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Abstract Streptococcus mitis commonly causes bloodstream infections (BSIs) in neutropenic patients but infrequently results in infective endocarditis (IE) in this population. Among 210 patients with neutropenia and S. mitis BSI, 55% underwent cardiac imaging. None were diagnosed with S. mitis IE; 3 had recurrent S. mitis BSI within 12 weeks.
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Practice guidelines often provide recommendations in which the strength of the recommendation is dissociated from the quality of the evidence.To create a clinical guideline for the diagnosis and management of adult bacterial infective endocarditis (IE) that addresses the gap between the evidence and recommendation strength.This consensus statement and systematic review applied an approach previously established by the WikiGuidelines Group to construct collaborative clinical guidelines. In...
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Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (.70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis...
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We sought to compare the outcomes of patients treated with intravenous (IV)-only vs. oral transitional antimicrobial therapy for infective endocarditis (IE) after implementing a new Expected Practice within The Los Angeles County Department of Health Services (LAC DHS).We conducted a multi-centered, retrospective cohort study of adults with definite or possible IE treated with IV-only vs. oral therapy at the three acute care, public hospitals in the LAC DHS system between December 2018 to...
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Background: Staphylococcus aureus bacteremia (SAB) is in 10% to 20% of cases complicated by infective endocarditis (SA-IE). Clinical prediction scores may select SAB patients at highest risk for endocarditis, improving the diagnostic process of endocarditis. We compared the accuracy of the POSITIVE, PREDICT and VIRSTA scores for classifying the likelihood of endocarditis in SAB patients.
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The use of intravascular devices for administration of drugs, fluids, blood products, and nutritional support is essential in patients undergoing transplantation procedures. These intravascular devices have a significant potential to produce iatrogenic disease, such as bloodstream infection originating from colonization of the indwelling intravascular devices. Over two-thirds of all healthcare-associated bacteremia originate from devices used for vascular access. Patients undergoing...
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Acute bloodstream infection (BSI) is one of the most severe forms of infection. BSI may be primary or secondary and community-acquired or healthcare-associated. BSI is frequently observed among immunocompromised and critically ill patients, but is rarely asymptomatic and may be associated with multiple organ failure (Pittet et al. JAMA. 1994;271(20):1598–601; Edmond et al. Clin Infect Dis. 1999;29(2):239–44; Marshall et al. Crit Care Med. 2003;31(5):1560–7). Infective endocarditis (IE) is...
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Document Reviewers: Adrian M. Baranchuk, MD, FACC, FRCPC, FCCS; Carina Blomström-Lundqvist, MD, PhD; Frank A. Fish, MD; James M. Horton, MD; Roberto Keegan, MD; Miguel A. Leal, MD, FACC, FHRS; Nigel Lever, MBChB, FRACP; Aman Mahajan, MD, PhD, MBA; Marc R. Moon, MD; Siva K. Mulpuru, BS, MB, MBBS, MD, FHRS, CCDS
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Background—Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today’s myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances.Methods and Results—This statement updates...
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Use of totally implantable venous-access ports (TIVAPs) is standard practice for patients with diseases such as solid-tumour cancers, haematological malignancies, and chronic digestive diseases. Use of TIVAPs allows long-term administration of venotoxic compounds, improves patients' quality of life, and reduces the risk of infection. Microbial contamination, formation of pathogenic biofilms, and infection, however, are associated with morbidity, mortality, and increased health-care costs....
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Background— The purpose of this statement is to update the recommendations by the American Heart Association (AHA) for the prevention of infective endocarditis that were last published in 1997. Methods and Results— A writing group was appointed by the AHA for their expertise in prevention and treatment of infective endocarditis, with liaison members representing the American Dental Association, the Infectious Diseases Society of America, and the American Academy of Pediatrics. The writing...
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