{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T13:19:28Z","timestamp":1763558368953,"version":"3.45.0"},"reference-count":25,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Infective endocarditis (IE) remains a rare but increasingly complex condition, posing significant challenges for cardiologists and cardiac surgeons. Blood groups from the ABO\/Rh system have been associated with susceptibility to various diseases, including infections and bacterial colonization tendencies. However, data on the distribution of ABO\/Rh blood types among IE patients are lacking. We hypothesized that the prevalence of ABO\/Rh blood types among IE patients differs from their frequency in the general population. This study aimed to assess the distribution of ABO\/Rh blood types in the LODZ-ENDO database in comparison to general populations. Methods: LODZ-ENDO is a single-center retrospective study conducted in a tertiary cardiology and cardiac surgery facility serving 2.35 million residents. All consecutive patients with confirmed IE hospitalized between 1 January 2015 and 1 October 2025 were included. Clinical data and ABO\/Rh blood types were collected and compared with national population data using Fisher\u2019s exact and chi-square tests. Results: A total of 329 patients with IE were analyzed (median age 61 (41\u201368) years; 69% men), of whom 227 underwent cardiac surgery. Overall ABO\/Rh distribution differed significantly from the general population (p = 0.033), driven by a tendency to an overrepresentation of B\u2212 (LODZ-ENDO 5.2% vs. Poland 2%; OR 2.88; 95% CI 1.17\u20137.29; p = 0.03; power 0.89; p(adj) = 0.23). Considering regional demographics and blood use (\u22483 units per surgery), this represents an excess annual use of 1.9 B\u2212 units, equal to 0.23% of regional B\u2212 reserves, with additional indirect depletion of O\u2212 blood. Based on WHO data, if this overrepresentation exists elsewhere, IE-related surgeries could consume 0.2\u20131.3% of national B\u2212 stocks in smaller European countries such as Malta, Iceland, Luxembourg, Cyprus, Estonia, Lithuania, Latvia, and Slovenia. Conclusions: This, probably the first report of B\u2212 blood type overrepresentation in IE indicates disproportionate use of a rare blood group, highlighting the need for targeted blood management strategies, especially near specialized cardiac surgery centers.<\/jats:p>","DOI":"10.3390\/jcm14228101","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T12:55:31Z","timestamp":1763556931000},"page":"8101","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Infective Endocarditis and Excessive Use of B\u2212 Blood Type Due to Surgical Treatment\u2014Is It Only a Local Problem? LODZ-ENDO Results (2015\u20132025)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0256-0813","authenticated-orcid":false,"given":"Robert","family":"Morawiec","sequence":"first","affiliation":[{"name":"2nd Department of Cardiology, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karolina","family":"Mlynczyk","sequence":"additional","affiliation":[{"name":"Laboratory of Transfusion Immunology with the Blood Bank MLD-CKD of Lodz, Pomorska 251, 92-213 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Krejca","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0732-2104","authenticated-orcid":false,"given":"Jaroslaw","family":"Drozdz","sequence":"additional","affiliation":[{"name":"2nd Department of Cardiology, Medical University of Lodz, Pomorska 251, 92-213 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3948","DOI":"10.1093\/eurheartj\/ehad193","article-title":"2023 ESC Guidelines for the management of endocarditis: Developed by the task force on the management of endocarditis of the European Society of Cardiology (ESC) Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM)","volume":"44","author":"Delgado","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"609","DOI":"10.33963\/v.phj.100275","article-title":"Preliminary results from the Polish Infective Endocarditis Registry (POL-ENDO): Time to change clinical practice?","volume":"82","author":"Orzech","year":"2024","journal-title":"Pol. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"3222","DOI":"10.1093\/eurheartj\/ehz620","article-title":"Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: A prospective cohort study","volume":"40","author":"Habib","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1128\/CMR.00109-14","article-title":"Blood Groups in Infection and Host Susceptibility","volume":"28","author":"Cooling","year":"2015","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1128\/iai.6.1.95-96.1972","article-title":"Effect of anti-B antiserum on the phagocytosis of Escherichia coli","volume":"6","author":"Check","year":"1972","journal-title":"Infect. Immun."},{"key":"ref_6","first-page":"135","article-title":"Enteric bacterial agents and the ABO blood groups","volume":"23","author":"Robinson","year":"1971","journal-title":"Am. J. Hum. Genet."},{"key":"ref_7","unstructured":"(2025, October 14). Available online: https:\/\/www.gov.pl\/web\/nck."},{"key":"ref_8","unstructured":"(2025, October 14). Available online: https:\/\/krwiodawcy.org\/."