Antimicrobial Resistance of Community-acquired Bloodstream Isolates of Viridans Group Streptococci

Underlying heart disease and microbiological spectrum of adult infective endocarditis in one Chinese university hospital: a 10-year retrospective study

BACKGROUND AND AIM

To identify the underlying heart disease and microbiological pathogen associated with infective endocarditis (IE) in Chinese patients in one university hospital over a 10-year period.

METHODS

We recruited 115 adult patients admitted to Peking University First Hospital from 2002 to 2011 who were diagnosed with definite IE. Statistical analysis was performed to analyse data on demographics, clinical and laboratory findings, as well as microbiological pathogens.

RESULTS

The most common underlying heart diseases for IE were congenital heart disease (24.3%) followed by degenerative valvular disease (17.4%). Aortic (44.3%) and mitral (43.5%) valves were most frequently affected. The right-sided IE cases were all found in patients with congenital heart disease. The age of patients was younger in right-sided cases than that in left-sided ones (P = 0.001). There was no difference in the mortality among groups with different underlying heart disease (P = 0.841). Forty-four (38.3%) patients were infected with viridans group streptococci. The isolation rate of staphylococci in right-sided IE was higher than that in the left-sided IE group (P = 0.021). More than 85% of streptococci were susceptible to β-lactams.

CONCLUSIONS

Congenital heart disease and degenerative valvular disease have overtaken rheumatic heart disease as the major underlying heart diseases associated with IE. Viridans group streptococci are the most common microbial cause of IE.