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. 2017 Jul 20;12(1):57.
doi: 10.1186/s13019-017-0623-3.

Influence of Staphylococcus aureus on Outcomes after Valvular Surgery for Infective Endocarditis

Sang Myung Han  1 , Robert A Sorabella  1 , Sowmya Vasan  1 , Mark Grbic  1 , Daniel Lambert  1 , Rahul Prasad  1 , Catherine Wang  1 , Paul Kurlansky  1 , Michael A Borger  1 , Rachel Gordon  2 , Isaac George  3
Affiliations

Influence of Staphylococcus aureus on Outcomes after Valvular Surgery for Infective Endocarditis

Sang Myung Han et al. J Cardiothorac Surg. .

Abstract

Background: As Staphylococcus aureus (SA) remains one of the leading cause of infective endocarditis (IE), this study evaluates whether S. aureus is associated with more severe infections or worsened outcomes compared to non-S. aureus (NSA) organisms.

Methods: All patients undergoing valve surgery for bacterial IE between 1995 and 2013 at our institution were included in this study (n = 323). Clinical data were retrospectively collected from the chart review. Patients were stratified according to the causative organism; SA (n = 85) and NSA (n = 238). Propensity score matched pairs (n = 64) of SA versus NSA were used in the analysis.

Results: SA patients presented with more severe IE compared to NSA patients, with higher rates of preoperative vascular complications, preoperative septic shock, preoperative embolic events, preoperative stroke, and annular abscess. Among the matched pairs, there were no significant differences in 30-day (9.4% SA vs. 7.8% NSA, OR = 1.20, p = 0.76) or 1-year mortality (20.3% SA vs. 14.1% NSA, OR = 1.57, p = 0.35) groups, though late survival was significantly worse in SA patients. There was also no significant difference in postoperative morbidity between the two matched groups.

Conclusions: SA IE is associated with a more severe clinical presentation than IE caused by other organisms. Despite the clearly increased preoperative risk, valvular surgery may benefit SA IE patients by moderating the post-operative mortality and morbidity.

Keywords: Aortic valve replacement; Endocarditis; Heart valve.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Columbia University Institutional Review Board and need for individual patient consent was waived.

Consent for publication

All authors listed contributed to the drafting and review of this manuscript. All authors have read and approved submission of the manuscript. The manuscript has not been published and is not being considered for publication elsewhere in whole or in part in any language. All authors agree to transfer copyrights to the Publisher upon acceptance. There are no conflicts of interest to disclose.

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1
Fig. 1
Kaplan-Meier analysis of late survival stratified by study group
See this image and copyright information in PMC

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