Abstract
Abstract
Purpose
To define the incidence and microbiological aetiology of infective endocarditis (IE) in patients with rheumatic heart disease (RHD) in tropical Australia.
Methods
A retrospective study that examined all episodes of IE between January 1998 and June 2021 among individuals on the RHD register in Far North Queensland, Australia.
Results
There were 1135 individuals with a diagnosis of RHD on the register during the study period, representing 10962 patient-years at risk. Overall, there were 18 episodes of definite IE occurring in 16 individuals, although only 7 episodes occurred in native valves (11 occurred in prosthetic valves) equating to 0.7 episodes of native valve IE/1000 patient-years. No patient with mild RHD - and only one child with RHD - developed IE during the study period. Despite the study’s tropical location, the causative organism was usually typical skin or oral flora. Among individuals with an indication for benzathine penicillin G (BPG) prophylaxis, only 1/6 episodes of IE due to a penicillin-susceptible organism received BPG in the month before presentation.
Conclusion
Although RHD predisposes individuals to IE, the absolute risk of IE in native valve disease in tropical Australia is low and might be reduced further by improved adherence to secondary BPG prophylaxis.
Funder
University of New South Wales
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Microbiology (medical),General Medicine
Reference30 articles.
1. Munoz P, Kestler M, De Alarcon A, Miro JM, Bermejo J, Rodriguez-Abella H et al (2015) Current epidemiology and outcome of infective endocarditis: a multicenter, prospective, cohort study. Medicine (Baltimore). 94(43):e1816. https://doi.org/10.1097/MD.0000000000001816
2. Baddour LM, Wilson WR, Bayer AS, Fowler VG Jr, Tleyjeh IM, Rybak MJ et al (2015) Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation 132(15):1435–1486. https://doi.org/10.1161/CIR.0000000000000296
3. McKinsey DS, Ratts TE, Bisno AL (1987) Underlying cardiac lesions in adults with infective endocarditis The changing spectrum. Am J Med 82(4):681–688. https://doi.org/10.1016/0002-9343(87)90001-5
4. Ambrosioni J, Hernandez-Meneses M, Tellez A, Pericas J, Falces C, Tolosana JM et al (2017) The changing epidemiology of infective endocarditis in the twenty-first century. Curr Infect Dis Rep 19(5):21. https://doi.org/10.1007/s11908-017-0574-9
5. Acute rheumatic fever and rheumatic heart disease in Australia 2016–2020. Canberra: Australian Institute of Health and Welfare, Australian Government; 2022. https://www.aihw.gov.au/reports/indigenous-australians/rheumatic-heart-disease-in-australia-2016-2020