title: Emerging trends of community acquired infective endocarditis.
abstract: 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.
authors.forename: Kai-Hang
authors.initials: KH
authors.lastname: Yiu
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
authors.forename: Kathy Lai-Fun
authors.initials: KL
authors.lastname: Lee
authors.forename: Yee-Tak
authors.initials: YT
authors.lastname: Fong
authors.forename: Hon-Wah
authors.initials: HW
authors.lastname: Chan
authors.forename: Stephen Wai-Lun
authors.initials: SW
authors.lastname: Lee
authors.forename: Chu-Pak
authors.initials: CP
authors.lastname: Lau
authors.forename: Hung-Fat
authors.initials: HF
authors.lastname: Tse
mesh_terms: 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