Profile of infective endocarditis in a referral hospital over the last 24 years

Research output: Contribution to journalArticle

Abstract

Objectives: To describe changes in demographic, clinical and micro-biological characteristics of infective endocarditis (IE), and to assess factors associated with an increased risk of death. Methods: Episodes fulfilling the Duke criteria for definite IE were included. Data collected in 1980-1991, and 1992-2003 from IVDU and non-IVDU patients' records were collected, and changes within each group and between the groups analysed. Results: There were 169 episodes of IE in IVDUs, and 114 in non-IVDUs. HIV-infected patients were 86 (82 IVDUs). Site of involvement, need for surgery, and case fatality rate (15.6% among IVDUs and 11.3% non-IVDUs) did not change in both groups over time. Staphylococci and streptococci were the most commonly isolated organisms among IVDUs and non-IVDU, respectively; independent predictors of mortality among IVDUs were negative blood cultures [adjusted OR (AOR) 7.85], and fungal etiology (AOR 21.33). Among non-IVDUs prosthetic heart valves had an AOR of 2.22 (95% CI 0.48-10.21); the proportion of negative blood cultures significantly increased. An higher case-fatality rate was observed among HIV-positive patients (AOR 2.64 95% CI 0.85-8.20). Conclusions: Late diagnosis and lack of etiological definition continue to represent the most important obstacles to an effective management of IE, suggesting the need for a wider use of molecular techniques in patients with suspected IE.

Original languageEnglish
Pages (from-to)140-146
Number of pages7
JournalJournal of Infection
Volume52
Issue number2
DOIs
Publication statusPublished - Feb 2006

Fingerprint

Endocarditis
Referral and Consultation
Mortality
HIV
Delayed Diagnosis
Heart Valves
Streptococcus
Staphylococcus
Demography
Blood Culture

Keywords

  • Etiological diagnosis
  • Infective endocarditis
  • Mortality
  • Risk factors

ASJC Scopus subject areas

  • Applied Microbiology and Biotechnology
  • Microbiology
  • Parasitology
  • Virology
  • Immunology and Allergy
  • Infectious Diseases

Cite this

Profile of infective endocarditis in a referral hospital over the last 24 years. / Cicalini, Stefania; Puro, Vincenzo; Angeletti, Claudio; Chinello, Pierangelo; Macrì, Giulia; Petrosillo, Nicola.

In: Journal of Infection, Vol. 52, No. 2, 02.2006, p. 140-146.

Research output: Contribution to journalArticle

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