Abstract
Background. 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. Methods. We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome. Results. 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% confdence 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. Conclusion. 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.
| Original language | American English |
|---|---|
| Pages (from-to) | 825-832 |
| Number of pages | 8 |
| Journal | Clinical Infectious Diseases |
| Volume | 66 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 5 Mar 2018 |
Keywords
- Candida
- endocarditis
- prosthetic valve
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Prosthetic Valve Candida spp. Endocarditis : New Insights into Long-term Prognosis-The ESCAPE Study. / Rivoisy, Claire; Vena, Antonio; Schaeffer, Laura; Charlier, Caroline; Fontanet, Arnaud; Delahaye, François; Bouza, Emilio; Lortholary, Olivier; Munoz, Patricia; Lefort, Agnès; Yazdanpanah, Yazdan; Wolff, Michel; Houzé, Sandrine; Ferry, Tristan; Wallon, Martine; Strady, Christophe; Toubas, Dominique; Brechot, Nicolas; Henry, Benoit; Fekkar, Arnaud; Fourme, Thierry; Amouroux, Isabelle; Mainardi, Jean Luc; Dannaoui, Eric; Rogeaux, Olivier; Levast, Marion; Chirouze, Catherine; Million, Laurence; Bastides, Fréderic; Chandenier, Jacques; Lançon, Jean Pierre; Ovize, Anne; Abgueguen, Pierre; Bouchara, Jean Philippe; Tric, Laurent; Habib, Gilbert; Gourriet, Frederic; Aaron, Laurent; Bougnoux, Marie Elisabeth; Camou, Fabrice; Accoceberry, Isabelle; Sánchez, Fernando Fernández; Noureddine, Mariam; Rosas, Gabriel; De La Torre Lima, Javier; Aramendi, José; Bereciartua, Elena; Victoria Boado, María; Campaña Lázaro, Marta; Goikoetxea, Josune; José Goiti, Juan; Hernández, José Luis; Iruretagoyena, José Ramón; Zuazabal, Josu Irurzun; López-Soria, Leire; Montejo, Miguel; Pérez, Pedro María; Rodríguez, Regino; Voces, Roberto; López, M. Victoria García; Georgieva, Radka Ivanova; Solero, Manuel Márquez; Bailón, Isabel Rodríguez; Morales, Josefa Ruiz; Cuende, Ana María; Echeverría, Tomás; Fuerte, Ana; Gaminde, Eduardo; Goenaga, Miguel Ángel; Idígoras, Pedro; Iribarren, José Antonio; Yarza, Alberto Izaguirre; Urkola, Xabier Kortajarena; Reviejo, Carlos; Carrasco, Rafael; Climent, Vicente; Llamas, Patricio; Merino, Esperanza; Plazas, Joaquín; Reus, Sergio; Álvarez, Nemesio; Bravo-Ferrer, Jose María; Castelo, Laura; Cuenca, José; Llinares, Pedro; Rey, Enrique Miguez; Mayo, María Rodríguez; Sánchez, Efrén; Regueiro, Dolores Sousa; Martínez, Francisco Javier; Del Mar Alonso, M.; Castro, Beatriz; Marrero, Dácil García; Durán, M. Del Carmen; Gómez, M. Antonia Miguel; Calzada, Juan La; Nassar, Ibrahim; Ciezar, Antonio Plata; Iglesias, José M.Reguera; Asensio, Víctor; Álvarez; Costas, Carlos; De La Hera, Jesús; Suárez, Jonnathan Fernández; Fraile, Lisardo Iglesias; Arguero, Víctor León; Menéndez, José López; Menciabajo, Pilar; Morales, Carlos; Torrico, Alfonso Moreno; Palomo, Carmen; Martínez, Begoña Paya; Esteban, Ángeles Rodríguez; García, Raquel Rodríguez; Asensio, Mauricio Telenti; Almela, Manuel; Armero, Yolanda; Azqueta, Manuel; Brunet, Mercé; Cartañá, Ramón; Cervera, Carlos; Falces, Carlos; Fita, Guillermina; Fuster, David; De La Maria, Cristina García; Gatell, José M.; Pérez, Jaume Llopis; Marco, Francesc; Mestres, Carlos A.; Miró, José