Temporal Trends in Infective Endocarditis in the Context of Prophylaxis Guideline Modifications
| Autor: | Thanh Doco-Lecompte, Bruno Hoen, Catherine Chirouze, Michelle Bes, Claire Poyart, Christine Selton-Suty, François Delahaye, Vincent Le Moing, Xavier Duval, Bernard Iung, Marie Célard, Christophe Strady, François Alla, Emmanuelle Cambau, Jean-François Obadia, Pierre Tattevin |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
education.field_of_study
Pediatrics medicine.medical_specialty business.industry Incidence (epidemiology) Population Context (language use) Guideline 030204 cardiovascular system & hematology medicine.disease 3. Good health 03 medical and health sciences 0302 clinical medicine Bacteremia Infective endocarditis Medicine Endocarditis 030212 general & internal medicine Antibiotic prophylaxis Cardiology and Cardiovascular Medicine education business |
| Zdroj: | Journal of the American College of Cardiology. 59:1968-1976 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2012.02.029 |
| Popis: | Objectives The goal of this study was to evaluate temporal trends in infective endocarditis (IE) incidence and clinical characteristics after 2002 French IE prophylaxis guideline modifications. Background There are limited data on changes in the epidemiology of IE since recent guidelines recommended restricting the indications of antibiotic prophylaxis of IE. Methods Three 1-year population-based surveys were conducted in 1991, 1999, and 2008 in 3 French regions totaling 11 million inhabitants age ≥20 years. We prospectively collected IE cases from all medical centers and analyzed age- and sex-standardized IE annual incidence trends. Results Overall, 993 expert-validated IE cases were analyzed (323 in 1991; 331 in 1999; and 339 in 2008). IE incidence remained stable over time (95% confidence intervals given in parentheses/brackets): 35 (31 to 39), 33 (30 to 37), and 32 (28 to 35) cases per million in 1991, 1999, and 2008, respectively. Oral streptococci IE incidence did not increase either in the whole patient population (8.1 [6.4 to 10.1], 6.3 [4.8 to 8.1], and 6.3 [4.9 to 8.0] in 1991, 1999, and 2008, respectively) or in patients with pre-existing native valve disease. The increased incidence of Staphylococcus aureus IE (5.2 [3.9 to 6.8], 6.8 [5.3 to 8.6], and 8.2 [6.6 to 10.2]) was not significant in the whole patient population (p = 0.228) but was significant in the subgroup of patients without previously known native valve disease (1.6 [0.9 to 2.7], 3.7 [2.6 to 5.1], and 4.1 [3.0 to 5.6]; p = 0.012). Conclusions Scaling down antibiotic prophylaxis indications was not associated with an increased incidence of oral streptococcal IE. A focus on avoidance of S. aureus bacteremia in all patients, including those with no previously known valve disease, will be required to improve IE prevention. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|