CLINICO-MICROBIOLOGICAL SPECTRUM OF INFECTIVE ENDOCARDITIS IN PATIENTS FROM A TERTIARY CARE IN CENTRAL INDIA

Abstract

Infective endocarditis is one of the prevalent diseases in india which effects heart endothelium, which is quite prevalent in india and other developing countries, this study highlights the clinic-microbiological parameters of patients with infective endocarditis presenting in a tertiary care institute in India. Materials and methods: A retrospective study based on evaluation and systematic review of 118 patients admitted in department of cardiology, Gandhi Medical College, Bhopal of Definitely diagnosed infective endocarditis, based on modified dukes criteria(1). The demographic Details of patients such as age, sex, clinical findings, prior antibiotic usage were noted along with three sets of blood cultures were sent for microbiological profile. The specimens were processed using BACTec 9240 automated system. Results : the mean age being 30 years, ranging between 20-70 years, with major of the age group being 41- 50 years.(table 1) with male predominance (M:F 1.4:1). Most of the Patients presented with complain of fever(67.7%,n=80), infective emboli (17.7%,n=21). Majority of the patients had Native valve endocarditis(83.05%,n=98){ 25.5%(n=25.5) culture positive Vs 74.4%(n=73) culture negative} and 16.9%(n=20) had prosthetic valve endocarditis{ 65% (n=13) were culture positive Vs 35%(n=7) culture negative} with most common underlying heart conditions being rheumatic heart disease77.9%(n=92), prosthetic heart valve 16.9%(n=20), ASD 1.6%(n=2), VSD 3.3%(n=4). The most common valve involved as mitral valve(50%, n=59) followed by aortic(28%,n=23.7), tricuspid (17.7%n=21) and lastly pulmonary valve(8.4%, n=10).The microbiological spectra noted in NVE culture positive cases the most common organism isolated were Streptococcus mitis(36% n=9), Streptococcus sanguinis(12%,n=3),Streptococcus pyogenes (12%n=3). Whereas in PVE culture positive cases the most common organism isolated were Methicillin Resistant Staphylococcus aureus (MRSA) (30.7%,n=4), Methicillin susceptible Staphylococcus aureus (MSSA) (30.7%, n=4), Methicillin Resistant Coagulase negative Staphylococcus (MRCONS) (23.0,n=3),Streptococcus pyogenes(15.3%n=2).