Clinical Characteristics and In-Hospital Prognosis of Infective Endocarditis in Two Eastern Counties of Taiwan.
BACKGROUND
Infective endocarditis (IE) is a common and potentially serious disease. Although it is an illness that affects populations around the world, narrower descriptions of this disease as it impacts specific regions are uncommon. We analyzed the clinical characteristics of IE patients from two eastern counties in Taiwan and studied the relationship between the isolated pathogens and clinical outcomes in these patients.


METHODS
This is a retrospective chart review study which enrolled patients who received services between January 2007 and December 2010. Subsequent to chart review, IE was confirmed in a total of 55 patients by the modified Duke criteria.


RESULTS
Of these patients, 17 (31%) had previous traumatic open skin wounds. Pre-existing cardiac abnormalities were found in 47 (85%) patients, 28 of whom had valvular abnormalities. Staphylococcus aureus was isolated from the blood as the leading pathogen in 25 (45%) patients (including 23 methicillin-sensitive and 2 methicillin-resistant). Septic emboli and shock occurred in 27 (49%) of 55 patients; surgery was performed on 11 (20%) of those patients, and 4 (36%) of them died post-operatively. The total in-hospital mortality rate was 40% (n = 22). Staphylococcus aureus infection was associated with significantly higher complication and mortality rate than non-Staphylococcus aureus infection (59% vs. 41% and 64% vs. 36%, respectively; p < 0.05). In addition, patients with complications had a very high mortality rate (81.5%).


CONCLUSIONS
We found that Staphylococcus aureus was the most common pathogen of IE in Eastern Taiwan, and was associated with higher rates of morbidities and mortality.


BACKGROUND
Infective endocarditis; Septic shock; Staphylococcus aureus; Systemic embolization.
Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; ; School of Medicine, Tzu Chi University, Hualien, Taiwan;
Jen-Che
JC
Hsieh
Institute of Epidemiology and Preventive Medicine, College of Pulbic Health, National Taiwan University, Taipei, Taiwan.
Ling-Yi
LY
Wang
Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; ; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan;
Huai-Ren
HR
Chang
Department of Cardiovascular Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; ; School of Medicine, Tzu Chi University, Hualien, Taiwan;
Shen-Feng
SF
Chao
Division of Cardiology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; ; School of Medicine, Tzu Chi University, Hualien, Taiwan;
Ji-Hung
JH
Wang