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Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis

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The characteristics of patients with infective endocarditis (IE) vary significantly by region of the world. The aim of this study was to evaluate the contemporary epidemiology, characteristics, and outcome of IE in a large, nationwide cohort of Italian patients.


We conducted a prospective, observational study at 24 medical centers in Italy, including all the consecutive patients with a definite or possible diagnosis of IE (modified Duke criteria) admitted from January 2004 through December 2009. A number of clinical variables were collected through an electronic case report form and analyzed to comprehensively delineate the features of IE. We report the data on patients with definite IE.


A total of 1,082 patients with definite IE were included. Of these, 753 (69.6 %) patients had infection on a native valve, 277 (25.6 %) on a prosthetic valve, and 52 (4.8 %) on an implantable electronic device. Overall, community-acquired (69.2 %) was more common than nosocomial (6.2 %) or non-nosocomial (24.6 %) health care-associated IE. Staphylococcus aureus was the most common pathogen (22.0 %). In-hospital mortality was 15.1 %. From the multivariate analysis, congestive heart failure (CHF), stroke, prosthetic valve infection, S. aureus, and health care-associated acquisition were independently associated with increased in-hospital mortality, while surgery was associated with decreased mortality.


The current mortality of IE remains high, and is mainly due to its complications, such as CHF and stroke.

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The authors declare that they have no competing interests.

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Correspondence to S. Leone.

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For the Italian Study on Endocarditis.



Italian Study on Endocarditis (SEI) investigators Fredy Suter, Marco Rizzi, Veronica Ravasio, Sebastiano Leone (Bergamo), Alberto Biglino, Paolo Crivelli (Asti), Giampiero Carosi, Roberto Stellini, Silvia Magri (Brescia), Peter Mian, Greta Spoladore (Bolzano), Domenico Di Caprio (Caserta), Nicoletta Barzaghi (Cuneo), Angelo Pan (Cremona), Marco Libanore, Mario Pantaleoni (Ferrara), Claudio Viscoli, Valerio Del Bono (Genova), Maria Riccarda Villa (Milano), Gianni Gattuso, Alfredo Scalzini (Mantova), Riccardo Utili, Emanuele Durante-Mangoni, Marie-Françoise Tripodi, Enrico Ragone, Irene Mattucci, Susanna Cuccurullo, Mariano Bernardo, Giovanni Dialetto (Napoli), Elke Erne, Francesco Barbaro (Padova), Laura Stoppini, Benedetta Canovari (Pesaro), Lorenzo Minoli (Pavia), Maria Bruna Pasticci, Laura Martinelli (Perugia), Nicola Petrosillo, Pierangelo Chinello, Mario Venditti, Marco Falcone (Roma), Palma Delle Foglie (Trento), Alberto Vaglia, Pier Giorgio Scotton, Mario Giobbia, Walter Inoiosa (Treviso), Pierluigi Viale, Massimo Crapis (Udine), Paolo Grossi, Daniela Dalla Gasperina, Alessandro Tebini (Varese), Gian Pietro Pellizzer, Roberto Nicolin (Vicenza), Ercole Concia, Paola Del Bravo, Andrea Tedesco (Verona).

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Leone, S., Ravasio, V., Durante-Mangoni, E. et al. Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis. Infection 40, 527–535 (2012).

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