M.; Moreno, Asunción; Ninot, Salvador; Quintana, Eduardo; Paré, Carlos; Pericás, Juan Manuel; Pomar, José L.; Ramírez, José; Rovira, Irene; Sitges, Marta; Soy, Dolors; Téllez, Adrián; Vila, Jordi; Bermejo, Javier; Cuerpo, Gregorio; De Egea, Viviana; Eworo, Alia; Cruz, Ana Fernández; Leoni, M. Eugenia García; Del Vecchio, Marcela González; Ramallo, Víctor González; Hernández, Martha Kestler; Marín, Mercedes; Martínez-Sellés, Manuel; Menárguez, M. Cruz; Rincón, Cristina; Rodríguez-Abella, Hugo; Rodríguez-Créixems, Marta; Pinilla, Blanca; Pinto, Ángel; Valerio, Maricela; Moreno, Eduardo Verde; Antorrena, Isabel; Loeches, Belén; Moreno, Mar; Ramírez, Ulises; Bastón, Verónica Rial; Romero, María; Saldaña, Araceli; Castillo, Carlos Armiñanzas; Arnaiz, Ana; Berrazueta, José; Bellisco, Sara; Belaustegui, Manuel Cobo; Durán, Raquel; Fariñas, M.; Fariñas-Álvarez, Concepción; Izquierdo, Rubén Gómez; Rico, Claudia González; Díez, José Gutiérrez; Durán, Rafael Martín; Pajarón, Marcos; Parra, José Antonio; Teira, Ramón; Zarauza, Jesús; Pavía, Pablo García; González, Jesús; Orden, Beatriz; Ramos, Antonio; Centella, Tomasa; Hermida, José Manuel; Luis Moya, José; Martín-Dávila, Pilar; Navas, Enrique; Oliva, Enrique; Del Río, Alejandro; Ruiz, Soledad; Tenorio, Carmen Hidalgo; De Castro, Antonio; De Cueto, Marina; Gallego, Pastora; Acebal, Juan Gálvez; Baño, Jesús Rodríguez; De Alarcón, Arístides; García, Emilio; Haro, Juan Luis; Lepe, José Antonio; López, Francisco; Luque, Rafael; Alonso, Luis Javier; Gutiérrez, José Manuel Azcona; Blanco, José Ramón; García, Lara; Oteo, José Antonio; De Benito, Natividad; Gurguí, Mercé; Pacho, Cristina; Pericas, Roser; Pons, Guillem; Álvarez, M.; Fernández, A. L.; Amparomartínez; Prieto, A.; Regueiro, Benito; Tijeira, E.; Vega, Marino; Blasco, Andrés Canut; Mollar, José Cordo; Arana, Juan Carlos Gainzarain; Uriarte, Oscar García; López, Alejandro Martín; De Zárate, Zuriñe Ortiz; Matos, José Antonio Urturi; Nacle, M. Belén; Sánchez-Porto, Antonio; Vallejo, Luis; Arribasleal, José M.; Vázquez, Elisa García; Torres, Alicia Hernández; Blázquez, Ana; De La Morena Valenzuela, Gonzalo; Alonso, Ángel; Aramburu, Javier; Calvo, Felicitas Elena; Rodríguez, Anai Moreno; Tarabini-Castellani, Paola; Gálvez, Eva Heredero; Bellido, Carolina Maicas; Pau, José Largo; Sepúlveda, M. Antonia; Sierra, Pilar Toledano; Iqbal-Mirza, Sadaf Zafar; Alcolea, Eva Cascales; Serrano, Pilar Egea; Roca, José Joaquín Hernández.
In: Clinical Infectious Diseases, Vol. 66, No. 6, 05.03.2018, p. 825-832.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Prosthetic Valve Candida spp. Endocarditis
T2 - New Insights into Long-term Prognosis-The ESCAPE Study
AU - Rivoisy, Claire
AU - Vena, Antonio
AU - Schaeffer, Laura
AU - Charlier, Caroline
AU - Fontanet, Arnaud
AU - Delahaye, François
AU - Bouza, Emilio
AU - Lortholary, Olivier
AU - Munoz, Patricia
AU - Lefort, Agnès
AU - Yazdanpanah, Yazdan
AU - Wolff, Michel
AU - Houzé, Sandrine
AU - Ferry, Tristan
AU - Wallon, Martine
AU - Strady, Christophe
AU - Toubas, Dominique
AU - Brechot, Nicolas
AU - Henry, Benoit
AU - Fekkar, Arnaud
AU - Fourme, Thierry
AU - Amouroux, Isabelle
AU - Mainardi, Jean Luc
AU - Dannaoui, Eric
AU - Rogeaux, Olivier
AU - Levast, Marion
AU - Chirouze, Catherine
AU - Million, Laurence
AU - Bastides, Fréderic
AU - Chandenier, Jacques
AU - Lançon, Jean Pierre
AU - Ovize, Anne
AU - Abgueguen, Pierre
