Epidemiological trends of infective endocarditis in a single center in Italy between 2003-2015

Autor:	Salvatore Sollima, Paolo Vanelli, Spinello Antinori, Massimo Galli, Carlo Antona, Maria Rita Gismondo, Laurenzia Ferraris, Alberto Barosi, Alessandro Cialfi, Cristina Mazzali, Laura Milazzo, Sara Giordana Rimoldi
Rok vydání:	2018
Předmět:	Microbiology (medical) Cross infection Male Methicillin-Resistant Staphylococcus aureus medicine.medical_specialty Pediatrics Staphylococcus aureus Fever 030204 cardiovascular system & hematology medicine.disease_cause Single Center 03 medical and health sciences 0302 clinical medicine Valvular disease Epidemiology medicine Humans 030212 general & internal medicine Aged Retrospective Studies Cross Infection General Immunology and Microbiology business.industry Incidence (epidemiology) Incidence Streptococcus General Medicine Endocarditis Bacterial Middle Aged medicine.disease Prognosis Methicillin-resistant Staphylococcus aureus Hospitalization Infectious Diseases Italy Echocardiography Infective endocarditis General Surgery Female sense organs business Enterococcus
Zdroj:	Infectious diseases (London, England). 50(10)
ISSN:	2374-4243
Popis:	Changes in the incidence, clinical features and microbiology of infective endocarditis (IE) observed in a single center in Italy were compared between the period 2003-2010 and 2011-2015.All cases of IE, defined as definite or possible according to the modified Duke criteria, observed at the 'L. Sacco' Hospital in Milan, Italy between 2003 and 2015 were retrospectively reviewed.366 episodes of IE were identified in 325 patients. The mean number of incident IE over the period 2003-2015 was 1.43 (range: 0.6-2.1) cases per 1000 admissions, with a significantly increasing trend from a mean of 1.28-1.72 cases per 1000 admissions/year in 2003-2010 and 2011-2015, respectively (+34%; p = .04). Staphylococci remain the leading pathogens causing IE (29%) with a relative increase of methicillin-resistant Staphylococcus aureus between the two periods. Streptococci and enterococci account for 26% and 18% of IE, respectively. We found an increase in the proportion of cases due to enterococci (from 14% in 2003-2010 to 22% in 2011-2015). The rate of in-hospital mortality was 19%, similar in the two periods studied.The incidence of IE continuously increased in our cohort over the past decade and, along with the aging of the population, a raise in the incidence of health care-associated infections and a change in the distribution of prevalent pathogens were observed. Surgery was independently associated with higher in-hospital survival (AOR, 95% CI: 0.38, 0.19-0.74; p = .005). A constant surveillance is required to guide the optimal management of the changing epidemiology of IE.
Databáze:	OpenAIRE
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