Changing Epidemiology, Healthcare-Associated Infections, and Outcomes in Infective Endocarditis: A Five-Year...

Area of Science:

• Cardiology
• Infectious Diseases
• Clinical Medicine

Background:

• Infective endocarditis (IE) poses a substantial clinical challenge, characterized by high morbidity and mortality despite advancements in diagnosis and treatment.
• Understanding the epidemiological and microbiological landscape of IE is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the epidemiological profile, microbiological characteristics, complications, and predictors of adverse outcomes in patients with IE.
• To analyze the impact of healthcare-associated infections (HAIs) on patient outcomes and identify associated risk factors.

Main Methods:

• Retrospective study of 156 patients diagnosed with IE between January 2020 and December 2024 at a tertiary cardiovascular center.
• Analysis of demographic data, comorbidities, microbiological findings, treatment, complications, and in-hospital outcomes.

Main Results:

• The study cohort was predominantly male (76.3%), with a mean age of 58.5 years. Native valve endocarditis was most common (80.1%).
• Complications were frequent (74.4%), including heart failure (70.5%), acute kidney injury (37.2%), and embolic events (32.7%). Healthcare-associated IE (HAIE) occurred in 10.3% of patients.
• Healthcare-associated infections (HAIs) impacted 26.9% of patients, leading to longer hospital stays. Central venous catheter use predicted HAI development. In-hospital mortality was 16.7%, with acute kidney injury and sepsis being strong predictors.

Conclusions:

• Infective endocarditis continues to be associated with a high burden of complications and mortality.
• Healthcare-associated infections complicate IE management and are linked to invasive device use.
• Improving outcomes requires robust infection prevention strategies, early risk stratification, and multidisciplinary care coordination.