Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During a 22-month period, 47 patients with 49 consecutive episodes of Staphylococcus aureus bacteremia were identified and observed prospectively for the development of endocarditis and metastatic infection. Eighteen (37%) of the episodes were community-acquired and 31 (63%) were nosocomial. The mean patient age was 55 years, and all but nine patients had one or more underlying diseases. A primary focus was identified for 38 episodes (78%) most often an intravenous catheter, and 21 episodes (43%) were associated with a removable focus of infection. In this group, no patient had endocarditis after a mean duration of 20 days of therapy. Overall, two of 47 patients had endocarditis by clinical criteria; one was a drug abuser and one had no known heart disease. Forty-five of 49 episodes were treated with a single antimicrobial agent. There were 12 (24%) deaths in this series, seven (14.2%) directly due to staphylococcal infection. In this prospective study we found a low but definite risk of endocarditis associated with S aureus bacteremia. The mortality was similar to that in other recently published studies. All deaths occurred within two weeks of initiating therapy, indicating the potential importance of host factors in the outcome.
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PMID:Staphylococcus aureus bacteremia: a prospective study. 661 91

Complicating infectious foci resulting from haematogenous or local spread of microorganisms are observed frequently in patients with Staphylococcus aureus bacteraemia (SAB) or Streptococcus species bacteraemia (SSB). The aim of this study was to compare the epidemiology of complicating infectious foci during SAB and SSB in a university hospital in The Netherlands. The charts of all adult patients diagnosed with SAB or SSB (except for Streptococcus pneumoniae bacteraemia) from July 2002 until December 2004 were reviewed retrospectively. Overall, 180 immunocompetent patients were identified, 127 with SAB and 53 with SSB. The percentage of patients with complicating infectious foci (39% of SAB patients, 25% of SSB patients) did not differ significantly between the groups. Endocarditis and cerebral involvement, however, were significantly more common in the SSB group. Of all complicating infectious foci, 32% lacked guiding signs or symptoms and 10% were detected only at autopsy. Factors associated with the development of complicating infectious foci were a delay in treatment for more than 48 h after the onset of symptoms, community acquisition, persistently positive blood cultures, congenital heart disease, and the presence of foreign bodies or prosthetic valves. Infection-related mortality was 18% in SAB patients and 11% in SSB patients and was significantly higher in patients with complicating infectious foci (29 vs. 9%). In conclusion, complicating infectious foci develop in approximately one-third of all patients with SAB and SSB. An active approach that entails searching for the complicating infectious foci is warranted in these patients, because only two-thirds of complicated infectious foci have guiding symptoms or signs, and infection-related mortality is significantly increased in patients with complicating infectious foci compared to patients without these infections.
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PMID:Complicating infectious foci in patients with Staphylococcus aureus or Streptococcus species bacteraemia. 1721 7

This is a retrospective cohort study of patients who were treated with cefazolin for methicillin-susceptible Staphylococcus aureus bacteremia, at Tokyo Women's Medical University Hospital between January 2006 and December 2010. During the study period, 84/140 (60%) patients received cefazolin (mean age, 54 years; range, 0-94 years, male patients 64%). Of these, 60/84 (71%) cases were hospital acquired infections, 55/84 (65%) had heart disease, and 19/84 (23%) had moderate to severe heart failure (New York Heart Association class III/IV). The treatment failure rate at 12 weeks was 35% (n = 29). All-cause mortality were 15% (n = 13) after 12 weeks and 21% (n = 18) after a year. Secondary endocarditis and neurological events were observed in 10% (n = 8) and 2% (n = 2). Moderate to severe heart failure and retained intravascular devices were associated with treatment failure at 12 weeks by multivariate analysis (P < 0.01, P = 0.018). Our results suggest that hospital-acquired methicillin-susceptible S. aureus bacteremia can cause severe complications in patients with moderate to severe heart failure who retain their intravascular devices. Both effective antimicrobial therapy and removal of infected foci are essential for S. aureus bacteremia treatments.
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PMID:Cefazolin therapy for methicillin-susceptible Staphylococcus aureus bacteremia in Japan. 2446 49