Infective endocarditis: changing aetiology of disease

Abstract

Infective endocarditis (IE) is an evolving disease resulting in high morbidity and mortality. Despite medical and diagnostic advances, the incidence of the disease has remained unchanged, reflecting the changing epidemiological and microbiological profile of IE. Classical risk factors such as rheumatic heart disease have now been overtaken by new risk factors including an ageing population, degenerative valve disease and intravenous drug use. The routine use of invasive procedures, implantable cardiac devices and prosthetic heart valves has served to increase the number of at-risk patients. The microbiology of IE mirrors the changing risk factors, with staphylococcal infections predominating over viridans streptococci. An overview of this rare disease is given describing current understanding, investigation and changing epidemiology and microbiology of IE.

Clinical – microbiological characterization and risk factors of mortality in infective endocarditis from a tertiary care academic hospital in Southern India

“…Under the impression of changing clinico-microbial epidemiology of endocarditis,4, 9, 15, 16 the preponderant clinico-microbiologic features and risk factors of mortality in IE patients admitted at the Kasturba Hospital, Manipal were determined.…”

Clinical features of infective endocarditis: Comparison between the 1990s and 2000s

“…In terms of the frequency of underlying valve heart disease on the host side, a decrease in rheumatic valve disease and increase in degenerative aortic stenosis in aging society are reported to be changing the etiology of IE [1,2]. Regarding the causative organisms, an increase in intravenous drug abuse (IVDA) brought differences among ages and countries [3].…”

Interleukin-10 production by myeloid-derived suppressor cells contributes to bacterial persistence during Staphylococcus aureus orthopedic biofilm infection

“…Staphylococcus aureus is a major cause of health care and community-associated infections, and because of the increased prevalence of methicillin-resistant S. aureus strains, this pathogen has become an even greater therapeutic challenge [1][2][3][4]. The risk of infection increases in the presence of a foreign body, and S. aureus is known for its ability to colonize and form biofilms on medical devices, such as indwelling catheters and orthopedic implants [5][6][7][8]. Biofilm-associated bacteria exhibit distinct properties compared with planktonic growth phases of the same species, and it is becoming clear that the composition and kinetics of the host immune response to S. aureus biofilms inadvertently facilitates biofilm persistence, whereas planktonic infections, such as abscesses, are often resolved [9,10].…”