AU - Bouchara, Jean Philippe
AU - Tric, Laurent
AU - Habib, Gilbert
AU - Gourriet, Frederic
AU - Aaron, Laurent
AU - Bougnoux, Marie Elisabeth
AU - Camou, Fabrice
AU - Accoceberry, Isabelle
AU - Sánchez, Fernando Fernández
AU - Noureddine, Mariam
AU - Rosas, Gabriel
AU - De La Torre Lima, Javier
AU - Aramendi, José
AU - Bereciartua, Elena
AU - Victoria Boado, María
AU - Campaña Lázaro, Marta
AU - Goikoetxea, Josune
AU - José Goiti, Juan
AU - Hernández, José Luis
AU - Iruretagoyena, José Ramón
AU - Zuazabal, Josu Irurzun
AU - López-Soria, Leire
AU - Montejo, Miguel
AU - Pérez, Pedro María
AU - Rodríguez, Regino
AU - Voces, Roberto
AU - López, M. Victoria García
AU - Georgieva, Radka Ivanova
AU - Solero, Manuel Márquez
AU - Bailón, Isabel Rodríguez
AU - Morales, Josefa Ruiz
AU - Cuende, Ana María
AU - Echeverría, Tomás
AU - Fuerte, Ana
AU - Gaminde, Eduardo
AU - Goenaga, Miguel Ángel
AU - Idígoras, Pedro
AU - Iribarren, José Antonio
AU - Yarza, Alberto Izaguirre
AU - Urkola, Xabier Kortajarena
AU - Reviejo, Carlos
AU - Carrasco, Rafael
AU - Climent, Vicente
AU - Llamas, Patricio
AU - Merino, Esperanza
AU - Plazas, Joaquín
AU - Reus, Sergio
AU - Álvarez, Nemesio
AU - Bravo-Ferrer, Jose María
AU - Castelo, Laura
AU - Cuenca, José
AU - Llinares, Pedro
AU - Rey, Enrique Miguez
AU - Mayo, María Rodríguez
AU - Sánchez, Efrén
AU - Regueiro, Dolores Sousa
AU - Martínez, Francisco Javier
AU - Del Mar Alonso, M.
AU - Castro, Beatriz
AU - Marrero, Dácil García
AU - Durán, M. Del Carmen
AU - Gómez, M. Antonia Miguel
AU - Calzada, Juan La
AU - Nassar, Ibrahim
AU - Ciezar, Antonio Plata
AU - Iglesias, José M.Reguera
AU - Asensio, Víctor
AU - Álvarez, null
AU - Costas, Carlos
AU - De La Hera, Jesús
AU - Suárez, Jonnathan Fernández
AU - Fraile, Lisardo Iglesias
AU - Arguero, Víctor León
AU - Menéndez, José López
AU - Menciabajo, Pilar
AU - Morales, Carlos
AU - Torrico, Alfonso Moreno
AU - Palomo, Carmen
AU - Martínez, Begoña Paya
AU - Esteban, Ángeles Rodríguez
AU - García, Raquel Rodríguez
AU - Asensio, Mauricio Telenti
AU - Almela, Manuel
AU - Armero, Yolanda
AU - Azqueta, Manuel
AU - Brunet, Mercé
AU - Cartañá, Ramón
AU - Cervera, Carlos
AU - Falces, Carlos
AU - Fita, Guillermina
AU - Fuster, David
AU - De La Maria, Cristina García
AU - Gatell, José M.
AU - Pérez, Jaume Llopis
AU - Marco, Francesc
AU - Mestres, Carlos A.
AU - Miró, José M.
AU - Moreno, Asunción
AU - Ninot, Salvador
AU - Quintana, Eduardo
AU - Paré, Carlos
AU - Pericás, Juan Manuel
AU - Pomar, José L.
AU - Ramírez, José
AU - Rovira, Irene
AU - Sitges, Marta
AU - Soy, Dolors
AU - Téllez, Adrián
AU - Vila, Jordi
AU - Bermejo, Javier
AU - Cuerpo, Gregorio
AU - De Egea, Viviana
AU - Eworo, Alia
AU - Cruz, Ana Fernández
AU - Leoni, M. Eugenia García
AU - Del Vecchio, Marcela González
AU - Ramallo, Víctor González
AU - Hernández, Martha Kestler
AU - Marín, Mercedes
AU - Martínez-Sellés, Manuel
AU - Menárguez, M. Cruz
AU - Rincón, Cristina
AU - Rodríguez-Abella, Hugo
AU - Rodríguez-Créixems, Marta
AU - Pinilla, Blanca
AU - Pinto, Ángel
AU - Valerio, Maricela
AU - Moreno, Eduardo Verde
AU - Antorrena, Isabel
AU - Loeches, Belén
AU - Moreno, Mar
AU - Ramírez, Ulises
AU - Bastón, Verónica Rial
AU - Romero, María
AU - Saldaña, Araceli
AU - Castillo, Carlos Armiñanzas
AU - Arnaiz, Ana
AU - Berrazueta, José
AU - Bellisco, Sara
AU - Belaustegui, Manuel Cobo
AU - Durán, Raquel
AU - Fariñas, M.
