Right-sided infectious endocarditis in patients with cardiac devices: Clinical profile and prognosis in Hospital University Ibn Rochd Casablanca

Abstract

Due to numerous indications relating to device implants and the aging of the population, the epidemiology of infective endocarditis on the right side has radically changed and is now one of the main groups affected.The aim of this work is to describe the epidemiology, clinical profile and outcomes of right-sided infectious endocarditis in people with cardiac devices. We included the final episodes of infectious endocarditis diagnosed in the cardiology department of CHU IBN Rochd Casablanca. A retrospective analysis of 81 variables, a follow-up analysis and a univariate analysis of hospital mortality was performed. Out of 112 episodes, 13 people with cardiac devices presented with right-sided infectious endocarditis (11.6%). The mean age ± was 28 years. Staphylococcus were the main microorganisms responsible (coagulase negative 37%, aureus 25%) and 40% resistant to methicillin. Surgery was performed in 42% of the patients. Mortality in the hospital was 7.6%. A univariate analysis showed that 38% had renal failure on admission, 7.6% had septic shock and 15.4% had persistent infection during clinical course; which increased hospital mortality while resuming surgery is a protective factor. Infectious endocarditis of the right heart has a low mortality in hospital. Coagulase-negative staphylococci are responsible for almost half of the episodes and the incidence of methicillin resistance is high. The removal of the device is mandatory because it reduces mortality in the hospital.