title: [An analysis of clinical characteristics, etiologies and prognosis of 218 patients with infective endocarditis].
abstract: OBJECTIVE
  To describe the profile of patients with infective endocarditis (IE) and assess prognostic factors of IE.
  
  
  METHODS
  Clinical and etiology data of 218 patients with IE were collected retrospectively from January 2011 to January 2013. The distribution and antimicrobial susceptibilities of pathogens causing IE were evaluated. Prognostic factors associated with IE were determined by univariate and multivariate regression analysis.
  
  
  RESULTS
  There were 148 men and 70 women with age of (46.0 ± 14.6) years. Ninety-five (43.6%) of them had heart diseases, including 72 cases (33.0%) of congenital heart disease and 23 cases (10.6%) of chronic rheumatic heart disease. Vegetations were detected by echocardiography in 171 (78.4%) patients. Microorganisms causing IE were identified in 84 cases (38.5%) cases. Streptococcus viridans was the dominant pathogen, accounted for 63.1% of all the pathogens, followed by Staphylococcus (13.1%) and Enterococcus (4.8%). Totally 7/11 Streptococcus viridans was susceptible to penicillin, while 100% susceptible to the third and fourth generation cephalosporins, vancomycin and linezolid. One hundred and eighty cases underwent operations. The in-hospital mortality rate of IE was 3.2%. In univariate regression, health care-associated infection, prosthetic valve, anemia and chest symptoms (distress or pain) were related to the increased risk of mortality in patients with IE, while surgery appeared to be a protective factor. In the logistic regression model, the variables significantly associated with IE prognosis were health care-associated infection (OR = 17.03, 95%CI 1.76-164.75, P = 0.014) and anemia (Hb < 90 g/L) (OR = 13.47, 95%CI 2.46-73.60, P = 0.003) and surgery treatment (OR = 0.17, 95%CI 0.03-0.97, P = 0.047).
  
  
  CONCLUSIONS
  Although Streptococcus viridans is the most common pathogen causing IE, the pathogens of IE become versatile. The antibacterial activity of penicillin against Streptococcus viridans is low. Health care-associated infection and anemia are risk factors of IE prognosis, while surgery treatment is a protective factor of severe IE.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Infective Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Email: hubijie@vip.sina.com.
authors.forename: Bijie
authors.initials: B
authors.lastname: Hu
authors.forename: Chunmei
authors.initials: C
authors.lastname: Zhou
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhou
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology*; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012214:Rheumatic Heart Disease / Q000453:epidemiology; D013210:Staphylococcus / Q000187:drug effects / Q000302:isolation & purification*; D034363:Viridans Streptococci / Q000187:drug effects / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents