Background The epidemiology of infective endocarditis (IE) is evolving, driven by an aging population and increased use of endovascular devices, and is associated with significant morbidity and mortality. This study aims to evaluate changes in microbiological trends and clinical outcomes in patients with IE over the past decade in Switzerland. Methods This nationwide cohort study analyzed in-hospital claims data from patients hospitalized with IE in Switzerland between 2012 and 2021. We assessed incidence rates per 100 000 hospitalizations, categorizing them by common pathogens. The outcomes included in-hospital and 6-month mortality, admission to the intensive care unit, and length of hospital stay. Results Among 15 255 hospitalizations with IE, the annual number of cases increased from 1361 in 2012 to 1636 in 2021. The most frequently diagnosed pathogens were Staphylococcus aureus (increasing from 19.8% to 30.0%, Ptrend < .01) and Streptococcus species (from 17.6% to 24.4%, Ptrend < .01). Infective endocarditis caused by Staphylococcus aureus was associated with the highest in-hospital (19.9%) and 6-month mortality (30.3%), and intensive care unit admission rates (44.2%), with no relevant changes over time. The longest length of hospital stay was observed in hospitalizations with IE caused by Enterococcus species (mean 23.9 days) and S. aureus (23.8 days). Conclusions This nationwide cohort study showed an increase in IE hospitalizations from 2012 to 2021, primarily from S. aureus and Streptococcus species. Predominantly, S. aureus was associated with adverse outcomes that remained consistently high over time compared to other or unidentified pathogens.

中文翻译：

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感染性心内膜炎的微生物学趋势、院内结局和死亡率：一项瑞士全国队列研究


背景 感染性心内膜炎 （IE） 的流行病学在人口老龄化和血管内装置使用增加的推动下不断发展，并与显着的发病率和死亡率相关。本研究旨在评估瑞士过去十年 IE 患者微生物学趋势和临床结果的变化。方法 这项全国性队列研究分析了 2012 年至 2021 年间瑞士 IE 住院患者的院内索赔数据。我们评估了每 100 000 例住院的发病率，并按常见病原体进行分类。结果包括住院和 6 个月死亡率、重症监护病房收治率和住院时间。结果 在 15 255 例 IE 住院患者中，年病例数从 2012 年的 1361 例增加到 2021 年的 1636 例。最常诊断的病原体是金黄色葡萄球菌 （从 19.8% 增加到 30.0%，Ptrend < .01） 和链球菌属 （从 17.6% 增加到 24.4%，Ptrend < .01）。由金黄色葡萄球菌引起的感染性心内膜炎与最高的住院死亡率 （19.9%） 和 6 个月死亡率 （30.3%） 以及重症监护病房入住率 （44.2%） 相关，随着时间的推移没有相关变化。在肠球菌属 （平均 23.9 天） 和金黄色葡萄球菌 （23.8 天） 引起的 IE 住院患者中观察到最长的住院时间。结论 这项全国性队列研究表明，从 2012 年到 2021 年，IE 住院人数有所增加，主要来自金黄色葡萄球菌和链球菌属。主要情况下，金黄色葡萄球菌与不良结局相关，与其他或未识别的病原体相比，这些不良结局随着时间的推移一直保持在较高水平。