Author + information
- Hoang Minh Tran1,
- Vien Thanh Truong1,
- Pham Phuong Linh2,
- Nguyen Minh Tri Nhan2,
- Thach Nguyen2,3 and
- Gianluca Rigatelli4
We aimed to evaluate the clinical, microbiological characteristics and risk factors for mortality of infective endocarditis in in-patients.
A retrospective study of 189 patients (120 men, 69 women; mean age 38 ± 18.0 years) with the diagnosis of probable or definite endocarditis (IE) according to the modified Duke Criteria admitted to The Heart Institute or Tam Duc Hospital between January 2005 and December 2014.
IE was related to a native valve in 165 patients (87.3%), and mechanical prosthetic valve in 24 (12.7%). Of the 189 patients in our series, the culture positive rate was 70.4%. The most common isolated pathogens were Streptococci (75.2%), Staphylococci (9.8%) followed by gram negative organism (4.5%). The sensitivity rate of Streptococci to ampicillin, ceftriaxone or vancomycin was 100%. The rate of methicillin resistant Staphylococcus aureus was 40%. There was a decrease in penicillin sensitivity for Streptococci over three eras: 2005 – 2007 (100%), and 2008 – 2010 (94%) and 2010 – 2014 (84%). The in-hospital mortality rate was 6.9%. Multivariate analysis found prosthetic valve involvement (OR = 46.27; p = 0.002) and NYHA grade 3 or 4 heart failure (OR = 38.38; p=0,003) as predictors of in-hospital mortality.
Streptococci was still the major pathogen of IE in the recent years with remaining high sensitivity rate to antibiotics. Prosthetic valve involvement, moderate or severe heart failure were independent predictors for in-hospital mortality in IE.