[Endocarditis 2007: Results of a multicentric study on occurrence and characteristics of infective endocarditis]

To recognize incidence and epidemiological characteristics of infective endocarditis (IE) in the Czech Republic.

A prospective multicentre observational study on occurrence and characteristics of IE in 29 hospitals within one year. A cooperative physician in every hospital reported all cases of IE that occurred in pre-defined hospital attraction area in 12 consecutive months. A unified anonymous form was used for reporting. Only patients fulfilling the modified Duke criteria were enrolled.

One hundred and thirty-four cases of IE were reported. Thus, crude incidence of IE appeared 3.4 cases/100,000/year. Vegetations were found on aortic valves in 45.5% and on mitral valves in 40.3%. The most common etiological agent was Staphylococcus aureus (29.9%). Etiology was not established in 45 cases (33.6%), mostly due to previous antibiotic treatment. The most frequent predisposing conditions were purulent infections, namely in lower extremities, and previous invasive cardiac procedures (cardiac surgery, permanent pacemaker/defibrillator etc.). Heart surgery within antibiotic treatment was performed in 36 patients (26.9%). Overall mortality was also 26.9%. Mortality was significantly higher in hospitals that did not dispose of transesophageal echocardiography (TEE).

We assume the real incidence of IE was slightly higher than we had found. The possible causes of such discreapance are discussed.