Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
권호 표지
DOI QR코드

DOI QR Code

Changes in Patient Characteristics of Infective Endocarditis with Congenital Heart Disease: 25 Years Experience in a Single Institution

  • Baek, Jae Eun (Division of Pediatric Cardiology, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Department of Pediatrics, Yonsei University College of Medicine) ;
  • Park, Su Jin (Department of Pediatric Cardiology, Sejong General Hospital) ;
  • Woo, Saet Byul (Division of Pediatric Cardiology, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Department of Pediatrics, Yonsei University College of Medicine) ;
  • Choi, Jae Young (Division of Pediatric Cardiology, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Department of Pediatrics, Yonsei University College of Medicine) ;
  • Jung, Jo Won (Division of Pediatric Cardiology, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Department of Pediatrics, Yonsei University College of Medicine) ;
  • Kim, Nam Kyun (Division of Pediatric Cardiology, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Department of Pediatrics, Yonsei University College of Medicine)
  • Received : 2013.10.05
  • Accepted : 2013.12.20
  • Published : 2014.01.30
⟨ Previous Next ⟩

Abstract

Background and Objectives: The profile of infective endocarditis (IE) has changed and is now showing an increasing prevalence of IE among congenital heart disease (CHD) patients. We studied the change of clinical profiles of IE over the past 25 years in patients with CHD at a single institution. Subjects and Methods: We reviewed medical records retrospectively for 325 patients diagnosed with IE between January 1, 1987, and March 31, 2012. We analyzed and compared the differences in patient characteristics and outcomes between 1987-2000 (group A) and 2001-2012 (group B). Results: Over the 25-year period, 93 cases of IE in CHD patients were diagnosed (59 cases in group A and 34 cases in group B). Ventricular septal defect was the most common underlying cardiac disease observed during the entire period. The most common causative pathogen was Streptococcus in both groups. Group A contained 16 cases (27.1%) that had undergone cardiac surgery, whereas this number was 19 (55.8%) in group B. The number of patients who had undergone palliative care or surgery using prosthetic materials was higher among group B patients (p<0.001). Surgical procedures due to uncontrolled infection were performed in three cases in group A and 10 cases in group B. Conclusion: Infective endocarditis and CHD show a close correlation, and the profile of IE patients can change in line with an increase in the survival rate of patients with complex CHD and the improvement of surgical techniques. Ongoing reassessment and the systematic management of these patients is crucial in the prevention and treatment of IE.

