Epidemiological differences, clinical aspects, and short-term prognosis of patients with healthcare-associated and community-acquired infective endocarditis

Background: The prevalence of healthcare-associated infective endocarditis in Brazil is poorly known. Aim: To analyze the epidemiological, clinical and microbiological characteristics, and the prognosis of healthcare-associated infective endocarditis (HAIE) compared with community-acquired infective endocarditis (CIE) and identify the associated factors with hospital mortality. Method: A historical cohort study was carried out, with a data collection period from January 2009 to December 2019 at the Federal University of Sa similar to o Paulo. Data were collected from medical records of patients with infective endocarditis (IE) hospitalized during the study period. Patients were classified into three groups: CIE, non-nosocomial HAIE (NNHAIE) and nosocomial HAIE (NHAIE). Results: A total of 204 patients with IE were included; of these, 127 (62.3%) were cases of HAIE, of which 83 (40.7%) were NN-HAIE and 44 (21.6%) were NHAIE. Staphylococcus spp. Were the main causative agents, especially in HAIE groups (P<0.001). Streptococcus spp. were more prevalent in the CIE group (P<0.001). In-hospital mortality was 44.6%, with no differences between groups. Independent risk factors for in-hospital mortality were age > 60 years (odds ratio (OR): 6.742), septic shock (OR 5.264), stroke (OR 3.576), heart failure (OR 7.296), and Intensive Care Unit admission (OR 7.768). Conclusion: HAIE accounted for most cases in this cohort, with a higher prevalence of nonnosocomial infections. Staphylococcus spp. were the main causative agents. Hospital mortality was high, 44.6%, with no difference between groups. 2024 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).