Background. The microbiological and clinicoepidemiological profile of infective endocarditis (IE) has undergone significant change over time. The pattern of IE studied at local level provides broader vision in understanding the current scenario of this disease. This study aimed to depict the overall picture of IE and its changing profile by evaluating the microbiological and clinicoepidemiological features in the context of a tertiary care center of eastern Nepal. Methods. The descriptive study was conducted from September 2017 to August 2018 among IE patients presenting to B. P. Koirala Institute of Health Sciences, Nepal. Detailed history and clinical manifestations of patients were noted. Microorganisms isolated from the blood culture were processed for identification by standard microbiological methods, and susceptibility testings were done. Each patient was assessed daily during hospital stay. Results. Ten definite and 7 possible endocarditis cases were studied. The mean age was 41.4 ± 15.85 (17–70) years with predominance of male (4.7 : 1). Rheumatic heart disease (41.1%) was the most common underlying heart disease observed followed by injection drug user endocarditis (23.5%). All the cases had native valve endocarditis. Aortic valve was the most common valve involved (35.3%) followed by mitral, tricuspid, and pulmonary valves. Blood culture positivity was 53%. Staphylococcus aureus was the major causative agent responsible for 23.5% of the cases followed by Enterococcus faecium, Enterococcus faecalis, and Pseudomonas aeruginosa. Mortality of 2 cases (11.8%) was associated with S. aureus and P. aeruginosa. Majority of patients developed acute kidney injury (35.3%) and congestive cardiac failure (23.5%). Conclusion. IE patients in our center exhibited differences from the west in terms of age at presentation and predisposing factors but held similarity in terms of commonly isolated microorganisms. The changing patterns of IE, etiological agents, and their antimicrobial susceptibility observed in this study may be helpful for clinicians in formulating a new empirical antibiotic treatment protocol.

中文翻译：

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尼泊尔东部一个中心的一系列感染性心内膜炎患者的微生物学和临床流行病学特征

背景。随着时间的推移，感染性心内膜炎 (IE) 的微生物学和临床流行病学特征发生了显着变化。在地方一级研究的 IE 模式为了解这种疾病的当前情况提供了更广阔的视野。本研究旨在通过评估尼泊尔东部三级护理中心的微生物学和临床流行病学特征来描绘 IE 的总体情况及其变化情况。方法. 该描述性研究于 2017 年 9 月至 2018 年 8 月在尼泊尔 BP Koirala 健康科学研究所的 IE 患者中进行。记录患者的详细病史和临床表现。从血液培养物中分离出的微生物通过标准微生物学方法进行鉴定，并进行敏感性测试。在住院期间每天对每位患者进行评估。结果. 研究了 10 例确诊和 7 例可能的心内膜炎病例。平均年龄为 41.4 ± 15.85 (17-70) 岁，男性占优势 (4.7:1)。风湿性心脏病（41.1%）是最常见的潜在心脏病，其次是注射吸毒者心内膜炎（23.5%）。所有病例均患有自体瓣膜心内膜炎。主动脉瓣是最常见的瓣膜（35.3%），其次是二尖瓣、三尖瓣和肺动脉瓣。血培养阳性率为 53%。金黄色葡萄球菌是造成 23.5% 病例的主要病原体，其次是粪肠球菌、粪肠球菌和铜绿假单胞菌。2 例 (11.8%) 的死亡率与金黄色葡萄球菌和铜绿假单胞菌。大多数患者出现急性肾损伤（35.3%）和充血性心力衰竭（23.5%）。结论。我们中心的 IE 患者在就诊年龄和诱发因素方面表现出与西方不同，但在常见的分离微生物方面具有相似性。本研究中观察到的 IE、病原体及其抗菌药物敏感性的变化模式可能有助于临床医生制定新的经验性抗生素治疗方案。