Analysis of Pathogens and Clinical Characteristics in 157 Cases with Infective Endocarditis

OBJECTIVE: To analyze the clinical characteristics of infective endocarditis (IE) in culture-positive patients,so as to provide the evidences for reasonable diagnosis and treatment of IE. METHODS: We performed a retrospective study of 157 culture-positive IE cases,which were diagnosed according to modified Duke criteria for IE from Jan. 2008 to Aug. 2015. RESULTS: The average age of 157 cases of IE was 40.85 years. One hundred and one patients (64.3%) had various underlying cardiac diseases,including congenital cardiovascular diseases in 44 cases and rheumatic heart diseases in 15 cases. The main clinical manifestations were anemia (147 cases,93.6%),fever(137 cases,87.3%) and heart murmur (120 cases,76.4%). Vegetation was found in 12 cases (7.6%) with transesophageal echocardiography (TEE) but not with transthoracic echocardiography (TTE) . Culture results showed the most common causative microorganisms were Streptococci (76 cases,48.4%),with Viridans streptococci dominated in 70 cases,and Staphylococci (33 cases,21.0%) (Staphylococcus aureus dominated in 18 cases). All patients were treated with antimicrobial agents. Eighty-five patients (54.1%) received surgical intervention,of which 72 cases received valve replacement. Twenty-seven patients were cured,88 patients were markedly improved,38 patients discontinued treatment,and 4 patients died. The therapeutic efficacy of operation group was better. CONCLUSION: The clinical characteristics of IE included: the age of onset increased,congenital heart disease was the most underlying disease,and Viridians streptococci was the most popular causative microorganism. Surgical therapy can effectively improve the outcomes of IE patients.