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 |
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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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