Temporal Trends in Infective Endocarditis

TLDR

In developed countries, infective endocarditis has shifted from rheumatic heart disease–associated viridans streptococci to mitral valve prolapse–associated Staphylococcus aureus, whereas developing countries still see rheumatic heart disease as the main predisposing factor. The study seeks to perform population‑based investigations in Olmsted County, Minnesota, to accurately characterize the epidemiology of infective endocarditis in the United States.

Abstract

ristic of the clinical features of infective endocarditis (IE) as described by Osler has undergone a significant change in developed countries. 1,2Previously, IE was a disease that commonly affected patients with predisposing valvular abnormalities caused by rheumatic carditis, with viridans group streptococci the most common causative pathogens. 3This presentation is currently seen in developing countries, where rheumatic heart disease is still prevalent.In developed countries, mitral valve prolapse (MVP) is now thought to be the most common predisposing cardiac condition in patients with IE. 2 Several recent studies from passively reported case series suggest that Staphylococcus aureus is now the most frequently identified causative pathogen. 1These more recent clinical observations of IE characteristics, however, are based on data that come primarily from large, tertiary care centers 4,5 and may not reflect true changes in the epidemiology of IE but rather temporal changes in referral patterns.Thus, population-based investigations are needed to more accurately characterize IE in the United States.Olmsted County, Minnesota, is a setting uniquely qualified for the conduct of population-based studies of dis-See also pp