Current data about the aetiology and treatment of infective endocarditis

The aim of this study was to provide current data on the incidence, the aetiology and the treatment of infective endocarditis (IE) in a group of patients from one centre over a period of ten years. Our study includes data from patients over the age of 18, diagnosed with bacterial endocarditis, over a period of 10 years (January 2010 -December 2019). The data analysed pertains to clinical presentation, lab results, medical imaging, treatment and outcome during hospitalization. A total of 92 cases were included, with an age average of 63.80 +/- 13.45 years, and a male/female ratio of 1.13. Most patients had endocarditis on native valves. Native valve IE was more frequent on the mitral valve, while in cases with prosthetic valves, the aortic valve was more frequently affected. A large number of patients had comorbidities and healthcare-associated IE. Negative blood cultures were recorded in 30.43% of the cases, probably due to the administration of antimicrobials before blood cultures were drawn. Gram-positive pathogens were predominant in terms of aetiology. Staphylococcus aureus and coagulase negative staphylococci (CoNS) were the most commonly isolated microorganisms, a large number of which were methicillin-resistant. The Charlson comorbidity index was higher in IEs caused by Enterococcus spp., and in those cases the patients were also older. Seven patients had positive cultures for Streptococcus spp., less frequently isolated than Staphylococcus spp., but showing the best antibiotic susceptibility rates. The main etiologic agent involved in healthcare -associated infective endocarditis was Staphylococcus aureus, followed by CoNS. Despite the best diagnostic and treatment options, the mortality rate remained high (33.7%). An increased incidence of Staphylococcus spp. as an etiological agent was found and this was correlated with complications and increased mortality.