Abstract
Background
A population-based study of infective endocarditis (IE) in Olmsted County, Minnesota provides a unique opportunity to define temporal and seasonal variations in IE incidence over an extended time period.
Methods
Population-based review of all adults (≥18 years) residing in Olmsted County, Minnesota, with definite or possible IE using the Rochester Epidemiology Project from January 1, 1970 through December 31, 2018. Poisson regression was used to characterize the trends in IE incidence; models were fitted with age, sex, calendar time and season, allowing for non-linearity and non-additivity of their effects.
Results
Overall, 269 cases of IE were identified over a 49-year study period. Median age of IE cases was 67.2 years and 33.8% were females. The overall age- and sex-adjusted incidence of IE was 7.9 cases per 100,000 person-years (95% confidence interval [CI], 7.0 – 8.9), with corresponding rates of 2.4, 2.4, 0.9 and 0.7 per 100,000 person-years for Staphylococcus aureus, viridans group streptococci (VGS), Enterococcus species, and coagulase-negative staphylococci (CoNS) IE, respectively. Temporal trends varied by age, sex and season but on average IE incidence increased over time (P=0.021). Enterococcal IE increased the most (P=0.018), while S. aureus IE appeared to increase but mostly in the winter months (P=0.018). Between 1996 and 2018, the incidence of VGS IE was relatively stable, with no statistically significant difference in the trends before and after the 2007 AHA IE prevention guidelines.
Conclusion
Overall, IE incidence, and specifically enterococcal IE, increased over time, while S. aureus IE was seasonally dependent. There was no statistically significant difference in VGS IE incidence in the periods before and after publication of the 2007 AHA IE prevention guidelines.
Temporal Trends of Infective Endocarditis in Olmsted County, Minnesota between 1970-2018: A Population-Based Analysis
