164 The infectious endocarditis epidemiologic profile is it changing?

Abstract

The literature reports a change in the infectious endocarditis (IE) epidemiological profile of industrialized countries. What about it in Algeria? To describe the evolution of the IE characteristics of patients admitted in Beni Messous Universitary Hospital Cardiology Unit (Algiers) between January 1996 and April 2010 (14 years) A retrospective study based on hospital records including patients hospitalized consecutively to certain or probable IE on Duke criteria. Depending on the date of hospitalization, patients were divided into 3 groups; G1: 01/01/199-30/04/2001, G2 : 01/05/2001-30/04/2005, G3 : 01/05/2005-30/04/2010 106 patients were included : n1 = 35, n2 = 35, n3 = 36. The mean age was 37.6 ± 13.0 years and the sex ratio of 2.0. The IE occurred on native valves in 88 cases (83%). Rheumatic valve diseases were the most frequent (n = 49). A predisposing extracardiac condition was found in 68 patients, most often presumed of dental orign (n = 43). Blood cultures were positive in 52 cases (49.1%). The isolated germs were streptococci (n = 21; 40.4%), staphylococci (n = 17; 32.7%), negative gram bacilli (n = 7; 13.5%). Among the 95 indications for surgery, this one was performed during hospitalization in 49 patients. The hospital mortality was 36.8% (n = 39). From G1 to G3, an average age increase was observed (33.0 ± 10.2, 35.9 ± 12.7, 43.8 ± 13.8; p = 0.001) and number of patients over 49 years has increased from 5.7% to 17.1% to 33.3% (p = 0.003); a rheumatic valvulopathies decrease (64.5%, 61.5%, 41.9%), but this decrease was not significant (p = 0.07); an increased rate of surgery during hospitalization (40%, 48.5%, 65.6%; p = 0.04) and a reduced hospital mortality rate (45.7%, 42.9%, 22.2%; p = 0.04). The analysis of other variables showed no notable change between the 3 periods. This study reveals changes in the profile of IE. The most significant being age, rate of surgery during hospitalization and hospital mortality.