TABLE 1

Key articles on epidemiology, diagnosis, management, conclusions, and prevention of S. aureus PVE and IEa

Author(s) (yr) (reference)EpidemiologyDiagnosisManagementConclusion(s) and/or prevention strategy
Béraud et al. (2011) (215)137 physicians participated in the studyInfective endocarditisEndocarditis was treated with gentamicin doses of 3 mg/kg/day by 61% of physicians, 4 mg/kg/day by 22.1%, and 5 mg/kg/day by 16.9%Guidelines were not followed by most of the physicians for gentamicin dosing in these patients; instead, they used validated regimens from published studies
Bille (1995) (216)Antimicrobial therapy reviewEndocarditis due to StaphylococcusA combination of 3 antibiotics (vancomycin or oxacillin + gentamicin and rifampin) is suggested for PVE during at least 6 wkFurther studies are needed to incorporate novel treatment options, especially in patients affected by MRSA
Calderwood et al. (1985) (37)2,642 patients who underwent valve replacement for the first time were included in the study116 patients with PVE (4.4%)At 12 mo, the risk of PVE was 3.1%, and at 60 mo, the risk was 5.7%; porcine valves had a significantly lower risk of PVE during the first 90 days from surgery than mechanical valves but a significantly higher risk after 12 mo postsurgeryThere were significant differences in the risk of PVE depending on the type of valve, but no significant differences between porcine and mechanical valves were observed in the risk of having PVE after 5 yr
Cervera et al. (2014) (217)Analysis of a study cohort93 cases of S. aureus infective endocarditis (left sided)57% had a vancomycin MIC of <1.5 μg/ml, and 43% had an MIC of ≥1.5 μg/mlPercentages of in-hospital death varied significantly between both groups, at 30 and 53%, respectively
Chirouze et al. (2004) (1)Evaluation of mortality risk61 cases of S. aureus PVEPatients who had their valve replaced early, despite having heart complications, showed lower mortality rates (P = 0.09)S. aureus PVE is a disease with high morbidity and mortality rates (28.6–85.7%)
Chirouze et al. (2015) (11)Impact of early valve surgery on clinical outcome of S. aureus PVE within the International Collaboration of Endocarditis747 cases of definite left-sided PVENon-S. aureus PVE caused significantly lower rates of death after 1 yr than S. aureus PVE; at this time, patients with S. aureus PVE and EVS also had lower mortality rates (P < 0.01); EVS did not diminish mortality at 1 yrDifferent factors should be taken into account before deciding on EVS
Cosgrove et al. (2009) (218)236 patients from 44 hospitals and 4 countries were prospectively evaluatedS. aureus bacteremia and native valve infective endocarditisVancomycin or an antistaphylococcal penicillin + low-dose gentamicin or daptomycin alone was administered to patients; renal adverse events were evaluatedLow-dose gentamicin should not be used routinely for S. aureus bacteremia and native valve infective endocarditis due to the nephrotoxicity shown
de Feiter et al. (2005) (219)Fusidic acid, rifampicin, vancomycin, oxacillin, and gentamicin treatment failuresPatient with Staphylococcus epidermidis PVEDespite the nonapproval for this indication, linezolid was administered to this patientPatient had a favorable outcome with linezolid
Del Río et al. (2014) (220)Rescue therapy with imipenem + fosfomycinComplicated bacteremia and MRSA endocarditisTreatment was successful in 69% of cases; the mortality rate due to MRSA was 1/5 (20%)Combination therapy was safe and effective as rescue therapy
Fernández Guerrero et al. (2009) (15)Incidence of infective endocarditis, epidemiology, clinical features, prognosisDefinite S. aureus endocarditis (right sided and left sided)NVE was a less common hospital-acquired infection than PVE; for both types of endocarditis, renal and cardiac failure and central nervous system complications were detectedValve replacement significantly improved outcomes for patients with PVE
Fowler et al. (2006) (157)Daptomycin vs standard therapyS. aureus bacteremia and endocarditisMicrobiological failure was more common in the group treated with daptomycin than in the one with standard therapyA noninferiority rate was observed in the group treated with daptomycin compared to the one treated with standard therapy for bacteremia and right-sided endocarditis caused by S. aureus
Hasbun et al. (2003) (221)Prognostic factorsLeft-sided endocarditis (native valve) with complicationsFactors related to mortality after 6 mo, including abnormal mental status, bacterial cause, comorbidities, medical treatment, moderate/severe congestive cardiac failure4 groups of patients were identified depending on the mortality risk 6 mo after baseline
Holland et al. (2014) (222)Review on hospital managementBacteremia caused by S. aureusDiagnostic methods and antibiotic treatment strategiesThere are groups of patients who do not need TEE
John et al. (1998) (3)Clinical strategies and prognostic factorsDefinite PVE caused by S. aureusComplications affecting the central nervous system (33%) and heart (67%) were found; the 3-mo mortality rate was 42%More patients died due to heart problems than due to problems affecting the central nervous system, but this mortality was diminished when there was surgery for valve replacement during antibiotic treatment
Kang et al. (2012) (223)6-wk occurrence of embolic events and mortalityPatients with large vegetations, severe disease in valves, left-sided endocarditis due to infectionPatients were randomized into 2 groups, conventional treatment or early surgeryRates of embolic events and mortality significantly decreased in the group with early surgery compared to the group of patients treated conventionally
