title: Clinical features of infective endocarditis: comparison between the 1990s and 2000s.
abstract: BACKGROUND
  The circumstances surrounding infective endocarditis (IE) are under constant change due to an increase in drug-resistant organisms, a decrease in rheumatic valve disease, progress in surgical treatment, and aging society. The purpose of this study was to compare clinical features of IE between the 1990s and 2000s and to elucidate the determinants of death or clinical event.
  
  
  METHODS
  All hospital admission records between January 1990 and December 2009 were retrospectively analyzed. The definition of IE was based on modified Duke criteria. Clinical presentation, blood culture, laboratory results, and echocardiography findings were compared between the 1990s and 2000s.
  
  
  RESULTS
  There were 112 patients with definite or probable IE according to modified Duke criteria. The most frequent organism causing IE was Streptococcus viridians both in the 1990s and 2000s. The determinants of in-hospital death were hemodialysis and congestive heart failure. The in-hospital mortality of IE was 5.4% in the 1990s and 13.3% in the 2000s. Composite events of in-hospital death and central nervous system disorders were significantly higher in the 2000s compared with the 1990s.
  
  
  CONCLUSIONS
  The most frequent causative organism of IE was S. viridians, both in the 1990s and 2000s. Independent predictors of in-hospital mortality in IE were hemodialysis and congestive heart failure.
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Tom
authors.initials: T
authors.lastname: Nakagawa
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. Electronic address: wada1006@hotmail.com.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakakura
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Kohki
authors.initials: K
authors.lastname: Ishida
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Ibe
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Nahoko
authors.initials: N
authors.lastname: Ikeda
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.affiliation: Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D004696:Endocarditis / Q000382:microbiology* / Q000401:mortality*; D005260:Female; D005544:Forecasting; D006333:Heart Failure; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D015999:Multivariate Analysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D034363:Viridans Streptococci / Q000302:isolation & purification* / Q000472:pathogenicity
keywords: Infective endocarditis; MRSA; Streptococcus; Surgery