Infective endocarditis in children:analysis of risk factors and pathogenic feature / 中国小儿急救医学

ABSTRACT

Objective To investigate pediatric infective endocarditis(IE) risk factors and the feature of pathogen.Methods We conducted a retrospective study of 46 cases who were diagnosed as IE from January 2000 to June 2007.Sixteen variables such as sex,primary disease,infectious site,complication,culture result and therapeutic measure were selected for logistic regression analysis.Results Forty-six IE patients accounted for 0.78‰ of all the hospitalized patients during the same period.Of 46 cases,40 had heart diseases.The incidence rate of left-sided endocarditis was higher than that of right-sided endocarditis.Twenty-four had positive blood culture result,one patient had positive culture from vegetation sample.The total positive culture rate was 54%.Gram-positive bacteria were found in 15 cases,and the most common organisms were α-hemolytic streptococcus.Gram-negative bacteria were in 7 cases and fungus infection was present in 3 cases.After antiboitic treatment,40 were cured,6 died.In the logistic regression model,the variables significantly associated with death included negative blood culture (OR=25.127,95%CI=1.110-363.236),hematological system disease (OR=28.620,95%CI=2.261-354.448) and multiple organ failure (OR=19.843,95%CI=0.786-221.754).Conclusion Streptococcus viridans is the most common pathogen in pediatric IE in our hospital.Higher incidence in the left heart than that in the right heart is found.Negative blood culture,hematological system disease and MOF are the risk factors in IE patients.