Infective endocarditis at a tertiary-care hospital in China

Abstract

Background: The aim of this study was to describe the clinical features and outcome of infective endocarditis at a general hospital in China and to identify the risk factors associated with in-hospital mortality. Methods: A retrospective study was conducted and all patients diagnosed with definite or possible infective endocarditis between January 2013 and June 2018 according to the modified Duke criteria were included. Results: A total of 381 patients were included. The mean age was 46 years old and 66.9% patients were male patients. Community acquired IE was the most common type of infective endocarditis and Viridans Group Streptococci (37.5%) was still the most common causative pathogen. The microbial etiology of infective endocarditis varied with location of acquisition. 97 (25.5%) patients had culture-negative infective endocarditis. Vegetations were detected in 85% patients and mitral valve was the most common involved valve. Operations were performed in 72.7% patients and in-hospital mortality rate was 8.4%. The risk factors of in-hospital mortality were age old than 70 years old, heart failure, stroke and medical therapy. Conclusions: Older age, heart failure, stroke and medical therapy were risk factors of in-hospital mortality. Infective endocarditis, were mainly caused by Viridans Group Streptococci, characterized by younger patients and lower mortality rate in China.

Clinical Characteristics and Risk Factors for in-Hospital Mortality in 240 Cases of Infective Endocarditis in a Tertiary Hospital in China: A Retrospective Study

“…Therapeutic schedules mainly rely on blood culture, the major criterion for IE, followed by identification and susceptibility testing of the isolate. 25 Consistent with previous reports in China, 26 , 27 Streptococcus was the primary causative organism in IE, followed by S. aureus , CoNS, and Enterococcus . Owing to population aging, a decrease in RHD burden, and advanced device management, the prevalence of S. aureus has increased, eventually becoming the dominant pathogen in IE in developed countries.…”

“…In our cohort, the mean age of IE patients was 51 y—that is, older than the mean age reported in a study conducted in China from 2013 to 2018. 26 Meanwhile, research from developed countries has reported an increasing proportion of elderly patients with IE, which increase stems from multiple factors: more extensive investigations in elderly cases, increased survival in patients with multiple comorbidities, widespread use of invasive therapeutic interventions (such as pacemakers and defibrillators), and hemodialysis. 19 The overall in-hospital mortality rate in our study was 6.3%, but a significantly high mortality rate (18.2%) was observed in the elderly (over 65 y old).…”

A Series of Frustrations of Fever for Congenital Heart Disease: Case Report

“…Infective endocarditis with high morbidity and mortality is one of the most serious and destructive complication of valvular heart disease [2]. Congenital heart disease is a common cause of infective endocarditis [3], and studies have shown that the incidence can reach 10% to 14%, which is more common in VSD, congenital bicuspid aortic valve, patent ductus arteriosus (PDA), and tetralogy of Fallot.…”

Dental Intervention and the Risks of Bacterial Endocarditis in the Hospital Environment

“…13,14 Another crucial type of examination is the echocardiogram, which uses sound waves to construct images of the structure of the heart, thus reproducing the conditions in which the heart valves are found and recognizing the presence of clots. 15,16 In addition, magnetic resonance imaging and computed tomography are other types of imaging tests that may be useful in certain situations, as they allow the recognition of the characteristics of bacterial endocarditis. 17,18 TREATMENT Since, with suspicion of infection, treatment protocols must be started and the same must be done in a hospital environment due to the indication of very high doses of antibiotics, intravenously for several weeks, depending on the clinical stage.…”