},{"key":"ref_9","unstructured":"(2025, October 14). Available online: https:\/\/stat.gov.pl\/obszary-tematyczne\/zdrowie\/zdrowie\/krwiodawstwo-w-2024-r-,18,4.html."},{"key":"ref_10","unstructured":"(2025, October 14). Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/blood-safety-and-availability."},{"key":"ref_11","first-page":"667","article-title":"The blood-group frequencies of European peoples, and racial origins","volume":"61","author":"Haldane","year":"1989","journal-title":"Hum. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"M\u00e4kivuokko, H., Lahtinen, S.J., Wacklin, P., Tuovinen, E., Tenkanen, H., Nikkil\u00e4, J., Bj\u00f6rklund, M., Aranko, K., Ouwehand, A.C., and M\u00e4tt\u00f6, J. (2012). Association between the ABO blood group and the human intestinal microbiota composition. BMC Microbiol., 12.","DOI":"10.1186\/1471-2180-12-94"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1038\/s41435-022-00169-5","article-title":"Rhesus negative males have an enhanced IFN\u03b3-mediated immune response to influenza A virus","volume":"23","author":"Sugrue","year":"2022","journal-title":"Genes Immun."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Rana, R., Ranjan, V., and Kumar, N. (2021). Association of ABO and Rh Blood Group in Susceptibility, Severity, and Mortality of Coronavirus Disease 2019: A Hospital-Based Study From Delhi, India. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.767771"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Butler, E.A., Parikh, R., Grandi, S.M., Ray, J.G., and Cohen, E. (2023). ABO and Rh blood groups and risk of infection: Systematic review and meta-analysis. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08792-x"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Jajosky, R.P., O\u2019Bryan, J., Spichler-Moffarah, A., Jajosky, P.G., Krause, P.J., and Tonnetti, L. (2023). The impact of ABO and RhD blood types on Babesia microti infection. PLoS Negl. Trop. Dis., 17.","DOI":"10.1371\/journal.pntd.0011060"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Rattanapan, Y., Duangchan, T., Wangdi, K., Mahittikorn, A., and Kotepui, M. (2023). Association between Rhesus Blood Groups and Malaria Infection: A Systematic Review and Meta-Analysis. Trop. Med. Infect. Dis., 8.","DOI":"10.3390\/tropicalmed8040190"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Jeric\u00f3, C., Zalba-Marcos, S., Quintana-D\u00edaz, M., L\u00f3pez-Villar, O., Santolalla-Arnedo, I., Abad-Motos, A., Laso-Morales, M.J., Sancho, E., Subir\u00e0, M., and Bassas, E. (2022). Relationship between ABO Blood Group Distribution and COVID-19 Infection in Patients Admitted to the ICU: A Multicenter Observational Spanish Study. J. Clin. Med., 11.","DOI":"10.3390\/jcm11113042"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e3500","DOI":"10.17795\/zjrms-3500","article-title":"Determination of Relative Frequency of ABO\/Rh Blood Groups in Patients with Bacteremia in Shahid Sadoughi Hospital, Yazd, Iran","volume":"18","author":"Atefi","year":"2016","journal-title":"Zahedan J. Res. Med. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e353","DOI":"10.1097\/CCM.0000000000006523","article-title":"ABO Blood Group and Risk Associated With Sepsis-Associated Thrombocytopenia: A Single-Center Retrospective Study","volume":"53","author":"Liufu","year":"2025","journal-title":"Crit. Care Med."},{"key":"ref_21","first-page":"a001","article-title":"Associa:on of Dental Caries with Different ABO Blood Groups","volume":"3000","author":"Kamil","year":"2024","journal-title":"Dentstry"},{"key":"ref_22","first-page":"413","article-title":"Correlation between blood group and dental caries in 20\u201360 years age group: A study","volume":"2","author":"Mazumdar","year":"2014","journal-title":"Int. J. Adv. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"253","DOI":"10.4103\/ccd.ccd_307_17","article-title":"Correlation of ABO Blood Group Phenotype and Rhesus Factor with Periodontal Disease: An Observational Study","volume":"8","author":"Gautam","year":"2017","journal-title":"Contemp. Clin. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Lin, L., Xu, J., Chai, Y., and Wu, W. (2025). Global, regional, and national burden of infective endocarditis from 2010 to 2021 and predictions for the next five years: Results from the Global Burden of Disease Study 2021. BMC Public Health, 25.","DOI":"10.1186\/s12889-025-22100-z"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"922","DOI":"10.5603\/cj.99587","article-title":"The importance of etiologic factor identification in patients with infective endocarditis\u2014Results of tertiary center analysis (2015\u20132023)","volume":"31","author":"Morawiec","year":"2024","journal-title":"Cardiol. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/8101\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T13:15:38Z","timestamp":1763558138000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/8101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,15]]},"references-count":25,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14228101"],"URL":"https:\/\/doi.org\/10.3390\/jcm14228101","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,11,15]]}}}