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Changing Patterns in Infective Endocarditis: A Contemporary Epidemiological Perspective
Vasiliki Rapti1, Anna-Pelagia Magiorakos2, Efthymia Giannitsioti3
1Third Department of Internal Medicine and Laboratory, School of Medicine, National & Kapodistrian University of Athens, Sotiria General Hospital, 115 27 Athens, Greece.
Pathogens (Basel, Switzerland)
|July 28, 2026
Summary
Infective endocarditis (IE) epidemiology has shifted, now affecting older patients with comorbidities and increased healthcare exposure. Key factors include host, healthcare, and microbiological changes influencing disease patterns.
Area of Science:
- Cardiology
- Infectious Diseases
- Epidemiology
Background:
- Infective endocarditis (IE) epidemiology has significantly evolved since the late 19th century.
- Historically affecting younger individuals with structural heart disease, IE now predominantly impacts older patients with comorbidities and healthcare exposure.
- Factors such as population aging, end-stage renal disease (ESRD), immunosuppression, and injection drug use (IDU) increase host susceptibility.
Purpose of the Study:
- To review the contemporary epidemiology of infective endocarditis (IE).
- To emphasize the host, healthcare, and microbiological factors driving the evolving clinical profile of IE.
- To highlight shifts in IE's affected demographics and etiological agents.
Main Methods:
- Review of contemporary epidemiological data on infective endocarditis (IE).
- Analysis of host factors, including age, comorbidities (ESRD), immunosuppression, and injection drug use (IDU).
- Examination of healthcare-related factors such as prosthetic valves (PVs), cardiac implantable electronic devices (CIEDs), and transcatheter interventions.
- Assessment of microbiological patterns, noting the rise of staphylococci and enterococci.
Main Results:
- IE epidemiology has transitioned, with increased prevalence in older individuals with multiple comorbidities and frequent healthcare exposure.
- Prosthetic valves (PVs), cardiac implantable electronic devices (CIEDs), and transcatheter interventions have reshaped the clinical landscape of IE.
- Microbiological patterns show a growing predominance of staphylococci and enterococci, with significant geographic and socioeconomic variations in disease burden.
Conclusions:
- Contemporary IE epidemiology is characterized by an aging population, increased comorbidities, and greater healthcare exposure.
- Shifts in host susceptibility, medical devices, interventions, and microbiological agents are key drivers of IE's evolving profile.
- Understanding these epidemiological changes is crucial for managing infective endocarditis effectively.
Keywords:
Staphylococcus aureusageing populationcardiac implantable electronic device infectionchronic kidney diseaseepidemiologyhealthcare-associated infectioninfective endocarditisinjection drug useprosthetic valve endocarditistranscatheter aortic valve replacementMore Related Videos
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