Emerging and Re-Emerging Pathogens in Valvular Infective Endocarditis: A Review

Area of Science:

• Cardiology
• Infectious Diseases
• Microbiology

Background:

• Infective endocarditis (IE) affects heart valves, with changing epidemiology and etiology.
• Increased elderly population and prosthetic heart valve use are key risk factors.
• Staphylococci have replaced Streptococci as the leading cause of IE.

Purpose of the Study:

• To review the evolving epidemiology and etiology of infective endocarditis.
• To highlight the shift in causative pathogens and associated clinical severity.
• To emphasize the need for advanced diagnostic and therapeutic strategies.

Main Methods:

• Literature review of epidemiological and etiological trends in infective endocarditis.
• Analysis of shifts in causative microorganisms, including common and emerging pathogens.
• Discussion of clinical implications, treatment challenges, and future directions.

Main Results:

• Staphylococci, especially Staphylococcus aureus, are now the predominant pathogens in IE.
• Emergence and re-emergence of pathogens like Streptococcus agalactiae, Pseudomonas aeruginosa, Coxiella burnetti, and Brucella.
• IE caused by these pathogens often presents with severe clinical courses and high mortality.

Conclusions:

• The changing landscape of IE necessitates updated diagnostic and management approaches.
• Antimicrobial resistance and pathogen virulence underscore the need for timely intervention.
• Surgical valve repair or replacement is frequently required for effective treatment.