Characteristics of Infective Endocarditis in 4 University Hospitals where Staphylococcus aureus is the Most Common Causative Organism

Sung Woo Seo; Tae Hyong Kim; Min Su Hyon; Eun Ju Choo; Min Hyok Jeon; Chul Moon; Dan Song; Jong Hwa Kim; Yong Gwan Lee; Jong Hyo Choi; Woong Jeon; Young Sin Jo; Moon Han Choi

doi:10.3947/ic.2008.40.6.316

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Seo, Kim, Hyon, Choo, Jeon, Moon, Song, Kim, Lee, Choi, Jeon, Jo, and Choi: Characteristics of Infective Endocarditis in 4 University Hospitals where Staphylococcus aureus is the Most Common Causative Organism

Original Article

Infection and Chemotherapy

Infection and Chemotherapy 2008; 40(6): 316-322.

Published online: 31 December 2008

DOI: https://doi.org/10.3947/ic.2008.40.6.316

Characteristics of Infective Endocarditis in 4 University Hospitals where Staphylococcus aureus is the Most Common Causative Organism

Sung Woo Seo, M.D.¹, Tae Hyong Kim, M.D.¹, Min Su Hyon, M.D.¹, Eun Ju Choo, M.D., Min Hyok Jeon, M.D., Chul Moon, M.D.², Dan Song, M.D.², Jong Hwa Kim, M.D.¹, Yong Gwan Lee, M.D.¹, Jong Hyo Choi, M.D.¹, Woong Jeon, M.D.¹, Young Sin Jo, M.D.¹, Moon Han Choi, M.D.¹

¹Department of Internal Medicine, Soon Chun Hyang University, College of Medicine, Seoul, Korea.

²Department of Surgery, Soon Chun Hyang University, College of Medicine, Seoul, Korea.

Correspondence: Tae Hyong Kim, M.D. Division of Infectious Diseases, Department of Internal Medicine, Soon Chun Hyang University Hospital, 22 Daesagwan-gil, Yongsan-gu, Seoul, Korea. Tel: +82-2-709-9029, Fax: +82-2-792-5812, geuncom@hosp.sch.ac.kr

Received 21 August 2008 Accepted 8 October 2008

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

To evaluate whether Staphylococcus aureus is actually the leading cause of infective endocarditis in Korea, investigation on updated clinical pictures, treatments, and prognosis was performed. This study also aims to describe differences in clinical characteristics of infective endocarditis in patients undergoing maintenance hemodialysis.

Materials and Methods

Fifty five patients who were diagnosed with infective endocarditis, using modified Duke criteria, at 4 Soon Chun Hyang University Hospitals (located in Seoul, Bucheon, Cheonan, and Gumi) from January of 2000 to June of 2007 were enrolled. Patients were separated into two groups; those on hemodialysis and those who were not on hemodialysis (control group). Medical records and laboratory results of each patient were reviewed retrospectively.

Results

The positive rate of blood culture was 72.7%. Staphylococcus aureus was isolated in 38.2% of the patients, making it the most common causative organism of infective endocarditis. It was also the most common organism in both hemodialysis group and non-hemodialysis group. Six patients (10.9%) died while admitted to the hospital and the in-hospital death rate for hemodialysis group was significantly higher.

Conclusion

In most parts of the world, S. aureus is increasingly becoming the principal causative organism of infective endocarditis. To our knowledge, this is the first study that shows S. aureus to be the most common causative organism of infective endocarditis in Korea, and that Korea is not except from this global epidemiology.

Keywords: Infective endocarditis, S. aureus, Hemodialysis

Figures and Tables

Table 1

Initial Clinical & Laboratory Characteristics of Infective Endocarditis Patients

Abbreviations : CVC, central venous catheter; WBC, white blood count; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; LDH, lactate dehydrogenase

Table 2

Microbiologic Characteristics of Infective Endocarditis

Abbreviations : MSSA, methicillin-susceptible Staphylococcus aureus; MRSA, methicillin-resistant Staphylococcus aureus

Table 3

Presence and Location of Vegetations among Infective Endocarditis Patients

LV, left ventricle; VSD, ventricular septal defect

Table 4

Causative Organism of Infective Endocarditis

Table 5

Causative Organism of Infective Endocarditis

^*HACEK : Haemophilus species, Actinobacillus actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, Kingella species ^†G(-) : gram negative

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