The Tygerberg Endocarditis Cohort (TEC) Study

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dc.contributor.advisorDoubell, Anton Fransen_ZA
dc.contributor.advisorHerbst, Philippus Georgeen_ZA
dc.contributor.advisorJanson, Jacques Teranen_ZA
dc.contributor.authorPecoraro, Alfonso Jan Kempen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Medicine: Cardiology.en_ZA
dc.date.accessioned2021-10-21T13:02:22Zen_ZA
dc.date.accessioned2022-02-22T10:17:06Zen_ZA
dc.date.available2021-10-21T13:02:22Zen_ZA
dc.date.issued2021-12en_ZA
dc.descriptionThesis (PhD)--Stellenbosch University, 2021en_ZA
dc.description.abstractENGLISH ABSTRACT: Background: The diagnosis of infective endocarditis (IE) is based on the modified Duke/ESC 2015 clinical criteria. The sensitivity of the criteria is unknown in South Africa, but high rates of blood culture negative endocarditis (BCNIE), coupled with a change in the clinical features of IE, may limit the sensitivity. Methods: The Tygerberg Endocarditis Cohort (TEC) study prospectively enrolled patients with IE between November 2019 and June 2021. A standardised protocol for organism detection, with management of patients by an Endocarditis Team, was employed. Patients with definite IE by pathological criteria were analysed to determine the sensitivity of the current clinical criteria. Results: Eighty (80) consecutive patients with IE were included of which 45 (56.3%) had definite IE by pathological criteria. In patients with definite IE by pathological criteria, 26/45 (57.8%) of patients were classified as definite IE by clinical criteria. BCNIE was present in 25/45 (55.6%) of patients and less than three minor clinical criteria were present in 32/45 (75.6%) of patients. The elevation of Bartonella serology to a major microbiological criterion of the modified Duke/ESC 2015 clinical criteria would increase the sensitivity (56.3% vs. 77.8%; p=0.07). Conclusion: The sensitivity of the modified Duke/ESC 2015 clinical criteria is lower than expected in patients with IE in South Africa, primarily due to the high rates of Bartonella-associated BCNIE. The elevation of Bartonella serology to a major microbiological criterion, similar to the status of Coxiella burnetii in the current criteria, would increase the sensitivity. The majority of patients with definite IE by pathological criteria had less than three minor criteria present.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaar.af_ZA
dc.description.versionDoctoralen_ZA
dc.embargo.terms2022-04-27en_ZA
dc.format.extent109 pages : illustrationsen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/124218en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University, 2021en_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectInfective endocarditisen_ZA
dc.subjectRheumatic heart diseaseen_ZA
dc.subjectHeart valves -- Surgeryen_ZA
dc.subjectCulturing organismsen_ZA
dc.subjectCardiologyen_ZA
dc.subjectBartonella speciesen_ZA
dc.subjectBlood cultureen_ZA
dc.subjectHeart disease -- Diagnosisen_ZA
dc.subjectUCTDen_ZA
dc.titleThe Tygerberg Endocarditis Cohort (TEC) Studyen_ZA
dc.typeThesisen_ZA
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