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Continued efforts needed to prevent infective endocarditis, improve treatment

Issue: October 2011

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CHICAGO — Bacterial infective endocarditis hospitalizations in the United States have significantly increased within the last decade and much of this growth can be attributed to Staphylococcus aureus infection.

“Despite over 100 years of research, bacterial infective endocarditis remains a serious and poorly understood condition,” Jeff Federspiel, MD/PhD-student, of the department of health policy and management at the University of North Carolina, said during a late breaker presentation here. “The infrequency of cases and difficulty of diagnoses have made it difficult to study.”

The researchers pooled data from the 1999-2008 Nationwide Inpatient Sample on hospital admissions in the US (n=83,700) and assessed the characteristics and trends in the epidemiology of infective endocarditis in this patient population. Discharge codes were used to identify admissions associated with infective endocarditis and etiologic organisms.

Infective endocarditis associated admissions increased at an average rate of 1.1% per quarter between 1999 and the first quarter of 2006 (P<.001); rates stabilized thereafter (P=.72).

Overall, S. aureus was the most common organism identified (46%). This was followed by streptococci and/or enterococci (33.3%) and coagulase-negative staphyloccoci (8.3%).

After adjusting for demographic data and comorbidities, S. aureus-associated infective endocarditis was associated with higher in-hospital mortality, greater inpatient charges (difference: $19,280) and extended hospitalizations (difference: 2.26 days) vs. streptococcal/enterococcal infective endocarditis (P< .001 for all).

“S. aureus infective endocarditis is associated with higher costs and worse outcomes compared with other organisms,” Federspiel said. “We believe our analysis underscore the need to continue efforts to prevent infective endocarditis and to improve its treatment.” — by Jennifer Henry

Disclosures: Federspiel reports no relevant financial disclosures.

For more information:

• Federspiel J. #044. Presented at: The 2011 ICAAC; Sept. 17-20; Chicago.

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