Infective Endocarditis in French West Indies: A 13-Year Observational Study

Elisabeth Fernandes Department of Infectious Diseases, Medicine B, Hospital of Basse Terre, Guadeloupe, France;

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Claude Olive Laboratory of Bacteriology, University Hospital of Martinique, Fort-de-France, France;
Université des Antilles, EA 4537, Fort-de-France, France;

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Jocelyn Inamo Department of Cardiology, University Hospital of Martinique, Fort-de-France, France;

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François Roques Department of Thoracic and Cardiovascular Surgery, University Hospital of Martinique, Fort-de-France, France;

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André Cabié Université des Antilles, EA 4537, Fort-de-France, France;
INSERM, CIC1424, Cayenne, France;
Department of Infectious Diseases, University Hospital of Martinique, Fort-de-France, France

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Patrick Hochedez Université des Antilles, EA 4537, Fort-de-France, France;
Department of Infectious Diseases, University Hospital of Martinique, Fort-de-France, France

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We conducted an observational study to describe the characteristics of infective endocarditis (IE) in French West Indies (FWI) and to identify variables associated with in-hospital case fatality. The records of the patients admitted for IE to the University Hospital of Martinique between 2000 and 2012 were collected using an electronic case report form. Only Duke-Li definite cases were considered for this analysis. Variables associated with in-hospital mortality were tested using univariate logistic regression analysis. The analysis included 201 patients (median age 58 years, sex ratio: two males to one female). There was no previously known heart disease in 45.8%, a prosthetic valve in 21.4%, and previously known native valve disease in 32.8% of the cases. Community-acquired IE represented 59.7% of all cases, health-care-associated IE represented 38.3% and injection-drug-use-acquired IE represented 1.5%. Locations of IE were distributed as follows: 42.3% were mitral valve IE, 34.8% were aortic valve IE, and 7% were right-sided IE. Microorganisms recovered from blood cultures included 30.4% streptococci, 28.9% staphylococci, and 5% enterococci. Blood cultures were negative in 20.9% of the cases. Surgical treatment was performed in 53% of the patients. In-hospital case fatality rate was 19%. Advanced age, Staphylococcus aureus IE, and health-care-associated IE were associated with in-hospital case fatality. The epidemiological and microbiological profile of IE in FWI is in between those observed in developed countries and developing countries: patients were younger, blood cultures were more frequently negative, and IE due to group D streptococci and enterococci were less common than in industrialized countries.

Author Notes

Address correspondence to Elisabeth Fernandes, Department of Infectious Diseases, Medicine B, Hospital of Basse Terre, Av. Gaston Feuillard, 97110 Basse Terre, Guadeloupe, France. E-mail: fernandes.elisabeth@free.fr

Authors’ addresses: Elisabeth Fernandes, Department of Infectious Diseases, Medicine B, Hospital of Basse Terre, Guadeloupe, France, E-mails: fernandes.elisabeth@free.fr or elisabeth.fernandes@ch-labasseterre.fr. Claude Olive, Laboratory of Bacteriology, University Hospital of Martinique, Fort-de-France, France, E-mail: claude.olive@chu-fortdefrance.fr. Jocelyn Inamo, Department of Cardiology, University Hospital of Martinique, Fort-de-France, France, E-mail: jocelyn.inamo@chu-fortdefrance.fr. François Roques, Department of Thoracic and Cardiovascular Surgery, University Hospital of Martinique, Fort-de-France, France, E-mail: francois.roques@chu-fortdefrance.fr. André Cabié and Patrick Hochedez, Department of Infectious Diseases, University Hospital of Martinique, Fort-de-France, France, E-mails: andre.cabie@chu-fortdefrance.fr and patrick.hochedez@chu-fortdefrance.fr.

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