Infective endocarditis in the Czech Republic: eight years of experience at one of the country's largest medical centers.

BACKGROUND AND AIM OF THE STUDY: Limited data have been reported that characterize infective endocarditis (IE) in the Czech Republic. Hence, some local cases of IE were examined to provide a current profile of the disease in Central Europe.

METHODS

A descriptive case series of IE patients seen on all internal medicine services of a major teaching institution in the Czech Republic over an eight-year period was developed.

RESULTS

Prosthetic valves and rheumatic carditis were the underlying predisposing conditions in 18% and 17%, respectively, of all IE episodes. Staphylococcal species were the most common pathogens identified, and were present in 45% of IE episodes. In contrast, streptococcal species were recovered in only 14% of episodes. The proportion of culture-negative endocarditis cases was sizable (18%). The aortic valve was most commonly involved in IE episodes (47%), followed by the mitral valve (33%). The in-hospital mortality rate was 21%.

CONCLUSION

Younger patients, the occurrence of underlying rheumatic carditis, a lack of injection drug use, and an increased frequency of culture-negative infections are unique IE characteristics among Czech patients, as compared to those seen in patients from Western Europe and the United States. The heralded microbiological shift from viridans group streptococci to Staphylococcus aureus may apply to the current study.