Bajracharya Sohani, Khanal Basudha, Siwakoti Shraddha, Singh Rupa Rajbhandari, Sharma Sanjib Kumar
Department of Microbiology & Infectious Diseases, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan 56700, Sunsari, Nepal.
Department of Pediatrics, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan 56700, Sunsari, Nepal.
Can J Infect Dis Med Microbiol. 2021 Jul 22;2021:9980465. doi: 10.1155/2021/9980465. eCollection 2021.
The microbiological and clinicoepidemiological profile of infective endocarditis (IE) has undergone significant change over time. The pattern of IE studied at local level provides broader vision in understanding the current scenario of this disease. This study aimed to depict the overall picture of IE and its changing profile by evaluating the microbiological and clinicoepidemiological features in the context of a tertiary care center of eastern Nepal.
The descriptive study was conducted from September 2017 to August 2018 among IE patients presenting to B. P. Koirala Institute of Health Sciences, Nepal. Detailed history and clinical manifestations of patients were noted. Microorganisms isolated from the blood culture were processed for identification by standard microbiological methods, and susceptibility testings were done. Each patient was assessed daily during hospital stay.
Ten definite and 7 possible endocarditis cases were studied. The mean age was 41.4 ± 15.85 (17-70) years with predominance of male (4.7 : 1). Rheumatic heart disease (41.1%) was the most common underlying heart disease observed followed by injection drug user endocarditis (23.5%). All the cases had native valve endocarditis. Aortic valve was the most common valve involved (35.3%) followed by mitral, tricuspid, and pulmonary valves. Blood culture positivity was 53%. was the major causative agent responsible for 23.5% of the cases followed by , , and . Mortality of 2 cases (11.8%) was associated with and . Majority of patients developed acute kidney injury (35.3%) and congestive cardiac failure (23.5%).
IE patients in our center exhibited differences from the west in terms of age at presentation and predisposing factors but held similarity in terms of commonly isolated microorganisms. The changing patterns of IE, etiological agents, and their antimicrobial susceptibility observed in this study may be helpful for clinicians in formulating a new empirical antibiotic treatment protocol.
感染性心内膜炎（IE）的微生物学和临床流行病学特征随时间发生了显著变化。在地方层面研究IE的模式有助于更全面地了解该疾病的当前状况。本研究旨在通过评估尼泊尔东部一家三级医疗中心的微生物学和临床流行病学特征，描绘IE的总体情况及其变化特征。
2017年9月至2018年8月，对在尼泊尔BP柯伊拉腊健康科学研究所就诊的IE患者进行了描述性研究。记录患者的详细病史和临床表现。对从血培养中分离出的微生物采用标准微生物学方法进行鉴定，并进行药敏试验。每位患者在住院期间每天进行评估。
研究了10例确诊和7例可能的心内膜炎病例。平均年龄为41.4±15.85（17 - 70）岁，男性占优势（4.7∶1）。风湿性心脏病（41.1%）是观察到的最常见的基础心脏病，其次是注射吸毒者心内膜炎（23.5%）。所有病例均为自体瓣膜心内膜炎。主动脉瓣是最常受累的瓣膜（35.3%），其次是二尖瓣、三尖瓣和肺动脉瓣。血培养阳性率为53%。 是23.5%病例的主要病原体，其次是 、 和 。2例（11.8%）死亡与 和 有关。大多数患者发生急性肾损伤（35.3%）和充血性心力衰竭（23.5%）。
我们中心的IE患者在就诊年龄和易感因素方面与西方存在差异，但在常见分离微生物方面具有相似性。本研究中观察到的IE、病原体及其抗菌药敏的变化模式可能有助于临床医生制定新的经验性抗生素治疗方案。
