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We aimed to evaluate microbiological profile, echocardiographic characteristics and early results of infective endocarditis (IE) in a tertiary university hospital.
In this retrospective case study of infective endocarditis (IE), the data of patients hospitalized for definite IE in our cardiology clinic were analysed. A total of 194 patients (128 males, 66 females; mean age 48±18 years) admitted with the modified Duke criteria for definitive IE were included in the study within a period of twelve-years between September 2000 and September 2012.
Infective endocarditis developed on a native valve in 169 (87.1%), a mechanical prosthetic valve in 25 (12.9%). Mitral valve was infected in 82 patients (42.2%), aortic valve in 67 patients (34.6%), tricuspidal/pulmonary valve in 15 patients (7.7%) and multiple valves in 30 patients (15.5%) of cases both native and prosthetic valves. Transthoracic and/or transesophageal echocardiography showed a vegetation in 161 cases (83%). Causative microorganisms were identified in 110 patients (56.7%) of cases; staphylococci (30.4%), streptococci (16.4%), enterococci (6.7%), and other pathogens (3.2%). Cultures were negative in 84 cases (43.3%). In patients with positive blood culture, antibiotics were prescribed on the basis of susceptibility test results. In patients with negative blood culture, empiric therapy was directed against Gram+ bacteria (glycopeptides, aminoglycosides and beta-lactams). Surgical therapy was necessary in 100 patients (51.7%). Among 194 patients accepted in the study 46 had a total recovery with appropriate antibiotherapy without needing any surgical procedures (23.7%). In-hospital mortality occurred in 38 cases (19.6%).
Our results showed that rapid diagnosis, appropriate antibiotic therapy and surgical treatment improve the outcome in patients with infective endocarditis.But infective endocarditis is still frequently associated with a high frequency of negative blood cultures and high in-hospital mortality.