Infectious Disease

Traumatic pores and skin wounds could be a threat issue for infectious endocarditis

March 04, 2021

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According to the results published in Heart, traumatic skin wounds can be a risk factor for infectious endocarditis in the weeks following wound development.

“There have been several case reports of infectious endocarditis following trauma episodes. Recently, two case studies have shown that trauma can be a risk factor for infectious endocarditis. ” Hiroyuki Ohbe, MD, MPH, PhD student in the Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo and colleagues wrote. “Finding a significant association between traumatic skin wounds and infectious endocarditis in the present study would mean that further studies are needed to determine whether antibiotic prophylaxis is in place (currently not recommended for traumatic skin wounds, even in patients at high risk for infectious ones Endocarditis). may reduce the risk of infectious endocarditis after traumatic skin wounds. “

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In nested case-control and self-control analyzes, researchers evaluated the association between traumatic skin wounds and the development of infectious endocarditis in participants from the Japan Medical Data Center (JMDC) database and the Kumamoto database. The researchers compared 544 hospital admissions with infectious endocarditis with 2,091 controls from the JMDC database and 670 hospital admissions with infectious endocarditis with 2,581 controls from the Kumamoto database. The short-term wound analysis was carried out 1 to 4 weeks after the traumatic skin wound, 5 to 8 weeks after the traumatic skin wound, 9 to 12 weeks after the traumatic skin wound and 13 to 16 weeks after the traumatic skin wound.

The study results from the JMDC database showed that 2.8% of patients with infectious endocarditis and 0.5% of controls were exposed to traumatic skin wounds between weeks 1 and 4 (adjusted OR = 4.31; 95% CI, 1.47-10.7). Further self-controlled analyzes at each time point examined gave incidence rates for infectious endocarditis of 3.78 (95% CI, 2.07-6.92) for 1 to 4 weeks, 1.58 (95% CI, 0.64-3.89 ) for 5 to 8 weeks, 1.6 (95% CI, 0.65-3.94) for 9 to 12 weeks and 1.29 (95% CI, 0.47-3.53) for 13 to 16 weeks compared to the base period.

The study results from the Kumamoto database showed traumatic wound stress on the skin in 4% of patients with infectious endocarditis and 1.1% of controls between 1 and 4 weeks (aOR = 4.15; 95% CI, 2.04-8, 46). Self-controlled analyzes showed incidence rates for infectious endocarditis of 2.61 (95% CI, 1.67-4.09) for 1 to 4 weeks, 1.73 (95% CI, 1.01-2.94) for 5 to 8 Weeks, 1.19 (95% CI, 0.63) -2.27) for 9 to 12 weeks and 1.52 (95% CI, 0.82-2.74) for 13 to 16 weeks compared to the base period .

“In clinical or epidemiological studies, it is generally difficult to establish the causality between traumatic skin wounds and infectious endocarditis. However, our findings of an increased risk of infectious endocarditis in the 1 to 4 weeks following traumatic skin wounds can be supported by the biological mechanisms suggested in previous baseline studies, ”concluded Ohbe and colleagues. “Further studies are needed to investigate whether antibiotic prophylaxis can reduce the risk of infectious endocarditis after traumatic skin wounds.”

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