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Infective endocarditis epidemiology over five decades: a systematic review.
Leandro Slipczuk1, J Nicolas Codolosa2, Carlos D Davila3
1Department of Medicine, Einstein Medical Center, Philadelphia, Pennsylvania, United States of America ; Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, United States of America.
Plos One
|December 19, 2013
Summary
Infective endocarditis (IE) has changed significantly over 50 years. Staphylococcal and enterococcal IE increased, while Streptococcus viridans and culture-negative IE decreased, with older, more male patients diagnosed.
Area of Science:
- Infectious Diseases
- Epidemiology
- Cardiology
Background:
- Infective endocarditis (IE) epidemiology has evolved over the past five decades.
- Understanding these shifts is crucial for effective clinical management and public health strategies.
Purpose of the Study:
- To systematically assess the epidemiological changes in infective endocarditis (IE) over the last 50 years.
- To identify trends in causative microorganisms, patient demographics, and geographical variations.
Main Methods:
- A systematic review of published literature from PubMed, MEDLINE, and EMBASE.
- Inclusion criteria: studies reporting IE microbiology, definition, population, and timeframe.
- Data extraction and quality assessment by two independent reviewers.
Main Results:
- Hospital-based studies (n=142) showed a rise in staphylococcal IE, particularly Staphylococcus aureus (SA) and coagulase-negative staphylococcus (CNS).
- Streptococcus viridans (SV) and culture-negative (CN) IE decreased, while enterococcal IE increased.
- Patient age and male predominance increased; SA increase in North America linked to intravenous drug abuse.
Conclusions:
- Significant epidemiological shifts in IE have occurred, especially in the last decade.
- Increased prevalence of staphylococcal and enterococcal IE, with a decline in SV and CN IE.
- Rising patient age and male-to-female ratio necessitate updated treatment and prophylaxis considerations.
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