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KMID : 0984720050370030152
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Infection and Chemotherapy
2005 Volume.37 No. 3 p.152 ~ p.160
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Observation of Clinical Characteristics of Infective Endocarditis
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Son Jun-Seong
Ki Hyun-Kyun
Oh Won-Sup
Peck Kyong-Ran
Lee Nam-Yong
Park Kay-Hyun
Park Pyo-Won
Song Jae-Hoon
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Abstract
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Background: Epidemiologic and clinical features of infective endocarditis have been changing with increasing longevity, new predisposing factors, and increase in nosocomial infections.
Materials & Methods: All consecutive cases of infective endocarditis from 1995 to 2003 at the Samsung Medical Center, Seoul, Korea, were evaluated. Epidemiologic and clinical characteristics of patients were analysed by review of medical records. Changing features of endocarditis were compared between Group I (1995-1999) and Group II (2000-2003).
Results: Total number of cases was 152; 64 cases in Group I and 88 cases in Group II. Mean age was 46+/-19 years with no difference between two groups. Blood cultures were positive in 119 of 152 cases(78.3%). Streptococcus viridans (39.4%) and Staphylococcus aureus (32.8%) were the most common pathogens of infective endocarditis followed by Staphylococcus epidermidis (8.4%), Enterococcus (7.6%), and Gram negative organism (5.9%). Pathogen distribution was not different between two groups. Medical procedures, such as hemodialysis (0%:12.5%, P=0.003) and intrvenous catheter insertion (1.6%:15.9%, P=0.003), were more frequently performed in Group II and the incidence of nosocomial endocarditis was significantly higher in Group II (3.1% versus 21.6%, P=0.001). Surgical treatment was performed in 53.3% of cases. The overall mortality rate in patients with infective endocarditis was 9.2%. The mortality rate among patients with community-acquired endocarditis was 6.9% and that among nosocomial endocarditis was 23.8%.
Conclusion: Epidemiological and clinical features of infective endocarditis over the past years have been changing, and clinicians should be aware of these differences when treating patients with endocarditis.
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KEYWORD
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Endocarditis, Clinical manifestation
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