Infective endocarditis: 10-year experience in a non-cardiovascular center.

Abstract

Background and objective:Infective endocarditis (IE) is an infection with a poor prognosis, and an associated in-hospital mortality of at least 25%. Optimal therapy of IE requires long-term effective antibiotic therapy and valve surgery in many cases. The aim of this study was to review the demographics, bacteriology, and outcomes of patients with IE admitted to a tertiary referral center in Mexico City, over a 10-year period.Methods:Retrospective cohort study of patients admitted at Instituto Nacional Salvador Zubiran with a new diagnosis of IE over a 10-year period, from January 2009 to January 2019. Patients who met the definition for definitive diagnosis of infective endocarditis according to the modified Duke criteria were included in the study.Results:There were 62 patients (50.85 ± 17.46 years, 40.3% females) with IE. The culprit microorganism was identified in all cases, with Staphylococcus aureus being the most frequently found (34%). Valve surgery was performed in 58.1%, while 41.9% only received medical treatment. The mortality rate was 25.8% at 30 days and 41.9% at 12 months. Comparing the surgical and medical treatment groups, we found that 50% and 36% in each group, respectively, had died within 12 months of admission.Conclusions:Our center has a high prevalence of health care-associated endocarditis, mostly related to the presence of intravascular access devices. Most of the patients had a surgical indication. Patients with type 2 diabetes mellitus and decreased right ventricular systolic function had an increased mortality rate at 12 months.