Abstract
The epidemiology, clinical presentation, and treatment of infective endocarditis (IE) has significantly changed over the past few years in developed countries. However, relevant data from developing countries are different and remain scarce. The objective of this study was to evaluate the clinical presentations, treatment and outcomes of IE patients in a tertiary hospital in East China over an 8-year period. This was a retrospective observational study of consecutive cases of definite or possible IE as per the modified Duke criteria between January 2008 and December 2015. A total of 135 definite and 39 probable IE cases were identified. The mean age was 47.8 ± 15.7 years, with a male preponderance (1.9: 1). Degenerative valve disease accounted for 30.5% cases of IE, followed by congenital heart disease (29.9%) and rheumatic heart disease (14.9%). Native cardiac valves were present in 93.7% of the IE patients. Echocardiography and blood culture were performed in all patients, of whom 55.2% were found to have large vegetations (≥10 mm) and the positive rate of blood culture was 60.3%. Streptococcus remained the chief causative agent that was identified in 61.9% of culture-positive patients. Glycopeptide antibacterials and cephalosporins were the most frequently used antimicrobial drugs for IE therapy. Seventy-six (43.7%) of the IE patients were surgically treated. The mortality rate during hospital stay was 10.9%. Our data reflected clinical and microbiological profile, and treatment of IE in a tertiary hospital located in the East China.
Highlights
Infective endocarditis (IE) is a rare but life-threatening serious disease that still has a high mortality, even in developed countries
The mean age of patients with IE were 47.8 ± 15.7 years, which was similar to the mean age of IE patients reported from Turkey (45.2 y) [18], but younger than the average age reported from the developed countries, such as Europe (61.4 y) [8]
Compared with the mean age reported from another study conducted in China from 1998 through 2009 [10] and other developing countries [11, 12, 19], the mean age of IE patients was older
Summary
Infective endocarditis (IE) is a rare but life-threatening serious disease that still has a high mortality, even in developed countries. A comprehensive systematic review of the literature in 21 world regions published between 1980 and 2008 revealed that almost 1 in 4 cases of IE will not survive [2]. The pattern of this disease varies worldwide [3]. The epidemiology, presentation, and treatment of IE has significantly changed over the past few years in developed countries [4,5,6]. There has been a reduction in rheumatic heart disease (RHD), an increase in congenital heart disease (CHD), prosthetic device implants, invasive procedures, PLOS ONE | DOI:10.1371/journal.pone.0166764 November 18, 2016
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