Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys.

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. There are limited data on changes in the epidemiology of IE since recent guidelines recommended restricting the indications of antibiotic prophylaxis of IE. 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. 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). 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.

Duval X ，Delahaye F ，Alla F ，Tattevin P ，Obadia JF ，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 ，AEPEI Study Group ... -  《-》

Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey.

Selton-Suty C ，Célard M ，Le Moing V ，Doco-Lecompte T ，Chirouze C ，Iung B ，Strady C ，Revest M ，Vandenesch F ，Bouvet A ，Delahaye F ，Alla F ，Duval X ，Hoen B ，AEPEI Study Group ... -  《-》

Treatment strategies for infective endocarditis.

Chopra T ，Kaatz GW 《-》

[Variations of the profile of infective endocarditis in France. Results of an epidemiologic survey carried out during a year].

Groupe d'enquête de l'Association pour l'étude et la prévention de l'endocardite infectieuse 《archives des maladies du coeur et des vaisseaux》

New trends in the epidemiological and clinical features of infective endocarditis: results of a multicenter prospective study.

Cecchi E ，Forno D ，Imazio M ，Migliardi A ，Gnavi R ，Dal Conte I ，Trinchero R ，Piemonte Infective Endocarditis Study Group ... -  《-》