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Significance of this study What is already known about this subject?
Despite advances in medical, surgical, and critical care interventions, infective endocarditis (IE) remains a disease that is associated with significant morbidity and mortality.
IE is three times more common in males than in females. It has no racial predilection.
Staphylococcus aureus was the most common pathogen followed by viridans streptococci and group D Enterococcus .
Several studies have suggested that S. aureus is the most common organism in prosthetic valve endocarditis (PVE), while Streptococcus is the main culprit in native valve endocarditis (NVE).
What are the new findings?
IE has no gender predilection. IE is mostly common in Hispanics followed by the Caucasian population. The mortality rate was highest in Caucasians followed by Hispanics and lowest in African-Americans, while the 30-day readmission rate was highest in Hispanics followed by African-Americans and the South Asian population.
The highest morbidity and mortality rates were in patients older than 50 years of age.
Despite appropriate treatment, the highest mortality was associated with the Staphylococcus organism, especially in methicillin-resistant S. aureus , particularly related to prosthetic valves and uncontrolled diabetes mellitus (DM). Mortality rates of patients with PVE and patients with risk factors were significantly higher compared with those of patients with NVE without risk factors.
Patients with DM and end-stage renal disease had a higher risk of IE.
Background
Infective endocarditis (IE) is defined as an infection of the endocardial surface of the heart, which may include one or more heart valves, the mural endocardium, or the septum. One of the most common intracardiac effects of IE is severe valvular insufficiency, which may lead to intractable congestive heart failure and myocardial abscesses. Additionally, IE has a wide variety of systemic signs and symptoms through several mechanisms, including both sterile and infected emboli with various immunological phenomena. 1
IE often occurs as a consequence of non-bacterial thrombotic endocarditis, which results from turbulence or trauma to the endothelial surface of the heart. A transient bacteremia seeds the sterile platelet and fibrin thrombus, ultimately leading to IE. Pathological complications from the infection include local tissue destruction and emboli formation. In addition, secondary autoimmune effects such as immune complex glomerulonephritis and vasculitis may occur.
IE remains a diagnostic and therapeutic...