AU - Fariñas-Álvarez, Concepción
AU - Izquierdo, Rubén Gómez
AU - Rico, Claudia González
AU - Díez, José Gutiérrez
AU - Durán, Rafael Martín
AU - Pajarón, Marcos
AU - Parra, José Antonio
AU - Teira, Ramón
AU - Zarauza, Jesús
AU - Pavía, Pablo García
AU - González, Jesús
AU - Orden, Beatriz
AU - Ramos, Antonio
AU - Centella, Tomasa
AU - Hermida, José Manuel
AU - Luis Moya, José
AU - Martín-Dávila, Pilar
AU - Navas, Enrique
AU - Oliva, Enrique
AU - Del Río, Alejandro
AU - Ruiz, Soledad
AU - Tenorio, Carmen Hidalgo
AU - De Castro, Antonio
AU - De Cueto, Marina
AU - Gallego, Pastora
AU - Acebal, Juan Gálvez
AU - Baño, Jesús Rodríguez
AU - De Alarcón, Arístides
AU - García, Emilio
AU - Haro, Juan Luis
AU - Lepe, José Antonio
AU - López, Francisco
AU - Luque, Rafael
AU - Alonso, Luis Javier
AU - Gutiérrez, José Manuel Azcona
AU - Blanco, José Ramón
AU - García, Lara
AU - Oteo, José Antonio
AU - De Benito, Natividad
AU - Gurguí, Mercé
AU - Pacho, Cristina
AU - Pericas, Roser
AU - Pons, Guillem
AU - Álvarez, M.
AU - Fernández, A. L.
AU - Amparomartínez, null
AU - Prieto, A.
AU - Regueiro, Benito
AU - Tijeira, E.
AU - Vega, Marino
AU - Blasco, Andrés Canut
AU - Mollar, José Cordo
AU - Arana, Juan Carlos Gainzarain
AU - Uriarte, Oscar García
AU - López, Alejandro Martín
AU - De Zárate, Zuriñe Ortiz
AU - Matos, José Antonio Urturi
AU - Nacle, M. Belén
AU - Sánchez-Porto, Antonio
AU - Vallejo, Luis
AU - Arribasleal, José M.
AU - Vázquez, Elisa García
AU - Torres, Alicia Hernández
AU - Blázquez, Ana
AU - De La Morena Valenzuela, Gonzalo
AU - Alonso, Ángel
AU - Aramburu, Javier
AU - Calvo, Felicitas Elena
AU - Rodríguez, Anai Moreno
AU - Tarabini-Castellani, Paola
AU - Gálvez, Eva Heredero
AU - Bellido, Carolina Maicas
AU - Pau, José Largo
AU - Sepúlveda, M. Antonia
AU - Sierra, Pilar Toledano
AU - Iqbal-Mirza, Sadaf Zafar
AU - Alcolea, Eva Cascales
AU - Serrano, Pilar Egea
AU - Roca, José Joaquín Hernández
N1 - Funding Information: Financial support. This work was supported by the Programa Multidisciplinar para la Gestión de Antifúngicos y la Reducción de Candidiasis Invasora (PROMULGA) II Project, Instituto de Salud Carlos III, partially financed by the European Regional Development Fund (grant PI13/01148). A. V. is supported by a Rio Hortega contract from the Instituto de Salud Carlos III, also partially financed by the European Regional Development Fund (grant CM15/00181). Publisher Copyright: © 2017 The Author(s). Copyright: Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/3/5
Y1 - 2018/3/5
N2 - Background. 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. Methods. We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome. Results. 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% confdence 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. Conclusion. 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.
AB - Background. 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. Methods. We retrospectively analyzed PVE-C cases collected in Spain and France between 2001 and 2015, with a focus on management and outcome. Results. 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% confdence 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. Conclusion. 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.
KW - Candida
KW - endocarditis
KW - prosthetic valve
UR - http://www.scopus.com/inward/record.url?scp=85043483717&partnerID=8YFLogxK
U2 - 10.1093/cid/cix913
DO - 10.1093/cid/cix913
M3 - Artículo
C2 - 29077791
AN - SCOPUS:85043483717
VL - 66
SP - 825
EP - 832
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
SN - 1058-4838
IS - 6
ER -