Changing Patterns in Infective Endocarditis: A Contemporary Epidemiological Perspective

Since its first description in the late nineteenth century, the epidemiology of infective endocarditis (IE) has changed considerably. Once primarily affecting younger individuals with structural heart disease, IE is now increasingly encountered in older patients with multiple comorbidities and frequent healthcare exposure. Population ageing, end-stage renal disease (ESRD), immunosuppression, and injection drug use (IDU) have broadened the pool of susceptible hosts. At the same time, the increasing use of prosthetic valves (PVs), cardiac implantable electronic devices (CIEDs), and transcatheter cardiac interventions has reshaped the clinical spectrum of IE. This epidemiological transition has also been accompanied by shifts in microbiological patterns, with a growing predominance of staphylococci and enterococci, as well as marked geographic and socioeconomic variation in disease burden. This review summarizes the contemporary epidemiology of IE, with an emphasis on the host-, healthcare-, and microbiological factors underlying its evolving clinical profile.