Epidemiological, clinical and microbiological profile of infective endocarditis in a tertiary hospital in the South-East Anatolia Region

Abstract

Objectives: We aimed to evaluate epidemiological, clinical, and microbiological features of infective endocarditis (IE) in a tertiary university hospital.

Study design: The study included 72 patients (31 women, 41 men; mean age 45+/-16 years; range 18 to 80 years) who were diagnosed as having definite IE, according to the modified Duke criteria, between 2004 and 2007. Data were reviewed on age, sex, underlying heart disease, predisposing conditions for bacteremia, echocardiographic and microbiological findings, treatment, complications, and mortality.

Results: Infective endocarditis developed on a native valve in 47 (65.3%), a mechanical prosthetic valve in 21 (29.2%), and a pacemaker in two cases. The location of IE could not be determined in two cases (2.8%). Rheumatic heart disease (36.1%) was the most common preexisting valvular abnormality. The mitral valve was the most commonly affected valve in both native valves (43.1%) and prosthetic valves (13.9%). The most frequent symptom was fever (n=60, 83.3%). Electrocardiography showed abnormal findings in 24 cases (33.3%). Transthoracic and/or transesophageal echocardiography showed a vegetation in 63 cases (87.5%), moderate or severe mitral regurgitation in 41 cases (56.9%), aortic regurgitation in 21 cases (29.2%), and tricuspid regurgitation in 29 cases (40.3%). Staphylococci (26.4%) and streptococci (22.2%) were the most common causative agents. Cultures were negative in 26 cases (36.1%). Twenty patients (27.8%) underwent surgical treatment. Congestive heart failure (n=23, 31.9%) and cerebrovascular accidents (n=10, 13.9%) were the major complications. In-hospital mortality occurred in 11 cases (15.3%).

Conclusion: Our data reflect epidemiological, clinical, and microbiological profile of IE in a tertiary hospital located in the Southeastern Anatolia.