Contemporary Pattern of Pediatric Infective Endocarditis from Tertiary Care Centre of Northern India: A Single Centre Experience

IF 0.3 Q4 PEDIATRICS Journal of Child Science Pub Date : 2021-01-01 DOI:10.1055/s-0041-1735881
Dinesh Kumar, S. Garg, D. Bhatt
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引用次数: 1

Abstract

Abstract With an increasing number of children with congenital heart disease (CHD) undergoing corrective treatments, improved pediatric intensive care, better antimicrobial treatments, and a relative decrease in rheumatic heart disease over the years, the epidemiology of pediatric infective endocarditis in India may be undergoing a change. The study was done in the department of pediatrics of a tertiary care teaching hospital of North India. A retrospective analysis of case records of children (<12 years) admitted with a diagnosis of infective endocarditis (IE) from January 2013 to April 2019 was performed. Modified Duke's criteria were used to diagnose IE. There were 21 children diagnosed with infective endocarditis during this period. The mean age at presentation was 70 months (range: 2.5–144 months). CHD (n = 13/21, 61.9%) was the most common predisposing condition. A total of 28% (6/21) patients had no preexisting structural heart disease. Nine percent (2/21) had rheumatic heart disease. Staphylococcus aureus was the most common etiological agent in those with a structurally normal heart. Most patients had blood culture–negative infective endocarditis (n = 12, 57.1%). Only one patient fulfilled Duke's major microbiological criteria. Six patients (28.57%) died during the hospital stay. Increasingly younger children are being diagnosed with infective endocarditis in India and a significant number of them are in the setting of a structurally normal heart. In view of high percentage of culture-negative endocarditis, the Duke criteria may need to be revised to retain their sensitivity in such settings.
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印度北部三级护理中心儿童感染性心内膜炎的现代模式:单一中心的经验
随着越来越多的先天性心脏病(CHD)患儿接受矫正治疗,儿科重症监护的改善,更好的抗菌治疗,以及多年来风湿性心脏病的相对减少,印度儿童感染性心内膜炎的流行病学可能正在发生变化。这项研究是在北印度一家三级护理教学医院的儿科进行的。回顾性分析2013年1月至2019年4月诊断为感染性心内膜炎(IE)的儿童(12岁以下)病例记录。采用修改后的Duke标准诊断IE。在此期间有21名儿童被诊断为感染性心内膜炎。平均年龄为70个月(范围:2.5-144个月)。冠心病(n = 13/21, 61.9%)是最常见的易感因素。共有28%(6/21)的患者没有先前存在的结构性心脏病。9%(2/21)患有风湿性心脏病。在结构正常的心脏患者中,金黄色葡萄球菌是最常见的病因。大多数患者有血培养阴性的感染性心内膜炎(n = 12, 57.1%)。只有一名患者符合杜克大学的主要微生物标准。6例患者(28.57%)在住院期间死亡。在印度,越来越多年龄较小的儿童被诊断患有感染性心内膜炎,其中相当多的儿童心脏结构正常。鉴于培养阴性心内膜炎的高比例,杜克标准可能需要修改,以保持其在这种情况下的敏感性。
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