Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis-The ESCAPE Study
Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment. We retrospectively analyzed PVE-C cases collected in Spain and France between 2001...
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| Veröffentlicht in: | Clinical infectious diseases 2018-03, Vol.66 (6), p.825-832 |
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| creator | Rivoisy, Claire Vena, Antonio Schaeffer, Laura Charlier, Caroline Fontanet, Arnaud Delahaye, François Bouza, Emilio Lortholary, Olivier Munoz, Patricia Lefort, Agnès |
| description | Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.
We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.
Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients |
| doi_str_mv | 10.1093/cid/cix913 |
| format | Article |
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We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.
Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.
L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/cid/cix913</identifier><identifier>PMID: 29077791</identifier><language>eng</language><publisher>United States: Oxford University Press (OUP)</publisher><subject>Cardiology and cardiovascular system ; Human health and pathology ; Life Sciences ; Microbiology and Parasitology ; Mycology</subject><ispartof>Clinical infectious diseases, 2018-03, Vol.66 (6), p.825-832</ispartof><rights>The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-a37ab07ed5a807c700c9e70243feb89d89ae31f244c7520b8c7ffab03f8db99f3</citedby><cites>FETCH-LOGICAL-c357t-a37ab07ed5a807c700c9e70243feb89d89ae31f244c7520b8c7ffab03f8db99f3</cites><orcidid>0000-0002-6150-2376 ; 0000-0001-8285-8550 ; 0000-0001-9954-075X ; 0000-0003-0289-6229 ; 0000-0002-9375-3620 ; 0000-0003-3899-9983 ; 0000-0002-5850-3415 ; 0000-0002-4159-0129 ; 0000-0002-2817-3830 ; 0000-0003-3082-7001 ; 0000-0001-9016-3847</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,777,781,882,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29077791$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-angers.hal.science/hal-02407034$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Rivoisy, Claire</creatorcontrib><creatorcontrib>Vena, Antonio</creatorcontrib><creatorcontrib>Schaeffer, Laura</creatorcontrib><creatorcontrib>Charlier, Caroline</creatorcontrib><creatorcontrib>Fontanet, Arnaud</creatorcontrib><creatorcontrib>Delahaye, François</creatorcontrib><creatorcontrib>Bouza, Emilio</creatorcontrib><creatorcontrib>Lortholary, Olivier</creatorcontrib><creatorcontrib>Munoz, Patricia</creatorcontrib><creatorcontrib>Lefort, Agnès</creatorcontrib><creatorcontrib>French Mycoses Study Group and Grupo de Apoyo al Manejo de las Endocarditis en España (GAMES)</creatorcontrib><title>Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis-The ESCAPE Study</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.
We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.
Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.
L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients.</description><subject>Cardiology and cardiovascular system</subject><subject>Human health and pathology</subject><subject>Life Sciences</subject><subject>Microbiology and Parasitology</subject><subject>Mycology</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNo9kF1LwzAUQIMoTqcv_gDJowqdN01rEt_GmE4YOvDjNaRJukW6djbZdP_eSOceLrmEc8_DQeiCwICAoLfamTg_gtADdEJyypK7XJDDuEPOk4xT3kOn3n8CEMIhP0a9VABjTJATVMzaxoeFDU7jD1VtLB6p2jijsF-tBnhcm0ar1rjg_D1-tt_4qfZuvgg-LqHB06aeJ8G2Sxw987rxzidvC4vHr6PhbIxfw9psz9BRqSpvz3dvH70_jN9Gk2T68vg0Gk4TTXMWEkWZKoBZkysOTDMALSyDNKOlLbgwXChLSZlmmWZ5CgXXrCzjBS25KYQoaR9dd96FquSqdUvVbmWjnJwMp_LvL7qAAc02JLJXHbtqm6-19UEunde2qlRtm7WXROQs4-KOQkRvOlTHUr615d5NQP71l7G_7PpH-HLnXRdLa_bof3D6C8JPgJo</recordid><startdate>20180305</startdate><enddate>20180305</enddate><creator>Rivoisy, Claire</creator><creator>Vena, Antonio</creator><creator>Schaeffer, Laura</creator><creator>Charlier, Caroline</creator><creator>Fontanet, Arnaud</creator><creator>Delahaye, François</creator><creator>Bouza, Emilio</creator><creator>Lortholary, Olivier</creator><creator>Munoz, Patricia</creator><creator>Lefort, Agnès</creator><general>Oxford University Press (OUP)</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-6150-2376</orcidid><orcidid>https://orcid.org/0000-0001-8285-8550</orcidid><orcidid>https://orcid.org/0000-0001-9954-075X</orcidid><orcidid>https://orcid.org/0000-0003-0289-6229</orcidid><orcidid>https://orcid.org/0000-0002-9375-3620</orcidid><orcidid>https://orcid.org/0000-0003-3899-9983</orcidid><orcidid>https://orcid.org/0000-0002-5850-3415</orcidid><orcidid>https://orcid.org/0000-0002-4159-0129</orcidid><orcidid>https://orcid.org/0000-0002-2817-3830</orcidid><orcidid>https://orcid.org/0000-0003-3082-7001</orcidid><orcidid>https://orcid.org/0000-0001-9016-3847</orcidid></search><sort><creationdate>20180305</creationdate><title>Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis-The