Prosthetic Valve Candida spp. Endocarditis: New Insights into Long-term Prognosis-The ESCAPE Study

Claire Rivoisy, Antonio Vena, Laura Schaeffer, Caroline Charlier, Arnaud Fontanet, François Delahaye, Emilio Bouza, Olivier Lortholary, Patricia Munoz, Agnès Lefort*, Yazdan Yazdanpanah, Michel Wolff, Sandrine Houzé, Tristan Ferry, Martine Wallon, Christophe Strady, Dominique Toubas, Nicolas Brechot, Benoit Henry, Arnaud FekkarThierry Fourme, Isabelle Amouroux, Jean Luc Mainardi, Eric Dannaoui, Olivier Rogeaux, Marion Levast, Catherine Chirouze, Laurence Million, Fréderic Bastides, Jacques Chandenier, Jean Pierre Lançon, Anne Ovize, Pierre Abgueguen, Jean Philippe Bouchara, Laurent Tric, Gilbert Habib, Frederic Gourriet, Laurent Aaron, Marie Elisabeth Bougnoux, Fabrice Camou, Isabelle Accoceberry, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier De La Torre Lima, José Aramendi, Elena Bereciartua, María Victoria Boado, Marta Campaña Lázaro, Josune Goikoetxea, Juan José Goiti, José Luis Hernández, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Pedro María Pérez, Regino Rodríguez, Roberto Voces, M. Victoria García López, Radka Ivanova Georgieva, Manuel Márquez Solero, Isabel Rodríguez Bailón, Josefa Ruiz Morales, Ana María Cuende, Tomás Echeverría, Ana Fuerte, Eduardo Gaminde, Miguel Ángel Goenaga, Pedro Idígoras, José Antonio Iribarren, Alberto Izaguirre Yarza, Xabier Kortajarena Urkola, Carlos Reviejo, Rafael Carrasco, Vicente Climent, Patricio Llamas, Esperanza Merino, Joaquín Plazas, Sergio Reus, Nemesio Álvarez, Jose María Bravo-Ferrer, Laura Castelo, José Cuenca, Pedro Llinares, Enrique Miguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, Francisco Javier Martínez, M. Del Mar Alonso, Beatriz Castro, Dácil García Marrero, M. Del Carmen Durán, M. Antonia Miguel Gómez, Juan La Calzada, Ibrahim Nassar, Antonio Plata Ciezar, José M.Reguera Iglesias, Víctor Asensio, Álvarez, Carlos Costas, Jesús De La Hera, Jonnathan Fernández Suárez, Lisardo Iglesias Fraile, Víctor León Arguero, José López Menéndez, Pilar Menciabajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, Begoña Paya Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez García, Mauricio Telenti Asensio, Manuel Almela, Yolanda Armero, Manuel Azqueta, Mercé Brunet, Ramón Cartañá, Carlos Cervera, Carlos Falces, Guillermina Fita, David Fuster, Cristina García De La Maria, José M. Gatell, Jaume Llopis Pérez, Francesc Marco, Carlos A. Mestres, José M. Miró, Asunción Moreno, Salvador Ninot, Eduardo Quintana, Carlos Paré, Juan Manuel Pericás, José L. Pomar, José Ramírez, Irene Rovira, Marta Sitges, Dolors Soy, Adrián Téllez, Jordi Vila, Javier Bermejo, Gregorio Cuerpo, Viviana De Egea, Alia Eworo, Ana Fernández Cruz, M. Eugenia García Leoni, Marcela González Del Vecchio, Víctor González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez-Sellés, M. Cruz Menárguez, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez-Créixems, Blanca Pinilla, Ángel Pinto, Maricela Valerio, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Romero, Araceli Saldaña, Carlos Armiñanzas Castillo, Ana Arnaiz, José Berrazueta, Sara Bellisco, Manuel Cobo Belaustegui, Raquel Durán, M. Fariñas, Concepción Fariñas-Álvarez, Rubén Gómez Izquierdo, Claudia González Rico, José Gutiérrez Díez, Rafael Martín Durán, Marcos Pajarón, José Antonio Parra, Ramón Teira, Jesús Zarauza, Pablo García Pavía, Jesús González, Beatriz Orden, Antonio Ramos, Tomasa Centella, José Manuel Hermida, José Luis Moya, Pilar Martín-Dávila, Enrique Navas, Enrique Oliva, Alejandro Del Río, Soledad Ruiz, Carmen Hidalgo Tenorio, Antonio De Castro, Marina De Cueto, Pastora Gallego, Juan Gálvez Acebal, Jesús Rodríguez Baño, Arístides De Alarcón, Emilio García, Juan Luis Haro, José Antonio Lepe, Francisco López, Rafael Luque, Luis Javier Alonso, José Manuel Azcona Gutiérrez, José Ramón Blanco, Lara García, José Antonio Oteo, Natividad De Benito, Mercé Gurguí, Cristina Pacho, Roser Pericas, Guillem Pons, M. Álvarez, A. L. Fernández, Amparomartínez, A. Prieto, Benito Regueiro, E. Tijeira, Marino Vega, Andrés Canut Blasco, José Cordo Mollar, Juan Carlos Gainzarain Arana, Oscar García Uriarte, Alejandro Martín López, Zuriñe Ortiz De Zárate, José Antonio Urturi Matos, M. Belén Nacle, Antonio Sánchez-Porto, Luis Vallejo, José M. Arribasleal, Elisa García Vázquez, Alicia Hernández Torres, Ana Blázquez, Gonzalo De La Morena Valenzuela, Ángel Alonso, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, M. Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, José Joaquín Hernández Roca

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

12 Citations (Scopus)

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 languageAmerican English
Pages (from-to)825-832
Number of pages8
JournalClinical Infectious Diseases
Volume66
Issue number6
DOIs
Publication statusPublished - 5 Mar 2018

Keywords

  • Candida
  • endocarditis
  • prosthetic valve

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