Infective Endocarditis in the Elderly. Clinical and Bacteriological Features

pp 487-490

Abstract

Objective

This study was performed to determine the clinical and bacteriological features of infective endocarditis in elder patients.

Material and method

We studied patients with infective endocarditis, by means of echocardiographic analysis and according to the Von Reyn and Duke University criteria for diagnosis. One hundred and fourteen patients were divided in two groups: >_ 65 years old (groupI) and < 65 years old (group II). We assessed clinical and bacteriological features of both groups, and compared them. Statistical analysis was performed using the chi-square test and Student's t test, a p value < 0.01 was considered statistically significant.

Results

Twenty-nine patients belonged to group I, and the remaining 115 to group II. Left side disease was more frequent in group I (28 patients, 96.6% vs 86 patients, 74.8%, for groups I and II, respectively), p = 0.0098. Intravenous drug abuse was the main cause of endocarditis in group II (29 patients, 25%) but not in group I (0 patients), p = 0.002. Clinical recovery with medical treatment was similar in both groups (78.26% in group I versus 74% in groupII, p= NS). The responsible germ came from the intestinal flora (S. bovis, E. faecalis, E. coli): 14 patients (48.28%) in group I, compared to 22 patients (19.3%), in group II, p = 0.001.

Conclusions

In the elder patients on risk of infective endocarditis, we have to look for digestive or genitourinary tract disease capable of generating bacteremia and it is indicated to recommend antibiotic prophylaxis if instrumental maneuvers have to be performed in these systems.