title: Incidence of Infective Endocarditis Due to Viridans Group Streptococci Before and After the 2007 American Heart Association's Prevention Guidelines: An Extended Evaluation of the Olmsted County, Minnesota, Population and Nationwide Inpatient Sample.
abstract: OBJECTIVE
  To determine whether the incidence of infective endocarditis (IE) due to viridans group streptococci (VGS) increased after the publication of the 2007 American Heart Association (AHA) IE prevention guidelines.
  
  
  METHODS
  We performed a population-based survey of all adults (18 years and older) residing in Olmsted County, Minnesota, from January 1, 1999, through December 31, 2013, to identify definite or possible cases of VGS-IE using the Rochester Epidemiology Project. The National (Nationwide) Inpatient Sample hospital discharge database was examined to determine the number of VGS-IE cases in the United States between 2000 and 2011.
  
  
  RESULTS
  Rates of incidence (per 100,000 person-years) during the intervals of 1999-2002, 2003-2006, 2007-2010, and 2011-2013 were 3.6 (95% CI, 1.3-5.9), 2.7 (95% CI, 0.9-4.4), 0.7 (95% CI, 0.0-1.6), and 1.5 (95% CI, 0.2-2.9), respectively, reflecting an overall significant decrease (P=.03 from Poisson regression). Likewise, nationwide estimates of hospital discharges with a VGS-IE diagnosis trended downward during 2000-2011, with a mean number per year of 15,853 and 16,157 for 2000-2003 and 2004-2007, respectively, decreasing to 14,231 in 2008-2011 (P=.05 from linear regression using weighted least squares method).
  
  
  CONCLUSIONS
  Despite major reductions in the number of indications for antibiotic prophylaxis for invasive dental procedures espoused by the 2007 AHA IE prevention guidelines, both local and national data indicate that the incidence of VGS-IE has not increased.
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN. Electronic address: desimone.daniel@mayo.edu.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: DeSimone
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Division of Infectious Diseases, King Fahd Medical Center, Riyadh, Saudi Arabia.
authors.forename: Imad M
authors.initials: IM
authors.lastname: Tleyjeh
authors.affiliation: Prairie Cardiovascular Consultants, Carbondale, IL.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Correa de Sa
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Nandan S
authors.initials: NS
authors.lastname: Anavekar
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Lahr
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN; Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Muhammad R
authors.initials: MR
authors.lastname: Sohail
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
authors.forename: James M
authors.initials: JM
authors.lastname: Steckelberg
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Walter R
authors.initials: WR
authors.lastname: Wilson
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Larry M
authors.initials: LM
authors.lastname: Baddour
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000572:American Heart Association; D019072:Antibiotic Prophylaxis / Q000379:methods*; D004696:Endocarditis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D015994:Incidence; D007297:Inpatients / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D055815:Young Adult