Recent Trends in Infective Endocarditis Among Patients with and Without Injection Drug Use: An Eight-Year Single...

Area of Science:

• Infectious Diseases
• Epidemiology
• Public Health

Background:

• Infective endocarditis (IE) poses significant morbidity and mortality risks.
• The opioid crisis and rising drug resistance necessitate examining IE trends.
• Understanding shifts in causative microorganisms is crucial for patient care.

Purpose of the Study:

• To analyze annual trends in IE hospitalization rates from 2011 to 2018.
• To investigate potential epidemiologic shifts in IE pathogens.
• To compare patient characteristics and outcomes based on injection drug use (IDU) status.

Main Methods:

• Retrospective cohort study of 244 adult IE patients.
• Calculation of annual IE hospitalization rates (2011-2018).
• Comparison of patient demographics, clinical features, and outcomes between IDU and non-IDU groups.

Main Results:

• IE hospitalization rates nearly quadrupled, with the most significant increase among patients with IDU.
• Staphylococcus aureus was the most common pathogen, especially in the IDU group.
• Patients with IDU were younger, more often female, and had tricuspid valve involvement; non-IDU patients had higher mortality and cardiac surgery needs.

Conclusions:

• The increasing incidence of IE is linked to the opioid crisis and increased use of central venous catheters.
• Urgent interventions for opioid use disorder and careful management of central venous catheters are recommended.
• Age remains the primary predictor of 90-day mortality in IE patients.