A changing profile of infective endocarditis at a tertiary hospital in China: A retrospective study from 2001 to 2018

Background: Infective endocarditis (IE) is a lethal disease which has been changing significantly over the past decades; however, information about IE in China remains scarce. This study surveyed the changes in clinical characteristics of IE in southern China over a period of nearly eighteen years. Methods: Medical records with IE patients consecutively hospitalized between June 2001 and June 2018 were selected from the electronic medical records system in Nanfang Hospital at Southern Medical University. Data were divided by admission time into two groups: early-period group, June 2001 to December 2009 and later-period group, January 2010 to July 2018. Results: A Total of 313 IE patients were included in our study. Compared with the early-period group, patients in the later-period group included fewer intravenous drug users (IVDU), older age at onset, reduced development of pulmonary embolism, less renal dysfunction, decreased proportion of Staphylococcus aureus infection and fewer vegetations observed in the right heart by echocardiography. The later-period group also showed a higher proportion of ischemic strokes and higher rate of whole-blood culture positive compared with the early-period group. The in-hospital mortality rate remained about the same between the two periods. Conclusions: Our study demonstrated a dramatic change in the profile and characteristics of IE over a period of eighteen years in southern China, especially the decrease in intravenous drug users (IVDU), which might be responsible for many other changes.