Karchmer et al. (1983) (24)Retrospective study of 75 PVE casesStaphylococcus epidermidis PVEThe gentamicin susceptibility rate was 78%, and those for rifampin and vancomycin were 100% for all isolates tested; dysfunction of valves and tissue progression were the most common problems, needing surgery in 30 casesAntibiotic therapy including vancomycin + rifampin or an aminoglycoside increased favorable outcome rates; surgical treatment was also important
Karchmer (1991) (224)Infection controlPVEDuring a year postsurgery, the nosocomial risk of PVE was 1.4–3.0%; the most common reason for hospital-acquired PVE was methicillin-resistant coagulase-negative StaphylococcusFurther studies are needed to detect postsurgical causes of hospital-acquired PVE and diminish them
Le and Bayer (2003) (225)Review on antibiotic treatment for endocarditis caused by frequently detected microorganismsFew strategies for in vitro, experimental, and clinical evaluation of enterococcal endocarditis have been shownHuman clinical data are scarce on combination antibiotic treatment for infective endocarditis due to S. aureus
Mayer and Schoenbaum (1982) (226)Review and approachPVEHigher rates of morbidity and mortality were detected in early than in late PVE cases; the etiology often included fungi, staphylococci, and Gram-negative rods in early PVE and streptococci in late PVEFactors related to poor outcome were early PVE, paravalvular leakage, emboli, persistent fever, nonstreptococcal microorganisms, nonheterograft aortic valve, congestive cardiac failure
Muñoz et al. (2015) (12)Epidemiology, clinical features, prognostic factorsInfective endocarditis (1,804 cases)Previous cardiac surgery, atrial fibrillation, cardiac complications and failure, septic shock, age, cerebrovascular complications, or Candida or Staphylococcus cause was related to in-hospital deaths (28.9%); after 1 yr, association was found for cancer, cardiac failure, age, and renal insufficiency (11.2%)The rates of in-hospital and 1-yr deaths were elevated, and surgery was the only protective factor
Murdoch et al. (2009) (4)Global infective causes and clinical featuresInfective endocarditisInfections of mitral and aortic valves due to S. aureus were the most frequent presentation, also complicated with heart failure, stroke, and other emboli and abscess in the heartRisk factors for in-hospital mortality were lung edema, age, prosthetic infection, S. aureus or coagulase-negative staphylococcal cause, mitral vegetation, and valve problems
Rajashekaraiah et al. (1980) (26)Evaluation of tolerance (MBC/MIC > 16)S. aureus bacteremia and endocarditisTolerant microorganisms were accompanied by more deaths, complications, hospitalization in ICU, prolongation of feverPoor outcomes of endocarditis were more common in cases caused by tolerant microorganisms than in cases caused by sensitive ones
Ribera et al. (1996) (27)Cloxacillin vs cloxacillin + gentamicin during 2 wkS. aureus endocarditis (right sided)Mortality occurred 1 and 2 cases, respectivelyCombination treatment was not more effective than the single one
Sohail et al. (2006) (17)Mortality rates in patients who received medical vs surgical treatmentS. aureus PVEMortality rates of 48% and 28%, respectivelyThe no. of deaths was lower in the surgical group; bioprosthetic valves and ASA class IV were prognostic factors
Wang et al. (2007) (6)Global infective causes and clinical featuresPVEThe most frequent microorganism was S. aureus; 36.5% of cases were related to health care; the of in-hospital death rate was 22.8% and was related to health care, age, persistent bloodstream infection, S. aureus cause, and cardiac and CNS problemsS. aureus is globally the main cause of PVE, and the presence of complications is an important prognostic factor
Wareham et al. (2005) (227)Cases treated with linezolidMRSE and VRE endocarditisIn vitro study of Staphylococcus epidermidis and Enterococcus faecalis infections treated with linezolid + gentamicin or vancomycinOutcome was favorable in both cases
Watanakunakorn (1979) (32)Treatment with penicillin vs penicillin + gentamicinS. aureus endocarditisThe death rate was 40% in both groups of patientsThere is no clinically demonstrated advantage of the use of combination therapy with gentamicin
Wilson et al. (1995) (228)Treatment efficacy experienceEndocarditis caused by enterococci, staphylococci, streptococci, and members of the HACEK groupRecommendations of treatment based on previously reported studiesLiterature is scarce
Yaw et al. (2014) (229)Clinical outcome evaluationMRSA and MSSA bacteremiaRehospitalization rates associated with infection were similar in both groups of patientsMSSA bacteremia outcomes were more favorable than MRSA bacteremia ones; patients colonized with MRSA should be treated carefully
  • a ASA, American Society of Anesthesiologists; EVS, early valve surgery; MBC, minimal bactericidal concentration; MRSA, methicillin-resistant Staphylococcus aureus; MRSE, methicillin-resistant Staphylococcus epidermidis; NVE, native valve endocarditis; PVE, prosthetic valve endocarditis; TEE, transesophageal echocardiography; VRE, vancomycin-resistant Enterococcus; ICU, intensive care unit; HACEK group, a group of Gram-negative bacilli consisting of Haemophilus spp., Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella spp.