Clinical, Microbiological, and Imaging Characteristics of Infective Endocarditis in Latin America: A Systematic Review

Abstract

Objectives: We aimed to describe the clinical, microbiological, and imaging characteristics of patients with infective endocarditis (IE) in studies from Latin America (LATAM).

Methods: A systematic search through PubMed, EMBASE, LILACS, and SciELO from inception until February 2021 was conducted. We included observational studies that assessed adults with IE from LATAM and reported data on clinical, microbiological, or imaging characteristics. Data were independently extracted by 2 authors and the risk of bias was evaluated by study design with its respective tool. Findings were summarized using descriptive statistics.

Results: Forty-four studies were included. Most cases were male (68.5%), had a predisposing condition including valve disease (24.3%), or had a prosthetic valve (23.4%). Clinical manifestations included fever (83.9%), malaise (63.2%), or heart murmur (57.7%). A total of 36.4% and 27.1% developed heart failure or embolism, respectively. Blood cultures were negative in 23.9% and S. aureus (18.6%) and the viridans group streptococci (17.8%) were the most common isolates. Most cases were native valve IE (67.3%) affecting mainly left-sided valves. Echocardiographic findings included vegetations (84.3%) and regurgitation (75.9%). In-hospital mortality was 25.1%.

Conclusions: This is the first systematic review that evaluated the characteristics of IE in LATAM patients. A lack of multicenter studies reflects the need for these studies in LATAM.

Keywords: Blood Culture; Echocardiography; Endocarditis; Latin America; Microbiology.