Infective Endocarditis at a Referral Children's Hospital During 19-Year Period: Trends and Outcomes.

Publisher: Springer Verlag Country of Publication: United States NLM ID: 8003849 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1971 (Electronic) Linking ISSN: 01720643 NLM ISO Abbreviation: Pediatr Cardiol Subsets: MEDLINE

Publication: New York Ny : Springer Verlag
Original Publication: [New York, Springer-Verlag]

Hospitals, Pediatric*/statistics & numerical data ; Endocarditis*/epidemiology ; Endocarditis*/microbiology ; Endocarditis*/mortality ; Heart Defects, Congenital*/epidemiology; Humans ; Retrospective Studies ; Male ; Female ; Incidence ; Infant ; Child ; Michigan/epidemiology ; Child, Preschool ; Risk Factors ; Adolescent ; Staphylococcal Infections/epidemiology ; Endocarditis, Bacterial/epidemiology ; Endocarditis, Bacterial/therapy ; Endocarditis, Bacterial/microbiology ; Endocarditis, Bacterial/mortality ; Infant, Newborn

Background: We noted a recent increase in cases of infective endocarditis (IE) at our institution. The purpose of the study is to examine the incidence, risk factors, microbiology and outcome of IE in our pediatric population.
Methods: Retrospective review of IE cases during 2002-2020 at Children's Hospital of Michigan, Detroit.
Results: 68 patients with IE were identified. There was a 2-fold increase in incidence during the 2012-2020 (late period) compared to the 2002-2011 (early period). The most common predisposing conditions were congenital heart disease (CHD) in 39 (57.4%) and central venous catheter (CVC) in 19 (27.9%). CHD was more frequent in the late period (29/43, 67.4%) compared to early period (10/25, 40.0%) (p = 0.042). In CHD patients, palliative or corrective cardiac surgery was performed prior to IE diagnosis in 4/25 (16%) in early period and 23/43 (53.5%) in the late period (p = 0.004). S. aureus was the most common causative organism (35.3%) followed by streptococci (22.1%). Valve replacement or valvuloplasty was performed in 22.1% of patients. Complications occurred in 20 (29.4%). Mortality occurred in 7 (10.3%): 3 had CHD, 3 had CVC and underlying conditions and 1 had fulminant MRSA infection.
Conclusion(s): The higher incidence of IE during the late period is likely due to an increase in patients with CHD who had undergone prior cardiac surgery. S. aureus was the predominant pathogen in all patients including those with CHD, followed by streptococci. IE in children continues to be associated with high rates of morbidity and mortality.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

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Keywords: Congenital heart disease; Endocarditis; Staphylococcus aureus; Viridans group streptococci

Date Created: 20230823 Date Completed: 20240930 Latest Revision: 20240930

20241001

10.1007/s00246-023-03274-y

37610636