Infective endocarditis at a tertiary care hospital in South Korea

Abstract

ObjectiveThe treatment of infective endocarditis (IE) has become more complex with the current myriad healthcare-associated factors and the regional differences in causative organisms. We aimed to investigate the overall trends, microbiological features, and outcomes of IE in South Korea.MethodsA 12-year retrospective cohort study was performed. Poisson regression was used to estimate the time trends of IE incidence and mortality rate. Risk factors for in-hospital mortality were identified with multivariable logistic regression, and model comparison was performed to evaluate the predictive performance of notable risk factors. Kaplan-Meier survival analysis and Cox regression were performed to assess long-term prognosis.ResultsWe included 419 patients with IE, the incidence of which showed an increasing trend (relative risk 1.06, p=0.005), whereas mortality demonstrated a decreasing trend (incidence rate ratio 0.93, p=0.020). The in-hospital mortality rate was 14.6%. On multivariable logistic regression analysis, aortic valve endocarditis (OR 3.18, p=0.001), IE caused by Staphylococcus aureus (OR 2.32, p=0.026), neurological complications (OR 1.98, p=0.031), high Sequential Organ Failure Assessment score (OR 1.22, p=0.023) and high Charlson Comorbidity Index (OR 1.11, p=0.019) were predictors of in-hospital mortality. Surgical intervention for IE was a protective factor against in-hospital mortality (OR 0.25, p<0.001) and was associated with improved long-term prognosis compared with medical treatment only (p<0.001).ConclusionsThe incidence of IE is increasing in South Korea. Although the mortality rate has slightly decreased, it remains high. Surgery has a protective effect with respect to both in-hospital mortality and long-term prognosis in patients with IE.

Role of procalcitonine, hsCRP and 16SrRNA in diagnosis of culture negative endocarditis

“…Also, another study found that diabetes mellitus was the most common risk factor (18.2%) for IE. 19 In this study the culture positive IE patients were 46 (76.6%) and culture negative IE patients 14 (23.4%). In contrast, a previous study revealed that culture positive IE patients accounted for 30.3% and culture negative for 69.7%.…”

Comparing Treatment Outcomes of Ampicillin-Sulbactam, Other β-Lactams, and Vancomycin in Blood Culture-Negative Infective Endocarditis

“…Second, as the epidemiology of IE may vary regionally, our conclusion based on single-institutional data may not be generally applicable. Still, we maintain our conclusion is sustainable regarding the main causative pathogens of IE are similar globally [ 24 , 34 ].Third, serologic assessment of non-culturable microorganisms like C . burnetii and Bartonella species was rarely performed in our study.…”

“…The protective effect of surgery for survival in patients with IE has been widely accepted by several authors [ 23 , 24 , 25 ]. Likewise, the benefit of surgical treatment in BCNIE has been suggested in a few studies.…”

Epidemiological investigation and physician awareness regarding the diagnosis and management of Q fever in South Korea, 2011 to 2017

“…In this study, Q fever endocarditis was only confirmed in 6 cases. However, culture-negative endocarditis cases accounted for about a quarter of endocarditis cases in South Korea [26,27]. This suggests that Q fever endocarditis may be an underestimated disease in South Korea, and serological tests or PCR tests for C. burnetii should be more actively performed in cases of culture-negative endocarditis.…”