The aim of the study was to analyze the epidemiological and clinical changes in EFIE. All definite IE episodes treated at a referral center between 2007 and 2018 were registered prospectively, and a trend test was used to study etiologies over time. EFIE cases were divided into three periods, and clinical differences between them were analyzed. All episodes of E. faecalis monomicrobial bacteremia (EFMB) between 2010 and 2018 and the percentage of echocardiograms performed were retrospectively collected. Six hundred forty-eight IE episodes were studied. We detected an increase in the percentage of EFIE (15% in 2007, 25.3% in 2018, P = 0.038), which became the most prevalent causative agent of IE during the last study period. One hundred and eight EFIE episodes were analyzed (2007–2010, n = 30; 2011–2014, n = 22; 2015–2018, n = 56). The patients in the last period were older (median 70.9 vs 66.5 vs 76.3 years, P = 0.015) and more frequently had an abdominal origin of EFIE (20% vs 13.6% vs 42.9%, P = 0.014), fewer indications for surgery (63.3% vs 54.6% vs 32.1%, P = 0.014), and non-significantly lower in-hospital mortality (30% vs 18.2% vs 12.5%, P = 0.139). There was an increase in the percentage of echocardiograms performed in patients with EFMB (30% in 2010, 51.2% in 2018, P = 0.014) and EFIE diagnoses (15% in 2010, 32.6% in 2018, P = 0.004). E. faecalis is an increasing cause of IE in our center, most likely due to an increase in the percentage of echocardiograms performed. The factors involved in clinical changes in EFIE should be thoroughly studied.

该研究的目的是分析 EFIE 的流行病学和临床变化。2007 年至 2018 年期间在转诊中心治疗的所有确定的 IE 发作都进行了前瞻性登记，并使用趋势检验来研究一段时间内的病因。EFIE病例分为三个时期，分析临床差异。回顾性收集了 2010 年至 2018 年间粪肠球菌单一微生物菌血症 (EFMB) 的所有事件以及所进行的超声心动图百分比。研究了 648 个 IE 剧集。我们发现 EFIE 的百分比有所增加（2007 年为 15%，2018 年为 25.3%，P = 0.038)，在上一个研究期间成为 IE 最普遍的病原体。分析了 108 次 EFIE 事件（2007-2010，n  = 30；2011-2014，n  = 22；2015-2018，n  = 56）。最后一个时期的患者年龄较大（中位数为 70.9 岁 vs 66.5 岁 vs 76.3 岁，P  = 0.015）并且更常发生腹部 EFIE（20% vs 13.6% vs 42.9%，P  = 0.014），手术指征较少（ 63.3% vs 54.6% vs 32.1%，P  = 0.014），并且住院死亡率没有显着降低（30% vs 18.2% vs 12.5%，P  = 0.139）。EFMB 患者进行超声心动图的百分比有所增加（2010 年为 30%，2018 年为 51.2%，P  = 0.014）和 EFIE 诊断（2010 年为 15%，2018 年为 32.6%，P  = 0.004）。E. faecalis是我们中心 IE 的一个增加的原因，很可能是由于执行的超声心动图的百分比增加。应彻底研究涉及 EFIE 临床变化的因素。