, Serap Şimşek-Yavuz 1
, Mukime Elif Sarıcaoğlu 2
, Mehtap Aydın 3
, Gökhan Aygün 4
, Alpay Azap 2
, Özlem Azap 5
, Aysun Benli 1
, Neşe Demirtürk 6
, Önder Ergönül 7
, Aysel Kocagül-Çelikbaş 8
, Ferit Kuşçu 9
, Selçuk Özger 10
, Selda Sayın Kutlu 11
, Nesrin Türker 12
, Emine Türkoğlu-Yılmaz 13
2Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, Ankara, Türkiye
3Department of Infectious Diseases and Clinical Microbiology, Ümraniye Training and Research Hospital, İstanbul, Türkiye
4Department of Infectious Diseases and Clinical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University Cerrahpaşa, İstanbul, Türkiye
5Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Başkent University, Ankara, Türkiye
6Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Türkiye
7Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Koç University, İstanbul, Türkiye
8Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, Çorum, Türkiye
9Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Çukurova University, Adana, Türkiye
10Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gazi University, Ankara, Türkiye
11Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Pamukkale University, Denizli, Türkiye
12Department of Infectious Diseases and Clinical Microbiology, İzmir Atatürk Training and Research Hospital, İzmir, Türkiye
13Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Türkiye
Abstract
Endocarditis is the most common cause of death from brucellosis. The information used to guide the management of cases with Brucella endocarditis has relied on case reports/series. Risk factors related to death and other adverse outcomes in patients with Brucella endocarditis were identified by an individual-patient data analysis of all reported Brucella endocarditis cases in the literature. The keywords “Bruce” and “endocard” were used to search articles published until July 2022 on PubMed and ULAKBIM databases. Case reports/series containing patients with endocarditis caused by Brucella spp., aged ≥17 years, and with data on antimicrobial or surgical treatment were included in the study. Epidemiological, clinical, laboratory, and treatment characteristics and outcomes of 273 cases from 86 eligible articles were recorded. It was found that male gender, a Wright serum tube agglutination (STA) titer of ≥1/1280 on admission, development of heart failure due to endocarditis were independent risk factors that increase mortality, while the usage of aminoglycoside and cardiac surgical intervention for endocarditis were factors reducing mortality. Including streptomycin or gentamicin in the treatment regimen may benefit patients with Brucella endocarditis. Valve surgery could be life-saving in patients with Brucella endocarditis. An STA titer of ≥1/1280, which probably reflects long-term and advanced disease, may be used as a marker for increased mortality. However, additional and more reliable studies are needed to define the most appropriate management approach in diagnosing and treating cases with Brucella endocarditis due to the low quality of the current evidence.