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.