A Study of Infective Endocarditis in Malta
Science Journal of Clinical Medicine
Volume 6, Issue 6, November 2017, Pages: 98-104
Received: Aug. 15, 2016;
Accepted: Oct. 7, 2016;
Published: Oct. 30, 2017
Views 2328 Downloads 127
Annalisa Montebello, Department of Medicine, Mater Dei Hospital, Msida, Malta
Anette Portelli, Department of Infectious Diseases, Mater Dei Hospital, Msida, Malta
Maria Alessandra Zammit, Department of Medicine, Mater Dei Hospital, Msida, Malta
Tonio Piscopo, Department of Infectious Diseases, Mater Dei Hospital, Msida, Malta
Follow on us
Infective endocarditis (IE) is a life threatening infection, especially if diagnosis and subsequent treatment are delayed. The aim of this retrospective study was to assess the clinical features and management of infective endocarditis in Malta. Patients admitted to Mater Dei Hospital (MDH) between January 2008 and December 2015 with a diagnosis of IE according to the modified Duke's criteria were selected from electronic case summaries. Demographic data and details on clinical features, risk factors, investigations, management and complications were obtained through the patients’ clinical notes and online laboratory results. There were 65 patients with a diagnosis of IE with a 12.3% (8) mortality rate. Our cohort included 57 patients as the eight deceased patients were not audited due to unavailable case notes. Native valve endocarditis was seen in 80.7% (46) of patients whilst 19.3% (11) had prosthetic valve endocarditis. Left sided vegetations were the most common at 68.4% (39). The majority of patients were culture positive at 87.7% (50). Staphylococci were the commonest organisms cultured at 36.8% (21) of which 57.1% (12) were Staphylococcus aureus with 19.0% (4) being Methicillin resistant staphylococcal aureus. Complication rates were highest in the native valve cohort at 67.4% (31) versus 36.4% (4) patients in the prosthetic valve endocarditis group. IE is not uncommon and can result in severe complications can arise with long-term sequelae. Preventive efforts should be of utmost importance both in the community and in hospitals.
Infective Endocarditis, Clinical Features, Investigations, Complications
To cite this article
Maria Alessandra Zammit,
A Study of Infective Endocarditis in Malta, Science Journal of Clinical Medicine.
Vol. 6, No. 6,
2017, pp. 98-104.
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/
) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Sexton D, Fowler V. Clinical manifestations and evaluation of adults with suspected native valve endocarditis [Internet]. http://www.uptodate.com. 2016 [cited 15 August 2016]. Available from: http://Clinical manifestations and evaluation of adults with suspected native valve endocarditis
Brusch J. Infective Endocarditis: Practice Essentials, Background, Pathophysiology [Internet]. Emedicine.medscape.com. 2015 [cited 15 August 2016]. Available from: http://emedicine.medscape.com/article/216650-overview.
Habib G, Derumeaux G, Avierinos J, et al. Value and limitations of the duke criteria for the diagnosis of infective endocarditis. J Am Coll Cardiol. 1999;33(7):2023-2029. doi:10.1016/S0735-1097(99)00116-3.
Tleyjeh IM, Steckelberg JM, Murad HS, et al. Temporal Trends in Infective Endocarditis: A Population-Based Study in Olmsted County, Minnesota. JAMA. 2005;293(24):3022-3028. doi:10.1001/jama.293.24.3022.
David H. Bor, Steffie Woolhandler, Rachel Nardin, John Brusch, and David U. Himmelstein, Infective Endocarditis in the U.S., 1998–2009: A Nationwide Study June 22/29, 2005, Vol 293, No. 24.
Prendergast B Tornos P. Surgery for Infective Endocarditis: Who and When? Circulation. 2010;121(9):1141-1152.
Keys T Infective endocarditis: Prevention, diagnosis, treatment, referral. Cleveland Clinic Journal of Medicine. 2000; 67(5):353-360.
Murdoch D et al. Clinical Presentation, Etiology, and Outcome of Infective Endocarditis in the 21st Century. Archives of Internal Medicine. 2009;169(5):463.