The Changing Epidemiology of Infective Endocarditis in the Twenty-First Century

Area of Science:

• Cardiology
• Infectious Diseases
• Epidemiology

Background:

• Infective endocarditis (IE) is a severe infection with a persistent high mortality rate.
• Epidemiological trends and risk factors for IE are evolving globally.
• Limited data exists on IE in low-income countries and the effects of recent guideline changes.

Purpose of the Study:

• To review the changing epidemiology of infective endocarditis.
• To compare IE risk factors and causative agents in high-income versus low-income countries.
• To assess the impact of updated prophylaxis guidelines on IE incidence.

Main Methods:

• Literature review of infective endocarditis epidemiology.
• Comparative analysis of IE risk factors and demographics across different income settings.
• Evaluation of studies examining the effects of prophylaxis guideline modifications.

Main Results:

• High-income countries show decreased rheumatic heart disease and increased IE related to prosthetic valves and devices; staphylococci are more prevalent.
• Low-income countries still identify rheumatic disease as a primary risk factor, with streptococci as common pathogens.
• Studies on prophylaxis guideline impacts yield conflicting results; IE complexity is increasing in high-income nations.

Conclusions:

• IE epidemiology is diverging, influenced by socioeconomic factors and healthcare advancements.
• Rheumatic heart disease remains a significant IE burden in low-income settings.
• Further research is needed to clarify the effects of prophylaxis guideline changes on IE incidence and outcomes.