Infective endocarditis in an Indian setup: Are we entering the ′modern′ era?

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Amit Varma
2. Anu Gupta
3. Upendra Kaul
4. Ashish Gupta
ISSN
0972-5229
DOI
10.4103/0972-5229.117041
Volume
17
Issue
3
Publishing Year
2013
Pages
8
Author Affiliations
    1. Batra Hospital and Medical Research Centre, 1, Tughlakabad Institutional Area, Mehrauli-Badarpur Road, New Delhi
    2. Batra Hospital and Medical Research Center, New Delhi; Jamia Hamdard University and Amity University, Noida, Uttar Pradesh, India
    3. Academics and Research, Batra Heart Center and Batra Hospital, and Medical Research Center, New Delhi, India
    4. Academics and Research, Batra Hospital and Medical Research Center, New Delhi, India
    5. Batra Heart Center and Batra Hospital and Medical Research Center, New Delhi, India
    6. Batra Hospital and Medical Research Center, New Delhi, India
    7. Batra Heart Centre, Batra Hospital and Medical Research Centre, New Delhi, India
    8. Clinical Research, Fortis Healthcare, New Delhi, India
    9. Fortis Health Care, New Delhi, India
    10. Fortis Escorts Heart Institute and Fortis Hospital, New Delhi, India
    11. Fortis Escorts Heart Institute and Research Center, New Delhi, India
    12. Fortis Escorts Heart Institute, New Delhi, India
    13. Fortis Hospital, New Delhi, India
    14. Fortis Escorts Heart Institute and
    1. Fortis Health Care, Delhi, India
    2. Critinext, New Delhi, India
    3. Fortis Escorts Heart Institute, New Delhi, India
    1. Postgraduate Institute of Medical Education and Research, Chandigarh 160 012, India
    2. University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
    3. Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India
    4. GB Pant Institute of Post graduate, Medical Education and Research, New Delhi, India
    5. All India Institute of Medical Sciences (AIIMS), New Delhi, India
    1. Depatment of Critical Care Medicine, Fortis Escorts Heart Institute, Okhla Road, New Delhi, India
  • Article keywords
    Demographics, echocardiography, infective endocarditis, microbiologic characteristics, rheumatic heart disease

    Abstract

    Background: The clinical profile of infective endocarditis (IE) has been continuously evolving over last 3-4 decades as highlighted by many studies from developed world. Objectives: To evaluate the recent changes in the spectrum and clinical profile, and outcome of IE in an Indian setup. Materials and Methods: This was a descriptive, cross-sectional study. Demographic, clinical, characteristics, treatment, and outcome were examined in ′definite′ cases of IE admitted at our institute between July 2005 and December 2010. Results: 61 ′definite′ cases were identified. Mean patient age was 49.3 ± 13.7 years. Male to female ratio was 3.3:1. Rheumatic heart disease was the underlying heart disease in 23 (37.7%) patients. 33 (54.1%) patients had already received antibiotic therapy before presentation to us. Blood cultures were positive in 41 (67.2%) patients. Streptococci and staphylococci were the commonest microbial isolates, 9 (21.4%) patients each. Transesophageal echocardiography (TEE) was done for all the patients. Vegetations were detected in 54 (88%) patients. Surgery was done in 30 (49.2%) patients. In-hospital mortality happened in 4 (6.5%) patients. Conclusions: We recorded several new trends, like: 1) an increasing age, 2) an increasing proportion of patients with no previously known heart disease, 3) improving culture positivity rates, 4) rise in staphylococcal infections, 5) increased usage of TEE, 6) high elective surgical rate, and 7) apparent improved survival rates. These changes point to the fact that ′modern era′ changes in the profile of IE have started to appear in a selected population in India.

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