Continuing changing profile of infective endocarditis results of a repeat one-year population-based survey in France, 2008
Abstract number: P2004
Hoen B., Célard M., Alla F., Le Moing V., Doco-Lecompte T., Revest M., Strady C., Cambau E., Bouvet A., Selton-Suty C., Duval X.
Objectives: Important changes in the characteristics and management of infective endocarditis (IE) were observed over the past decades. For the third time we conducted a one-year, population-based prospective survey to describe the changes in epidemiological, clinical, and microbiological characteristics, surgical management, and outcome of IE, as compared to the results of the 2 similar surveys we had conducted in France in 1991 and 1999.
Methods: We collected data of all adult patients hospitalized for IE in 2008 in the regions that participated in the previous 2 studies and in 2 additional regions, accounting for a total of 20 million inhabitants, i.e. 32% of the whole French population. Cases were notified by the patient's attending clinicians, echocardiographists, surgeons, and/or microbiologists. For each patient, a case report form was filled out by a specially trained research nurse. A validation committee reviewed all forms. Of the 983 cases notified, 487 cases fulfilled the inclusion criteria, were Duke-Li definite and were analysed. Standardised annual incidence rates (SAIR) were calculated and compared between the 3 surveys.
Results: Sex ratio was 3M/1F. Patients' mean age was 62.4 years. 50.7% of patients had no known valve disease and 22.6% had a prosthetic valve. The distribution of causative microorganisms was as follows: Staphylococcus aureus 26.9%, oral streptococci 18.5%, group D streptococci 12.5%, enterococci 10.5%, coagulase-negative staph 10.1%, pyogenic streptococci 4.7%, other streptococci 1.8%, and other pathogens 8.0%. More than one and no microorganism was identified in 1.6% and 5.3% of the cases respectively. Blood cultures were negative in 8.4% of the cases. Valve surgery was performed in 48.3% of the patients during the initial hospital stay. Overall in-hospital lethality rate was 21%. Overall SAIR of IE in 1991, 1999, and 2008 were 35.0, 33.4, and 32.4, per 100.000 inhabitants respectively. Specific incidence rates increased for IE in patients with no known valve diseases and IE due to S. aureus, decreased for group D streptococcal IE, and remained stable for oral streptococcal IE.
Conclusion: Incidence of IE appears stable in France. This repeat population-based survey confirmed the increasing proportion and incidence rate of S. aureus IE as well as the increasing incidence of IE in patients with no known valve disease. Conversely, the incidence of group D streptococcal IE sharply decreased.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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