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Multicenter Study
. 2015 Jul;90(7):874-81.
doi: 10.1016/j.mayocp.2015.04.019.

Incidence of Infective Endocarditis Due to Viridans Group Streptococci Before and After the 2007 American Heart Association's Prevention Guidelines: An Extended Evaluation of the Olmsted County, Minnesota, Population and Nationwide Inpatient Sample

Daniel C DeSimone  1 , Imad M Tleyjeh  2 , Daniel D Correa de Sa  3 , Nandan S Anavekar  4 , Brian D Lahr  5 , Muhammad R Sohail  6 , James M Steckelberg  7 , Walter R Wilson  7 , Larry M Baddour  7 ; Mayo Cardiovascular Infections Study Group
Affiliations
Multicenter Study

Incidence of Infective Endocarditis Due to Viridans Group Streptococci Before and After the 2007 American Heart Association's Prevention Guidelines: An Extended Evaluation of the Olmsted County, Minnesota, Population and Nationwide Inpatient Sample

Daniel C DeSimone et al. Mayo Clin Proc. 2015 Jul.

Abstract

Objective: To determine whether the incidence of infective endocarditis (IE) due to viridans group streptococci (VGS) increased after the publication of the 2007 American Heart Association (AHA) IE prevention guidelines.

Patients and methods: We performed a population-based survey of all adults (18 years and older) residing in Olmsted County, Minnesota, from January 1, 1999, through December 31, 2013, to identify definite or possible cases of VGS-IE using the Rochester Epidemiology Project. The National (Nationwide) Inpatient Sample hospital discharge database was examined to determine the number of VGS-IE cases in the United States between 2000 and 2011.

Results: Rates of incidence (per 100,000 person-years) during the intervals of 1999-2002, 2003-2006, 2007-2010, and 2011-2013 were 3.6 (95% CI, 1.3-5.9), 2.7 (95% CI, 0.9-4.4), 0.7 (95% CI, 0.0-1.6), and 1.5 (95% CI, 0.2-2.9), respectively, reflecting an overall significant decrease (P=.03 from Poisson regression). Likewise, nationwide estimates of hospital discharges with a VGS-IE diagnosis trended downward during 2000-2011, with a mean number per year of 15,853 and 16,157 for 2000-2003 and 2004-2007, respectively, decreasing to 14,231 in 2008-2011 (P=.05 from linear regression using weighted least squares method).

Conclusion: Despite major reductions in the number of indications for antibiotic prophylaxis for invasive dental procedures espoused by the 2007 AHA IE prevention guidelines, both local and national data indicate that the incidence of VGS-IE has not increased.

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Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
Temporal trends in age- and sex-adjusted incidence rate of infective endocarditis (IE) caused by viridans group streptococci (VGS) from 1999 to 2013 in Olmsted County, Minnesota.
Figure 2
Figure 2
Total number of hospital discharges in adult patients with ICD-9-CM discharge diagnosis of acute and subacute bacterial endocarditis (421.0), streptococcus unspecified (041.00), and other streptococci (041.09) from 2000 to 2011 from the Nationwide Inpatient Sample.
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References

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