Buergler Helene, Gregoriano Claudia, Laager Rahel, Mueller Beat, Schuetz Philipp, Conen Anna, Kutz Alexander
Department of Internal Medicine, Cantonal Hospital Aarau, Medical University Clinic, Aarau, Switzerland.
Medical Faculty, University of Basel, Basel, Switzerland.
Clin Infect Dis. 2025 Apr 30;80(4):784-794. doi: 10.1093/cid/ciae582.
The epidemiology of infective endocarditis (IE) is evolving, driven by an aging population and increased use of endovascular devices, and is associated with significant morbidity and mortality. This study aims to evaluate changes in microbiological trends and clinical outcomes in patients with IE over the past decade in Switzerland.
This nationwide cohort study analyzed in-hospital claims data from patients hospitalized with IE in Switzerland between 2012 and 2021. We assessed incidence rates per 100 000 hospitalizations, categorizing them by common pathogens. The outcomes included in-hospital and 6-month mortality, admission to the intensive care unit, and length of hospital stay.
Among 15 255 hospitalizations with IE, the annual number of cases increased from 1361 in 2012 to 1636 in 2021. The most frequently diagnosed pathogens were Staphylococcus aureus (increasing from 19.8% to 30.0%, Ptrend < .01) and Streptococcus species (from 17.6% to 24.4%, Ptrend < .01). Infective endocarditis caused by Staphylococcus aureus was associated with the highest in-hospital (19.9%) and 6-month mortality (30.3%), and intensive care unit admission rates (44.2%), with no relevant changes over time. The longest length of hospital stay was observed in hospitalizations with IE caused by Enterococcus species (mean 23.9 days) and S. aureus (23.8 days).
This nationwide cohort study showed an increase in IE hospitalizations from 2012 to 2021, primarily from S. aureus and Streptococcus species. Predominantly, S. aureus was associated with adverse outcomes that remained consistently high over time compared to other or unidentified pathogens.
受人口老龄化和血管内装置使用增加的推动，感染性心内膜炎（IE）的流行病学正在演变，且与显著的发病率和死亡率相关。本研究旨在评估瑞士过去十年中IE患者微生物学趋势和临床结局的变化。
这项全国性队列研究分析了2012年至2021年期间瑞士因IE住院患者的住院索赔数据。我们评估了每10万次住院的发病率，并按常见病原体进行分类。结局指标包括住院期间及6个月死亡率、入住重症监护病房情况和住院时间。
在15255例IE住院病例中，年病例数从2012年的1361例增加到2021年的1636例。最常诊断出的病原体是金黄色葡萄球菌（从19.8%增至30.0%，趋势P<0.01）和链球菌属（从17.6%增至24.4%，趋势P<0.01）。由金黄色葡萄球菌引起的感染性心内膜炎与最高的住院期间死亡率（19.9%）、6个月死亡率（30.3%）以及重症监护病房入住率（44.2%）相关，且随时间无相关变化。住院时间最长的是由肠球菌属（平均23.9天）和金黄色葡萄球菌（23.8天）引起的IE住院病例。
这项全国性队列研究显示，2012年至2021年期间IE住院病例增加，主要由金黄色葡萄球菌和链球菌属引起。与其他或未明确的病原体相比，金黄色葡萄球菌主要与一直居高不下的不良结局相关。
