Evolving trends in infective endocarditis in a developing country: a consequence of medical progress?

Autor: Ramesh Singh Arjan Singh, Huynh Quoc Hieu, Kelvin Shenq Woei Siew, Alexander Loch, Mohamed Sunil, Sasheela Ponnampalavanar
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
Healthcare associated infection
lcsh:QR1-502
030204 cardiovascular system & hematology
lcsh:Microbiology
0302 clinical medicine
Epidemiology
Prevalence
Blood culture
030212 general & internal medicine
Cross Infection
medicine.diagnostic_test
General Medicine
Middle Aged
Staphylococcal Infections
Anti-Bacterial Agents
Infectious Diseases
Infective endocarditis
Female
Staphylococcus infection
Microbiology (medical)
Adult
medicine.medical_specialty
Staphylococcus aureus
Microbial Sensitivity Tests
lcsh:Infectious and parasitic diseases
03 medical and health sciences
Young Adult
Internal medicine
medicine
Endocarditis
Humans
lcsh:RC109-216
Developing Countries
Aged
Retrospective Studies
business.industry
Research
lcsh:RM1-950
Malaysia
Streptococcus
Retrospective cohort study
Endocarditis
Bacterial
Mortality predictors
medicine.disease
lcsh:Therapeutics. Pharmacology
Complication
business
Rheumatism
Zdroj: Annals of Clinical Microbiology and Antimicrobials
Annals of Clinical Microbiology and Antimicrobials, Vol 18, Iss 1, Pp 1-9 (2019)
ISSN: 1476-0711
Popis: Background Staphylococcus has replaced streptococcus as the most common cause of infective endocarditis (IE) in developed health care systems. The trend in developing countries is less clear. Aim To examine the epidemiological trends of infective endocarditis in a developing nation. Methods Single-centre, retrospective study of patients admitted with IE to a tertiary hospital in Malaysia over a 12-year period. Results The analysis included 182 patients (n = 153 Duke’s definite IE, n = 29 possible IE). The mean age was 51 years. Rheumatic heart disease was present in 42%, while 7.6% were immunocompromised. IE affected native valves in 171 (94%) cases. Health-care associated IE (HCAIE) was recorded in 68 (37.4%). IE admission rates increased from 25/100,000 admissions (2012) to 59/100,000 admissions (2017). At least one major complication on admission was detected in 59 (32.4%) patients. Left-sided IE was more common than right-sided IE [n = 159 (87.4%) vs. n = 18 (9.9%)]. Pathogens identified by blood culture were staphylococcus group [n = 58 (40.8%)], streptococcus group [n = 51 (35.9%)] and Enterococcus species [n = 13 (9.2%)]. staphylococcus infection was highest in the HCAIE group. In-hospital death occurred in 65 (35.7%) patients. In-hospital surgery was performed for 36 (19.8%) patients. At least one complication was documented in 163 (85.7%). Conclusion Staphylococcus is the new etiologic champion, reflecting the transition of the healthcare system. Streptococcus is still an important culprit organism. The incidence rate of IE appears to be increasing. The rate of patients with underlying rheumatic heart disease is still high.
Databáze: OpenAIRE
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