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Infective endocarditis: an epidemiological review of 128 episodes
C Dyson1, R A Barnes, G A Harrison
1Department of Medical Microbiology, University Hospital of Wales, Health Park, Cardiff, UK.
The Journal of Infection
|May 26, 1999
Summary
Infective endocarditis epidemiology has changed, with diagnosis often difficult due to unknown risk factors. Low early prosthetic valve endocarditis incidence and mortality suggest improved cardiac care.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Infective endocarditis (IE) epidemiology is evolving.
- Understanding current trends is crucial for diagnosis and management.
- Previous studies may not reflect contemporary IE patterns.
Purpose of the Study:
- To determine the current epidemiology of infective endocarditis.
- To analyze patient demographics, affected sites, risk factors, and outcomes.
- To assess the incidence of early prosthetic valve endocarditis and mortality rates.
Main Methods:
- Retrospective review of microbiologically positive IE episodes over 9 years (1987-1996).
- Data collected from The University Hospital of Wales and other Welsh hospitals.
- Epidemiological parameters included age, sex, affected sites, risk factors, prosthetic valve endocarditis, and mortality.
Main Results:
- 128 episodes in 125 patients; mean age 53.1 years.
- Aortic valve most frequently involved (51.6%); presumed source identified in 20%.
- Low incidence of early prosthetic valve endocarditis (0.6%) and low mortality rates (12.3% native, 24.5% prosthetic). Viridans streptococci were predominant.
Conclusions:
- IE epidemiology has significantly changed, often making diagnosis challenging.
- Low early prosthetic valve endocarditis and mortality suggest improved cardiac care.
- The definition of early prosthetic valve endocarditis should be extended to one year post-surgery.