Keywords

References

  1. Micheletti A, Negura D, Piazza L, et al. [Infective endocarditis in patients with congenital heart disease]. Pediatr Med Chir 2010;32:270-3.
  2. Gewitz MH. Prevention of bacterial endocarditis. Curr Opin Pediatr 1997;9:518-22. https://doi.org/10.1097/00008480-199710000-00015
  3. Nakatani S, Mitsutake K, Hozumi T, et al. Current characteristics of infective endocarditis in Japan: an analysis of 848 cases in 2000 and 2001. Circ J 2003;67:901-5. https://doi.org/10.1253/circj.67.901
  4. Fortun J, Centella T, Martin-Davila P, et al. Infective endocarditis in congenital heart disease: a frequent community-acquired complication. Infection 2013;41:167-74. https://doi.org/10.1007/s15010-012-0326-6
  5. Garg N, Kandpal B, Garg N, et al. Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 192 Indian patients, 1992-2001. Int J Cardiol 2005;98:253-60. https://doi.org/10.1016/j.ijcard.2003.10.043
  6. Park CB, Kim JJ, Song JK, et al. Right-sided infective endocarditis in Korea. Korean Circ J 2005;35:633-8. https://doi.org/10.4070/kcj.2005.35.8.633
  7. Ternhag A, Cederstrom A, Torner A, Westling K. A nationwide cohort study of mortality risk and long-term prognosis in infective endocarditis in Sweden. PLoS One 2013;8:e67519. https://doi.org/10.1371/journal.pone.0067519
  8. Elbey MA, Akdag S, Kalkan ME, et al. A multicenter study on experience of 13 tertiary hospitals in Turkey in patients with infective endocarditis. Anadolu Kardiyol Derg 2013;13:523-7.
  9. Ikama MS, Nkalla-Lambi M, Kimbally-Kaky G, Loumouamou ML, Nkoua JL. Profile of infective endocarditis at Brazzaville University Hospital. Med Sante Trop 2013;23:89-92.
  10. Li JS, Sexton DJ, Mick N, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 2000; 30:633-8. https://doi.org/10.1086/313753
  11. Ahn S, Lee MH, Pyun WB, Kim SS. Clinical observation of infective endocarditis. Korean Circ J 2000;30:166-73. https://doi.org/10.4070/kcj.2000.30.2.166
  12. Kim SH, Huh J, Kang IS, et al. Infective endocarditis in adolescents and adults with congenital heart disease. Korean Circ J 2006;36:318-23. https://doi.org/10.4070/kcj.2006.36.4.318
  13. Morris CD, Reller MD, Menashe VD. Thirty-year incidence of infective endocarditis after surgery for congenital heart defect. JAMA 1998; 279:599-603. https://doi.org/10.1001/jama.279.8.599
  14. Wilson W, Taubert KA, Gewitz M, et al. Prevention of infective endocarditis: guidelines from the American Heart Association: a guideline from the American Heart Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. J Am Dent Assoc 2008;139 Suppl:3S-24S. https://doi.org/10.14219/jada.archive.2008.0346
  15. Di Filippo S, Delahaye F, Semiond B, et al. Current patterns of infective endocarditis in congenital heart disease. Heart 2006;92:1490-5. https://doi.org/10.1136/hrt.2005.085332
  16. De Gevigney G, Pop C, Delahaye JP. The risk of infective endocarditis after cardiac surgical and interventional procedures. Eur Heart J 1995; 16 Suppl B:7-14.
  17. Barnes PD, Crook DW. Culture negative endocarditis. J Infect 1997;35: 209-13. https://doi.org/10.1016/S0163-4453(97)92662-1
  18. Petti CA, Fowler VG Jr. Staphylococcus aureus bacteremia and endocarditis. Cardiol Clin 2003;21:219-33, vii. https://doi.org/10.1016/S0733-8651(03)00030-4
  19. Rubinstein E, Lang R. Fungal endocarditis. Eur Heart J 1995;16 Suppl B: 84-9.
  20. Baek JS, Bang JS, Bae EJ, et al. Current characteristics of infective endocarditis with congenital heart disease: a retrospective survey of 121 cases between 1985 and 2006. Korean Circ J 2007;37:635-40. https://doi.org/10.4070/kcj.2007.37.12.635
  21. Harris PS, Cobbs CG. Cardiac, cerebral, and vascular complications of infective endocarditis. Cardiol Clin 1996;14:437-50. https://doi.org/10.1016/S0733-8651(05)70294-0
  22. Yoon KA, Lee HJ, Koh YY, Choi JY, Yun YS, Hong CY. A Clinical Observation on Infective Endocarditis in Childhood. J Korean Pediatr Soc 1989;32:11-9.
  23. Niwa K, Nakazawa M, Tateno S, Yoshinaga M, Terai M. Infective endocarditis in congenital heart disease: Japanese national collaboration study. Heart 2005;91:795-800. https://doi.org/10.1136/hrt.2004.043323
  24. Knirsch W, Haas NA, Uhlemann F, Dietz K, Lange PE. Clinical course and complications of infective endocarditis in patients growing up with congenital heart disease. Int J Cardiol 2005;101:285-91. https://doi.org/10.1016/j.ijcard.2004.03.035

Cited by

  1. 2015 ESC Guidelines for the management of infective endocarditis : The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by: European Associa vol.36, pp.44, 2014, https://doi.org/10.1093/eurheartj/ehv319
  2. 선천성 심장병을 가진 소아와 성인에서 발생한 감염성 심내막염의 비교: 1개 3차 병원의 16년간 경험 vol.23, pp.3, 2014, https://doi.org/10.14776/piv.2016.23.3.209