Emerging trends of community acquired infective endocarditis.
BACKGROUND
To obtain epidemiological information and to evaluate the emerging trend of incidence and clinical features of community acquired infective endocarditis (IE) in Hong Kong.


METHODS
Population-based survey in a regional hospital in Hong Kong which served 0.55 million population over an 11-year period was conducted. 172 patients diagnosed to have IE between 1995 and 2005 were analyzed. Incidence, underlying heart disease, causative microorganisms and clinical outcomes of IE were studied.


RESULTS
The standardized annual incidence of community acquired IE was 2.8 cases per 100,000 person-year and remain stable over the past 10 years in Hong Kong (P=0.57 for trends). The most common underlying heart diseases for IE were intravenous drug addict (30%), followed by chronic rheumatic heart disease (18%). There was a time trend of increasing age in patients suffered from IE, both in patients with or without intravenous drug abuse (overall P=0.004). Although there were no significant changes in the overall proportion of IE patients with different underlying etiologies, site of IE involvement and types of microorganisms, non-addict patients showed an increasing trend of staphylococcal IE during the study period (P=0.01). The adverse clinical outcome of IE during the study period remained unchanged (P=0.71).


CONCLUSIONS
The results of this study have demonstrated that IE continued to be an important disease with stable incidence and high morbidity and mortality over time in Asia. Furthermore, our study also highlighted that IE is an emerging disease with continuously changing clinical and microbiologic patterns, and significant differences are still present between different countries.
Yiu
Kai-Hang
KH
Siu
Chung-Wah
CW
Lee
Kathy Lai-Fun
KL
Fong
Yee-Tak
YT
Chan
Hon-Wah
HW
Lee
Stephen Wai-Lun
SW
Lau
Chu-Pak
CP
Tse
Hung-Fat
HF
D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006306:Health Surveys; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology