Changing epidemiology of infective endocarditis.

Infective endocarditis (IE) continues to be a serious infection with a stable incidence rate over time and a persistently high mortality. Population-based studies from France, Netherlands, Sweden, and the United States reported on the epidemiology of this infection. These studies suggest a changing distribution of underlying valvular heart disease in patients with IE, namely a decreasing proportion of patients with rheumatic heart disease and an increasing proportion with underlying prosthetic valves or mitral valve prolapse. There is controversy regarding the change of spectrum of IE-causative organisms. In some geographically defined populations with complete case ascertainment, viridans group streptococci continue to be the most common causative organisms, whereas in passively reported community surveys and in referral-center case series, Staphylococcus aureus is surpassing streptococci as the leading cause for IE.