Stina Jordal1, Bård Reiakvam Kittang2, Pirjo-Riitta Salminen3, Geir Egil Eide4,5, Øyvind Kommedal6, Øystein Wendelbo1, Rune Haaverstad3, Haakon Sjursen1. 1. a Section of Infectious Disease, Department of Medicine , Haukeland University Hospital , Bergen , Norway. 2. b Department of Medicine , Haraldsplass Deaconess Hospital , Bergen , Norway. 3. c Section of Cardiothoracic Surgery , Department of Heart Disease , Haukeland University Hospital , Bergen , Norway. 4. d Centre for Clinical Research , Haukeland University Hospital , Bergen , Norway. 5. e Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway. 6. f Department of Microbiology , Haukeland University Hospital , Bergen , Norway.
Abstract
BACKGROUND: To investigate epidemiological trends of infective endocarditis (IE) in western Norway a retrospective study was performed. METHODS: Characteristics of 706 IE admissions from 1996 to 2005 and 2006 to 2015 were analysed and compared using the Chi-square test for categorical variables and the t-test for age. Survival was analysed by multiple Cox regression and reported by the hazard ratio (HR). RESULTS: Mean annual incidence rates increased from 4.6 to 7.4 per 100,000 inhabitants (rate ratio: 1.97, 95% confidence interval: 1.52-2.56, p < .001). Non-viridans streptococci, enterococci and Staphylococcus aureus (S. aureus), were all independently associated with increased mortality. The frequency of IE caused by enterococci increased from 3.7 to 13.0% (p < .001). The proportion of intravenous drug users (IVDU) increased from 16.5 to 23.5% (p = .015) and had increasing aortic valve involvement (p = .023). Prosthetic valve endocarditis (PVE) constituted 30% of IE cases in both decades with biological PVE increasing from 9.4 to 22.1% (p < .001) and mechanical PVE decreasing from 18.7 to 8.9% (p < .001). In the last decade, valve replacement surgery was performed in 37.6% of the patients, of which 85.5% received a bioprosthesis. CONCLUSIONS: The incidence of IE increased significantly. Non-viridans streptococci, enterococci and S. aureus were all significantly associated with increased mortality. The increased number of enterococcal IE and the increased number of IVDUs with left-sided IE constituted new challenges. Biological implants were preferred in a majority of patients requiring surgery.
BACKGROUND: To investigate epidemiological trends of infective endocarditis (IE) in western Norway a retrospective study was performed. METHODS: Characteristics of 706 IE admissions from 1996 to 2005 and 2006 to 2015 were analysed and compared using the Chi-square test for categorical variables and the t-test for age. Survival was analysed by multiple Cox regression and reported by the hazard ratio (HR). RESULTS: Mean annual incidence rates increased from 4.6 to 7.4 per 100,000 inhabitants (rate ratio: 1.97, 95% confidence interval: 1.52-2.56, p < .001). Non-viridans streptococci, enterococci and Staphylococcus aureus (S. aureus), were all independently associated with increased mortality. The frequency of IE caused by enterococci increased from 3.7 to 13.0% (p < .001). The proportion of intravenous drug users (IVDU) increased from 16.5 to 23.5% (p = .015) and had increasing aortic valve involvement (p = .023). Prosthetic valve endocarditis (PVE) constituted 30% of IE cases in both decades with biological PVE increasing from 9.4 to 22.1% (p < .001) and mechanical PVE decreasing from 18.7 to 8.9% (p < .001). In the last decade, valve replacement surgery was performed in 37.6% of the patients, of which 85.5% received a bioprosthesis. CONCLUSIONS: The incidence of IE increased significantly. Non-viridans streptococci, enterococci and S. aureus were all significantly associated with increased mortality. The increased number of enterococcal IE and the increased number of IVDUs with left-sided IE constituted new challenges. Biological implants were preferred in a majority of patients requiring surgery.
Authors: Michael L Williams; Mathew P Doyle; Nicholas McNamara; Daniel Tardo; Manish Mathew; Benjamin Robinson Journal: Ther Adv Cardiovasc Dis Date: 2021 Jan-Dec
Authors: Khawaja M Talha; Larry M Baddour; Martin H Thornhill; Verda Arshad; Wajeeha Tariq; Imad M Tleyjeh; Christopher G Scott; Meredith C Hyun; Kent R Bailey; Nandan S Anavekar; Raj Palraj; M Rizwan Sohail; Daniel C DeSimone; Mark J Dayer Journal: Open Heart Date: 2021-10