Incidence of infective endocarditis caused by viridans group streptococci before and after publication of the 2007 American heart association's endocarditis prevention guidelines

Daniel C. DeSimone, Imad M. Tleyjeh, Daniel D. Correa De Sa, Nandan S. Anavekar, Brian D. Lahr, Muhammad R. Sohail, James M. Steckelberg, Walter R. Wilson, Larry M. Baddour

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Background-The American Heart Association published updated guidelines for infective endocarditis (IE) prevention in 2007 that markedly restricted the use of antibiotic prophylaxis in certain at-risk patients undergoing dental and other invasive procedures. The incidence of IE caused by viridans group streptococci (VGS) in the United States after publication of the 2007 American Heart Association guidelines has not been reported. Methods and Results-We performed a population-based review of all definite or possible cases of VGS-IE using the Rochester Epidemiology Project of Olmsted County, Minnesota. Patient demographics and microbiological data were collected for all VGS-IE cases diagnosed from January 1, 1999, through December 31, 2010. We also examined the Nationwide Inpatient Sample hospital discharge database to determine the number of VGS-IE cases included between 1999 and 2009. We identified 22 cases with VGS-IE in Olmsted County over the 12-year study period. Rates of incidence (per 100 000 person-years) during time intervals of 1999-2002, 2003-2006, and 2007-2010 were 3.19 (95% confidence interval, 1.20 -5.17), 2.48 (95% confidence interval, 0.85- 4.10), and 0.77 (95% confidence interval, 0.00 -1.64), respectively (P=0.061 from Poisson regression). The number of hospital discharges with a VGS-IE diagnosis in the Nationwide Inpatient Sample database during 1999-2002, 2003-2006, and 2007-2009 ranged between 15 318 to 15 938, 16 214 to 17 433, and 14 728 to 15 479, respectively. Conclusions-On the basis of data complete through 2010, there has been no perceivable increase in the incidence of VGS-IE in Olmsted County, Minnesota, since the publication of the 2007 American Heart Association endocarditis prevention guidelines.

Original languageEnglish (US)
Pages (from-to)60-64
Number of pages5
JournalCirculation
Volume126
Issue number1
DOIs
StatePublished - Jul 3 2012

Fingerprint

Viridans Streptococci
American Heart Association
Endocarditis
Publications
Guidelines
Incidence
Confidence Intervals
Inpatients
Databases
Antibiotic Prophylaxis
Tooth
Epidemiology
Demography

Keywords

  • Dental prophylaxis
  • Endocarditis
  • Guidelines
  • Infective endocarditis
  • Prevention

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Incidence of infective endocarditis caused by viridans group streptococci before and after publication of the 2007 American heart association's endocarditis prevention guidelines. / DeSimone, Daniel C.; Tleyjeh, Imad M.; Correa De Sa, Daniel D.; Anavekar, Nandan S.; Lahr, Brian D.; Sohail, Muhammad R.; Steckelberg, James M.; Wilson, Walter R.; Baddour, Larry M.

In: Circulation, Vol. 126, No. 1, 03.07.2012, p. 60-64.

Research output: Contribution to journalArticle

DeSimone, DC, Tleyjeh, IM, Correa De Sa, DD, Anavekar, NS, Lahr, BD, Sohail, MR, Steckelberg, JM, Wilson, WR & Baddour, LM 2012, 'Incidence of infective endocarditis caused by viridans group streptococci before and after publication of the 2007 American heart association's endocarditis prevention guidelines', Circulation, vol. 126, no. 1, pp. 60-64. https://doi.org/10.1161/CIRCULATIONAHA.112.095281
DeSimone, Daniel C. ; Tleyjeh, Imad M. ; Correa De Sa, Daniel D. ; Anavekar, Nandan S. ; Lahr, Brian D. ; Sohail, Muhammad R. ; Steckelberg, James M. ; Wilson, Walter R. ; Baddour, Larry M. / Incidence of infective endocarditis caused by viridans group streptococci before and after publication of the 2007 American heart association's endocarditis prevention guidelines. In: Circulation. 2012 ; Vol. 126, No. 1. pp. 60-64.
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abstract = "Background-The American Heart Association published updated guidelines for infective endocarditis (IE) prevention in 2007 that markedly restricted the use of antibiotic prophylaxis in certain at-risk patients undergoing dental and other invasive procedures. The incidence of IE caused by viridans group streptococci (VGS) in the United States after publication of the 2007 American Heart Association guidelines has not been reported. Methods and Results-We performed a population-based review of all definite or possible cases of VGS-IE using the Rochester Epidemiology Project of Olmsted County, Minnesota. Patient demographics and microbiological data were collected for all VGS-IE cases diagnosed from January 1, 1999, through December 31, 2010. We also examined the Nationwide Inpatient Sample hospital discharge database to determine the number of VGS-IE cases included between 1999 and 2009. We identified 22 cases with VGS-IE in Olmsted County over the 12-year study period. Rates of incidence (per 100 000 person-years) during time intervals of 1999-2002, 2003-2006, and 2007-2010 were 3.19 (95{\%} confidence interval, 1.20 -5.17), 2.48 (95{\%} confidence interval, 0.85- 4.10), and 0.77 (95{\%} confidence interval, 0.00 -1.64), respectively (P=0.061 from Poisson regression). The number of hospital discharges with a VGS-IE diagnosis in the Nationwide Inpatient Sample database during 1999-2002, 2003-2006, and 2007-2009 ranged between 15 318 to 15 938, 16 214 to 17 433, and 14 728 to 15 479, respectively. Conclusions-On the basis of data complete through 2010, there has been no perceivable increase in the incidence of VGS-IE in Olmsted County, Minnesota, since the publication of the 2007 American Heart Association endocarditis prevention guidelines.",
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AU - Correa De Sa, Daniel D.

AU - Anavekar, Nandan S.

AU - Lahr, Brian D.

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