remains around 20%. In part, this is because more patients are living longer with prosthetic heart valves and have more comorbidity, and IV drug abuse continues to be a problem. The most frequent cause of death is congestive heart failure, less frequently followed by major embolic events and ruptured mycotic aneurysms. Death is usually not caused by uncontrolled infection. In the past, early-onset PVE mortality was as high as 90% because surgeons were reluctant to re-operate on patients with active infection. Now, with surgical expertise and perioperative support, mortality has been reduced to approximately 25%.

http://www.clevelandclinicmeded.com...nt/infectious-disease/infective-endocarditis/

After reading this article it appears that Streptococcus viridans (which is the strain I had) still "leads" all other strains as the cause of endocarditis (which is the strain I had). Staphylococcus aureus seems to be rising in frequency, especially among those who have had any type of invasive procedure from having an IV line put in to having surgery. IMO they should rename this strain of endocarditis "hospital acquired endocarditis".