DeSimone Daniel C, Lahr Brian D, Anavekar Nandan S, Sohail Muhammad R, Tleyjeh Imad M, Wilson Walter R, Baddour Larry M
Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
Open Forum Infect Dis. 2021 Jan 27;8(3):ofab038. doi: 10.1093/ofid/ofab038. eCollection 2021 Mar.
A population-based study of infective endocarditis (IE) in Olmsted County, Minnesota, provides a unique opportunity to define temporal and seasonal variations in IE incidence over an extended time period.
This was a population-based review of all adults (≥18 years) residing in Olmsted County, Minnesota, with definite or possible IE using the Rochester Epidemiology Project from January 1, 1970, through December 31, 2018. Poisson regression was used to characterize the trends in IE incidence; models were fitted with age, sex, calendar time, and season, allowing for nonlinearity and nonadditivity of their effects.
Overall, 269 cases of IE were identified over a 49-year study period. The median age of IE cases was 67.2 years, and 33.8% were female. The overall age- and sex-adjusted incidence of IE was 7.9 cases per 100 000 person-years (95% CI, 7.0-8.9), with corresponding rates of 2.4, 2.4, 0.9, and 0.7 per 100 000 person-years for , viridans group streptococci (VGS), species, and coagulase-negative staphylococci IE, respectively. Temporal trends varied by age, sex, and season, but on average IE incidence increased over time ( = .021). Enterococcal IE increased the most ( = .018), while IE appeared to increase but mostly in the winter months ( = .018). Between 1996 and 2018, the incidence of VGS IE was relatively stable, with no statistically significant difference in the trends before and after the 2007 AHA IE prevention guidelines.
Overall, IE incidence, and specifically enterococcal IE, increased over time, while IE was seasonally dependent. There was no statistically significant difference in VGS IE incidence in the periods before and after publication of the 2007 AHA IE prevention guidelines.
在明尼苏达州奥尔姆斯特德县开展的一项基于人群的感染性心内膜炎（IE）研究，为确定较长时间段内IE发病率的时间和季节变化提供了独特机会。
这是一项基于人群的回顾性研究，利用罗切斯特流行病学项目，对1970年1月1日至2018年12月31日期间居住在明尼苏达州奥尔姆斯特德县、患有确诊或可能IE的所有成年人（≥18岁）进行研究。采用泊松回归来描述IE发病率的趋势；模型拟合了年龄、性别、日历时间和季节，考虑到它们效应的非线性和非相加性。
在49年的研究期间，共确定了269例IE病例。IE病例的中位年龄为67.2岁，33.8%为女性。IE的总体年龄和性别调整发病率为每10万人年7.9例（95%CI，7.0 - 8.9），草绿色链球菌（VGS）、 种和凝固酶阴性葡萄球菌IE的相应发病率分别为每10万人年2.4例、2.4例、0.9例和0.7例。时间趋势因年龄、性别和季节而异，但总体而言IE发病率随时间增加（P = 0.021）。肠球菌性IE增加最多（P = 0.018），而 IE似乎增加，但主要在冬季月份（P = 0.018）。1996年至2018年期间，VGS IE的发病率相对稳定，2007年美国心脏协会（AHA）IE预防指南前后的趋势无统计学显著差异。
总体而言，IE发病率，特别是肠球菌性IE，随时间增加，而 IE具有季节依赖性。2007年AHA IE预防指南发布前后，VGS IE发病率无统计学显著差异。
