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Long-Term Temporal and Seasonal Trends of Infective Endocarditis
Session:
Posters (Sessão 2 - Écran 8) - Endocardite
Speaker:
Carolina Pereira Mateus
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
16. Infective Endocarditis
Subtheme:
16.8 Infective Endocarditis - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Carolina Pereira Mateus; Inês Fialho; Mariana Passos; Filipa Gerardo; Inês Miranda; Joana Lopes; Marco Beringuilho; Carlos Morais; João Bicho Augusto
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background</strong>: Over the past two decades, the epidemiology of infective endocarditis (IE) has changed significantly with the increase of life expectancy, use of cardiac implantable devices, and more invasive procedures. There is an ongoing shift in the incidence of IE, but a temporal/seasonal association with specific pathogens is yet to be investigated. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Aims</strong>: In this study, we aimed to assess (1) whether there is a temporal trend / increase in IE incidence in recent years, and (2) if there is a seasonality among specific IE-related pathogens.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods</strong>: We conducted a single center retrospective study of all consecutive patients in a 6-year period between 2017 and 2022, with a diagnosis of definite infective endocarditis as assessed by the modified Duke criteria. All electronic medical records were reviewed for demographics, blood cultures dates and results, and echocardiographic results were analyzed. The blood cultures collection date was used to define the time of the year for IE. Seasons were defined according to the northern hemisphere as Winter (January to March), Spring (April to June), Summer (July to September) and Autumn (October do December). If blood cultures were negative, the date of the first echocardiography with signs of infective endocarditis was noted.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong>: A total of 103 cases of IE were identified over a 6-year period. Mean age of IE patients was 70±13 years, 31.1% were female (n=32). No significant difference was found over the years. Overall, 76.7% had one isolated pathogen (n=79), 3.9% had 2 different pathogens (n=4), and 19.4% had persistent negative blood cultures (n=20). The most predominant infective agent was <em>Streptococcus</em> species (30.1% of cases, n=31), followed by <em>Staphylococcus</em> species (29.1%, n=30) and <em>Enterococcus</em> species (18.4%, n=19). The most affected valve was native aortic valve (35.9%, n=37), followed by native mitral valve (30.1%, n=31) and biological prosthetic aortic valve (17.5%, n=18). Summer had the fewer cases of IEs (18.4%), while Spring is the season with more IEs (32.0%). Negative blood cultures were more frequent in the Spring (24.2%). In Autumn, the proportion of <em>Staphylococcus </em>IE increases to 36% of all infections in this season. The most frequent pathogen in Winter and Spring is <em>Streptococcus</em>, representing 34.6% and 36.4% of IEs in these seasons.</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion</strong>: In our population, there was no significant increase in the incidence of IEs over the years. However, there was a seasonal trend both in frequency and in specific pathogens: Summer had fewer IEs and Spring was the season with the highest frequency; <em>Streptococcus </em>is the most frequent pathogen in both Winter and Spring. These results may not represent the reality nationwide, and further epidemiological studies would be necessary to establish a trend.</span></span></p>
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