Temporal Trends in Infective Endocarditis in the Context of Prophylaxis Guideline Modifications
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Objectives The goal of this study was to evaluate temporal trends in infective endocarditis (IE) incidence and clinical characteristics after 2002 French IE prophylaxis guideline modifications.Background There are limited data on changes in the epidemiology of IE since recent guidelines recommended restricting the indications of antibiotic prophylaxis of IE.Methods Three 1-year population-based surveys were conducted in 1991, 1999, and 2008 in 3 French regions totaling 11 million inhabitants age ≥20 years. We prospectively collected IE cases from all medical centers and analyzed age- and sex-standardized IE annual incidence trends.Results Overall, 993 expert-validated IE cases were analyzed (323 in 1991; 331 in 1999; and 339 in 2008). IE incidence remained stable over time (95% confidence intervals given in parentheses/brackets): 35 (31 to 39), 33 (30 to 37), and 32 (28 to 35) cases per million in 1991, 1999, and 2008, respectively. Oral streptococci IE incidence did not increase either in the whole patient population (8.1 [6.4 to 10.1], 6.3 [4.8 to 8.1], and 6.3 [4.9 to 8.0] in 1991, 1999, and 2008, respectively) or in patients with pre-existing native valve disease. The increased incidence of Staphylococcus aureus IE (5.2 [3.9 to 6.8], 6.8 [5.3 to 8.6], and 8.2 [6.6 to 10.2]) was not significant in the whole patient population (p = 0.228) but was significant in the subgroup of patients without previously known native valve disease (1.6 [0.9 to 2.7], 3.7 [2.6 to 5.1], and 4.1 [3.0 to 5.6]; p = 0.012).Conclusions Scaling down antibiotic prophylaxis indications was not associated with an increased incidence of oral streptococcal IE. A focus on avoidance of S. aureus bacteremia in all patients, including those with no previously known valve disease, will be required to improve IE prevention.
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The proportion of infective endocarditis patients undergoing surgery has increased over time to approximately 50%.
“the proportion of IE patients undergoing surgery has increased over time to reach ≈50%.1,10,11”
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- Authors
- Duval, X., Delahaye, F., Alla, F., Tattevin, P., Obadia, J.-F., Le Moing, V., Doco-Lecompte, T., Celard, M., Poyart, C., Strady, C., Chirouze, C., Bes, M., Cambau, E., Iung, B., Selton-Suty, C., & Hoen, B.
- Affiliations
- Inserm (FR)
- Lyon 1 Université (FR)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- Hôpital Pontchaillou (FR)
- Hôpital Louis Pradel (FR)
- Centre National de la Recherche Scientifique (FR)
- Centre Hospitalier Universitaire de Reims (FR)
- Centre Hospitalier Universitaire de Besançon (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Corresponding author
- Duval, Xavier
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2012-05
- Volume
- 59
- Issue
- 22
- Pages
- 1968-1976
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2136033275
- Cited by
- 383
- References
- 43
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 16 · 2023: 15 · 2022: 27 · 2021: 25 · 2020: 43 · 2019: 45 · 2018: 29 · 2017: 52 · 2016: 29 · 2015: 26 · 2014: 18 · 2013: 28 · 2012: 10
- FWCI
- 19.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Funders
- French Ministry of Health
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Streptococcal Infections and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Keywords
- infective endocarditis, antibiotic prophylaxis, prevention guidelines, incidence trends, Staphylococcus aureus endocarditis, temporal trends
- MeSH terms
- Adult, Endocarditis, Bacterial, Female, Follow-Up Studies, France, Humans, Male, Middle Aged, Population Surveillance, Prognosis, Retrospective Studies, Risk Factors, Staphylococcal Infections, Staphylococcus aureus, Incidence, Practice Guidelines as Topic, Age Distribution, Sex Distribution, Antibiotic Prophylaxis, Guideline Adherence, Young Adult
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