Recurrent Endocarditis in Persons Who Inject Drugs

Open Forum Infectious Diseases
Laura RodgerMichael Silverman

Abstract

Infective endocarditis (IE) is increasing among persons who inject drugs (PWID) and has high morbidity and mortality. Recurrent IE in PWID is not well described. This was a retrospective cohort study conducted between February 2007 and March 2016. It included adult inpatients (≥18) at any of 3 tertiary care centers in London, Ontario, with definite IE based on the Modified Duke's Criteria. The objectives were to characterize recurrent IE in PWID, identify risk factors for recurrent IE, identify the frequency of fungal endocarditis, and establish whether fungal infection was associated with higher mortality. Three hundred ninety patients had endocarditis, with 212/390 in PWID. Sixty-eight of 212 (32%) PWID had a second episode, with 28/212 (12%) having additional recurrences. Second-episode IE was more common in PWID (11/178 [6.2%] vs 68/212 [32.1%]; P < .001). Peripherally inserted central catheter (PICC) line abuse was associated with increased risk of recurrent endocarditis (odds ratio [OR], 1.97; 95% confidence interval [CI], 1.01-3.87; P = .04). In PWID, fungal IE was more common in second episodes than first episodes (1/212 [0.5%] vs 5/68 [7.4%]; P = .004). Additionally, fungal infections were associated with mortality in ...Continue Reading

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Citations

May 6, 2020·International Journal of Legal Medicine·Federico ManettiStefano D'Errico
Feb 5, 2021·Journal of the American College of Cardiology·Juan M PericàsUNKNOWN International Collaboration on Endocarditis (ICE) Investigators
Aug 13, 2020·Infectious Disease Clinics of North America·Asher Schranz, Joshua A Barocas

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