Epidemiology of Endocarditis, Past and Present

The reported incidence of infective endocarditis (IE) varies worldwide and over time from 3.0 to 15.0/100,000 person-years. The literature shows an increasing trend in IE incidence over the last decades with the most pronounced increment among patients 70–80 years of age. With this increase in incidence, certain patient characteristics are becoming more dominant showing higher frequencies of diabetes mellitus, patients with prosthetic heart valves, dialysis and acquired native heart valve disease relative to the pre-antibiotic era. The sex ratio (men represent two-third of patients) has remained stable, but rheumatic heart disease is now more rarely seen as an underlying condition. Although these changes have occurred there has been little variation in the in-hospital mortality of IE (around 20%). These findings are reported from studies from Europe and the United States and little data are available from other regions.