Analysis Of Distribution And Drug Resistance Of Pathogens In Infective Endocarditis From 2002 To 2014 In Luzhou And Yibin

Background and objective: Infective endocarditis is a microbial infection of the endocardial surface of the heart, most commonly affecting heart valves. infective endocarditis is a difficult to treat and life-threatening condition with high mortality rate. Advancements in medical technology and increased life expectancy have been described as contributing to the evolution of endocarditis. There was no exact epidemiology date of infective endocarditis in China. The objective of this study was to investigate the distribution and drug resistance of pathogens in blood culture of infective endocarditis patients in Luzhou and Yibin from 2002 to 2014.Methods : We retrospectively collected the cases diagnosed as infective endocarditis from 2002 to 2014 in Luzhou and Yibin. The standard questionnaire was used to collect the information of age, gender, medical history, history of heart surgery and the results of blood culture. Statistical analysis were performed using SPSS 17.0 software package.Results: 1. Overall, 172 cases that met modified Duke criteria for the diagnosis of infective endocarditis were analyzed in this study(74 in 2002-2009 and 98 in2010-2014). The endocarditis incidence per number of admissions increased from 9.25/year to 19.6/year. The average age of 2002-2009 and 2010-2014 groups were35.11±16.19 and 43.74±14.95, respectively( p<0.001).2. There were 54(31.4%) cases with history of heart surgery or cardiac under conditions(congenital heart disease, 25, 14.53%, rheumatic heart disease, 24, 13.95%, history of heart surgery, 17, 9.88%). Although the cases of infective endocarditis with cardiac under conditions increased in 2010-2014 group, there was no significant difference between two groups.3. Sixty pathogens were isolated,6(4%) for fungus, and 54(35.76%) for bacteria, among which staphylococcus and streptococcus( n = 22, 40.74%, respectively) were the most common pathogens.Staphylococcus aureus(SA) was the most isolated bacteria(14, 25.93%), followed by Streptococcus viridans(SV, 11, 20.37%). The blood culture positive rates were 29.7% in 2002-2009 group and 35.6% in 2010-2014 group(p >0.05).4. The resistance rate of Staphylococcus to penicillin was 68.82%, to amoxicillin was 36.4%, to levofloxacin was 4.5%,while to norvancomycin was 0%. Streptococcus to penicillin was 22.7%, to cefazolin was 45.5%,while sensitive to levofloxacin and norvancomycin.Conclusion: The monitoring of changes of distribution and drug resistance of pathogens in infective endocarditis may guide the rational application of antibiotics.