Infective Endocarditis Epidemiology Over Five Decades: A Systematic Review
نویسندگان
چکیده
AIMS To Assess changes in infective endocarditis (IE) epidemiology over the last 5 decades. METHODS AND RESULTS We searched the published literature using PubMed, MEDLINE, and EMBASE from inception until December 2011. DATA FROM Einstein Medical Center, Philadelphia, PA were also included. Criteria for inclusion in this systematic review included studies with reported IE microbiology, IE definition, description of population studied, and time frame. Two authors independently extracted data and assessed manuscript quality. One hundred sixty studies (27,083 patients) met inclusion criteria. Among hospital-based studies (n=142; 23,606 patients) staphylococcal IE percentage increased over time, with coagulase-negative staphylococcus (CNS) increasing over each of the last 5 decades (p<0.001) and Staphylococcus aureus (SA) in the last decade (21% to 30%; p<0.05). Streptococcus viridans (SV) and culture negative (CN) IE frequency decreased over time (p<0.001), while enterococcal IE increased in the last decade (p<0.01). Patient age and male predominance increased over time as well. In subgroup analysis, SA frequency increased in North America, but not the rest of the world. This was due, in part, to an increase in intravenous drug abuse IE in North America (p<0.001). Among population-based studies (n=18; 3,477 patients) no significant changes were found. CONCLUSION Important changes occurred in IE epidemiology over the last half-century, especially in the last decade. Staphylococcal and enterococcal IE percentage increased while SV and CN IE decreased. Moreover, mean age at diagnosis increased together with male:female ratio. These changes should be considered at the time of decision-making in treatment of and prophylaxis for IE.
منابع مشابه
Focus on: Epidemiology of Cardiovascular Disease in Spain Over the Past 20 Years (IV) Epidemiology of Infective Endocarditis in Spain in the Last 20 Years
Infective endocarditis is an uncommon disease, with an estimated incidence of 3.1 to 3.7 episodes per 100 000 inhabitants/year. The incidence is highest in elderly people. The microorganisms most frequently isolated in infective endocarditis are staphylococci and streptococci. In the last few decades, the spectrum of heart diseases predisposing to infective endocarditis has changed, since degen...
متن کاملThe Changing Epidemiology of Infective Endocarditis
Infective endocarditis (IE), or infection of an endocardial surface of the heart, remains an uncommon disease associated with significant morbidity, including complications of heart failure, stroke, systemic embolization, and sepsis. Despite continued progress in the diagnosis and treatment of this condition, IE continues to have an in-hospital mortality of approximately 20%, essentially unchan...
متن کاملEpidemiology of infective endocarditis in Spain in the last 20 years.
Infective endocarditis is an uncommon disease, with an estimated incidence of 3.1 to 3.7 episodes per 100 000 inhabitants/year. The incidence is highest in elderly people. The microorganisms most frequently isolated in infective endocarditis are staphylococci and streptococci. In the last few decades, the spectrum of heart diseases predisposing to infective endocarditis has changed, since degen...
متن کاملAcute infective endocarditis.
Acute infective endocarditis is a complex disease with changing epidemiology and a rapidly evolving knowledge base. To consistently achieve optimal outcomes in the management of infective endocarditis, the clinical team must have an understanding of the epidemiology, microbiology, and natural history of infective endocarditis, as well as a grasp of guiding principles of diagnosis and medical an...
متن کامل