title: A 27-year experience with infective endocarditis in Lebanon.
abstract: Although rare, infective endocarditis (IE) continues to cause significant morbidity and mortality. Previous data from the American University of Beirut Medical Center (AUBMC) had shown predominance of streptococcal infection. As worldwide studies in developed countries show increasing trends in Staphylococcus aureus endocarditis, it becomes vital to continually inspect local data for epidemiological variations. We reviewed all IE cases between 2001 and 2014, and we performed a comparison to a historical cohort of 86 IE cases from 1987 to 2001. A total of 80 patients were diagnosed with IE between 2001 and 2014. The mean age was 61 years. The most commonly isolated organisms were streptococci (37%), compared to 51% in the previous cohort. S. aureus accounted for 11%. Only one S. aureus isolate was methicillin-resistant. In the historical cohort, 26% of cases were caused by S. aureus. Enterococci ranked behind staphylococci with 22% of total cases, while in the previous cohort, enterococcal IE was only 4%. Compared to previous data from AUBMC, the rates of streptococcal and staphylococcal endocarditis have decreased while enterococcal endocarditis has increased. This study reconfirms that in Lebanon, a developing country, we continue to have a low predominance of staphylococci as etiologic agents in IE.
authors.affiliation: University Hospitals Case Medical Center, Cleveland, OH, United States.
authors.forename: Nadim
authors.initials: N
authors.lastname: El-Chakhtoura
authors.affiliation: Staten Island University Hospital, Staten Island, New York, United States.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Yasmin
authors.affiliation: American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Souha S
authors.initials: SS
authors.lastname: Kanj
authors.affiliation: University of Balamand, Beirut, Lebanon.
authors.forename: Tania
authors.initials: T
authors.lastname: Baban
authors.affiliation: Mayo Clinic, Rochester, MN, United States.
authors.forename: Jad
authors.initials: J
authors.lastname: Sfeir
authors.affiliation: American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: zk10@aub.edu.lb.
authors.forename: Zeina A
authors.initials: ZA
authors.lastname: Kanafani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004696:Endocarditis / Q000453:epidemiology* / Q000382:microbiology*; D016983:Enterococcus / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013291:Streptococcus / Q000302:isolation & purification*; D055815:Young Adult
keywords: Endocarditis; Enterococcus; Lebanon; Staphylococcus; Streptococcus