ESCAPE Study</title><author>Rivoisy, Claire ; Vena, Antonio ; Schaeffer, Laura ; Charlier, Caroline ; Fontanet, Arnaud ; Delahaye, François ; Bouza, Emilio ; Lortholary, Olivier ; Munoz, Patricia ; Lefort, Agnès</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-a37ab07ed5a807c700c9e70243feb89d89ae31f244c7520b8c7ffab03f8db99f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Cardiology and cardiovascular system</topic><topic>Human health and pathology</topic><topic>Life Sciences</topic><topic>Microbiology and Parasitology</topic><topic>Mycology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rivoisy, Claire</creatorcontrib><creatorcontrib>Vena, Antonio</creatorcontrib><creatorcontrib>Schaeffer, Laura</creatorcontrib><creatorcontrib>Charlier, Caroline</creatorcontrib><creatorcontrib>Fontanet, Arnaud</creatorcontrib><creatorcontrib>Delahaye, François</creatorcontrib><creatorcontrib>Bouza, Emilio</creatorcontrib><creatorcontrib>Lortholary, Olivier</creatorcontrib><creatorcontrib>Munoz, Patricia</creatorcontrib><creatorcontrib>Lefort, Agnès</creatorcontrib><creatorcontrib>French Mycoses Study Group and Grupo de Apoyo al Manejo de las Endocarditis en España (GAMES)</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rivoisy, Claire</au><au>Vena, Antonio</au><au>Schaeffer, Laura</au><au>Charlier, Caroline</au><au>Fontanet, Arnaud</au><au>Delahaye, François</au><au>Bouza, Emilio</au><au>Lortholary, Olivier</au><au>Munoz, Patricia</au><au>Lefort, Agnès</au><aucorp>French Mycoses Study Group and Grupo de Apoyo al Manejo de las Endocarditis en España (GAMES)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis-The ESCAPE Study</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clin Infect Dis</addtitle><date>2018-03-05</date><risdate>2018</risdate><volume>66</volume><issue>6</issue><spage>825</spage><epage>832</epage><pages>825-832</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Prosthetic valve endocarditis caused by Candida spp. (PVE-C) is rare and devastating, with international guidelines based on expert recommendations supporting the combination of surgery and subsequent azole treatment.
We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome.
Forty-six cases were followed up for a median of 9 months. Twenty-two patients (48%) had a history of endocarditis, 30 cases (65%) were nosocomial or healthcare related, and 9 (20%) patients were intravenous drug users. "Induction" therapy consisted mainly of liposomal amphotericin B (L-amB)-based (n = 21) or echinocandin-based therapy (n = 13). Overall, 19 patients (41%) were operated on. Patients <66 years old and without cardiac failure were more likely to undergo cardiac surgery (adjusted odds ratios [aORs], 6.80 [95% confidence interval [CI], 1.59-29.13] and 10.92 [1.15-104.06], respectively). Surgery was not associated with better survival rates at 6 months. Patients who received L-amB alone had a better 6-month survival rate than those who received an echinocandin alone (aOR, 13.52; 95% CI, 1.03-838.10). "Maintenance" fluconazole therapy, prescribed in 21 patients for a median duration of 13 months (range, 2-84 months), led to minor adverse effects.
L-amB induction treatment improves survival in patients with PVE-C. Medical treatment followed by long-term maintenance fluconazole may be the best treatment option for frail patients.</abstract><cop>United States</cop><pub>Oxford University Press (OUP)</pub><pmid>29077791</pmid><doi>10.1093/cid/cix913</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6150-2376</orcidid><orcidid>https://orcid.org/0000-0001-8285-8550</orcidid><orcidid>https://orcid.org/0000-0001-9954-075X</orcidid><orcidid>https://orcid.org/0000-0003-0289-6229</orcidid><orcidid>https://orcid.org/0000-0002-9375-3620</orcidid><orcidid>https://orcid.org/0000-0003-3899-9983</orcidid><orcidid>https://orcid.org/0000-0002-5850-3415</orcidid><orcidid>https://orcid.org/0000-0002-4159-0129</orcidid><orcidid>https://orcid.org/0000-0002-2817-3830</orcidid><orcidid>https://orcid.org/0000-0003-3082-7001</orcidid><orcidid>https://orcid.org/0000-0001-9016-3847</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 2018-03, Vol.66 (6), p.825-832 |
| issn | 1058-4838 1537-6591 |
| language | eng |
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| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Cardiology and cardiovascular system Human health and pathology Life Sciences Microbiology and Parasitology Mycology |
| title | Prosthetic Valve Candida spp. Endocarditis: New Insights Into Long-term Prognosis-The ESCAPE Study |
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