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Infective Endocarditis at a Referral Children's Hospital During 19-Year Period: Trends and Outcomes
Nahed Abdel-Haq1,2,3,4, Ahmed Shawaqfeh5, Shipra Gupta6
1Children's Hospital of Michigan, Detroit, MI, USA. nabdel@dmc.org.
Pediatric Cardiology
|August 23, 2023
Summary
Pediatric infective endocarditis (IE) incidence doubled, linked to increased congenital heart disease (CHD) and prior cardiac surgeries. Staphylococcus aureus was the leading cause, with significant morbidity and mortality persisting in children.
Area of Science:
- Pediatrics
- Cardiology
- Infectious Diseases
Background:
- Infective endocarditis (IE) cases have recently increased in pediatric populations.
- Understanding trends in pediatric IE is crucial for timely diagnosis and treatment.
Purpose of the Study:
- To examine the incidence, risk factors, microbiology, and outcomes of infective endocarditis (IE) in a pediatric population.
- To identify changes in IE patterns over time and associated predisposing conditions.
Main Methods:
- A retrospective review of pediatric IE cases was conducted at Children's Hospital of Michigan from 2002 to 2020.
- Data collected included patient demographics, predisposing conditions, causative organisms, interventions, and outcomes.
Main Results:
- A 2-fold increase in IE incidence was observed from 2012-2020 compared to 2002-2011.
- Congenital heart disease (CHD) and central venous catheter (CVC) use were the most common predisposing factors.
- Staphylococcus aureus was the predominant pathogen, and complications occurred in 29.4% of patients, with a 10.3% mortality rate.
Conclusions:
- The rising IE incidence is associated with an increase in pediatric patients with CHD who have undergone prior cardiac surgery.
- Staphylococcus aureus remains the primary pathogen in pediatric IE, including cases with CHD.
- Infective endocarditis in children continues to present significant challenges with high rates of morbidity and mortality.
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