ABSTRACT

Infective Endocarditis in The Central Coast. A Snapshot

Elijah Nyakudarika¹ (MBChB), Andrew Hill¹ (FRACP, DDU)

Background: Infective endocarditis (IE) is an inflammation of the endocardium and intracardiac devices most commonly due to infective causes(1). In the modern era, IE presents most frequently as an acute, rather than chronic problem(2).

Methods: Over a 3-year period, medical records of patients with a final diagnosis of IE were
retrospectively reviewed. Risk factors, patient outcomes as well as results of blood
cultures and echocardiography were evaluated. 78 patients fulfilled the study inclusion
criteria.

Results: 10 patients, 18.5%, had a history of current or prior intravenous drug use (IVDU), figure 3. Most cases of IE are due to staphylococcus aureus (s aureus) infection(3). Our review confirmed this, with methicillin-sensitive s aureus (MSSA) being the leading pathogen, present in 17 subjects, 31%, figure 1. Gentamicin, used alone or in combination, was the most commonly used antimicrobial agent. The aortic valve (AV) was the most commonly affected, 25 subjects (44%), followed by the mitral valve (MV). 24 study subjects, 48%, were transferred to a tertiary centre with cardiothoracic surgery availability. There were 4 deaths, representing 7% of our patientcohort, Figure 2.

Conclusions: Most cases of IE were due MSSA infection and gentamicin was the most commonly used antimicrobial therapy, alone or in combination. AV involvement was the commonest valve lesion. The presence of prosthetic valves was the commonest risk present in the IE cohort.