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

2017; Oxford University Press; Volume: 66; Issue: 6 Linguagem: Inglês

10.1093/cid/cix913

1537-6591

C. Rivoisy, Antonio Vena, Laura Schaeffer, Caroline Charlier, Arnaud Fontanet, François Delahaye, Emilio Bouza, Olivier Lortholary, Patricia Muñóz, A. Lefort, Yazdan Yazdanpanah, Michel Wolff, Sandrine Houzé, Tristan Ferry, Martine Wallon, C. Strady, D. Toubas, Nicolas Bréchot, Benoît Henry, Arnaud Fekkar, Thierry Fourme, Isabelle Amouroux, Jean‐Luc Mainardi, Éric Dannaoui, O. Rogeaux, Marion Levast, Catherine Chirouze, L. MILLION, Frédéric Bastides, J. Chandenier, J P Lançon, Anne Ovize, P. Abgueguen, Jean-Philippe Bouchara, Laurent Tric, Gilbert Habib, Frederic Gourriet, Laurent Aaron, Osipova Yu.L., Marie‐Elisabeth Bougnoux, Fabrice Camou, Isabelle Accoceberry, Fernando Fernández Sánchez, Mariam Noureddine, Gabriel Rosas, Javier de la Torre, José I. Aramendi, Elena Bereciartúa, María Victoria Boado, Marta Campaña Lázaro, Josune Goikoetxea, J.J. Goiti, José L. Hernández, José Ramón Iruretagoyena, Josu Irurzun Zuazabal, Leire López-Soria, Miguel Montejo, Pedro María Pérez, Regino Rodríguez, Roberto Voces, Ma Victoria García López, Radka Ivanova Georgieva, Manuel Márquez, Isabel Rodríguez Bailón, Josefa Ruíz 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, José María Bravo-Ferrer, Laura Castelo, José J. Cuenca‐Castillo, Pedro Llinares, Enrique Míguez Rey, María Rodríguez Mayo, Efrén Sánchez, Dolores Sousa Regueiro, F.J. Martínez-Moreno, M.M. Alonso, Beatriz Castro, Dácil García Marrero, Ma del Carmen Durán, Ma Antonia Miguel Gómez, Juan La Calzada, Ibrahim Nassar, Antonio Plata, José Ma Reguera Iglesias, Víctor Ortega Asensio, Clara V. Álvarez, Carlos Costas, Jesús de la Hera, Jonathan Fernández-Suarez, Lisardo Iglesias Fraile, Víctor León, José López Menéndez, Pilar Mencia-Bajo, Carlos Morales, Alfonso Moreno Torrico, Carmen Palomo, B. Martínez, Ángeles Rodríguez Esteban, Raquel Rodríguez-García, Mauricio Telenti Asensio, Manuel Almela, Yolanda Armero, Manuel Azqueta, Merçè Brunet, Ramón Cartañá, Carlos Cervera, Carlos Falces, Guillermina Fita, David Fuster, Cristina García de la Mària, José M. Gatell, Jaume Llopis Pérez, Francesc Marco, Carlos A. Mestres, José Ma Miró, Asunción Moreno, Salvador Pié i Ninot, Eduard Quintana, Carlos Paré, Juan M. Pericàs, José Luís Pomar, José Ramírez, Irene Rovira, Marta Sitges, Dolors Soy, Adrián Téllez, Jordi Vilà, Javier Bermejo, Eleonor Venegas B, Gregorio Cuerpo, Viviana de Egea, Alia Eworo, Ana Fernández‐Cruz, Ma Eugenia García Leoni, Marcela González del Vecchio, Víctor José González Ramallo, Martha Kestler Hernández, Mercedes Marín, Manuel Martínez‐Sellés, Ma Cruz Menárguez, Patricia Muñóz, Cristina Rincón, Hugo Rodríguez-Abella, Marta Rodríguez‐Créixems, Blanca Pinilla, Ángel González Pinto, Maricela Valerio, Eduardo Verde Moreno, Isabel Antorrena, Belén Loeches, Mar Moreno, Ulises Ramírez, Verónica Rial Bastón, María Pilar Romero‐Gómez, Araceli Saldaña, Carlos Armiñanzas Castillo, Ana Arnáiz, José R. Berrazueta, Sara Bellisco, Manuel Cobo Belaustegui, Raquel Durán, MaCarmen Fariñas, Concepción Fariñas-Álvarez, Carlos Fernández Mazarrasa, 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, António Ramos, Elena Rodríguez‐González, Tomasa Centella, José Manuel Hermida, José Luis Betrán Moya, Pilar Martín‐Dávila, Enrique Navas, Enrique Oliva, Alejandro del Río, Soledad Ruíz, 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, José Ramón Blanco, Lara García-Álvarez, José A. Oteo, Natividad Benito, Mercè Gurguí, Cristina Pacho, R. Pericás, Guillem Pons, Mar Álvarez, Ángel 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, Ma Belén Nacle, Antonio Sánchez-Porto, Luis Vallejo, José Ma Arribas-Leal, Elisa García Vázquez, Alicia Hernández Torres, Ana Lozano-Blázquez, Gonzalo de la Morena, Ángel Barajas, Javier Aramburu, Felicitas Elena Calvo, Anai Moreno Rodríguez, Paola Tarabini-Castellani, Eva Heredero Gálvez, Carolina Maicas Bellido, José Largo Pau, Ma Antonia Sepúlveda, Pilar Toledano Sierra, Sadaf Zafar Iqbal-Mirza, Eva Cascales Alcolea, Pilar Egea Serrano, Jose Roca,

Antimicrobial Resistance in Staphylococcus

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.