Objectives: To determinate predictors of morbidity and mortality in children with native infective endocarditis (EI).
Methods: 111 patients (pts) with definitive IE according to the Duke criteria were evaluated.
Two groups of pts were identified according to age: younger than (<) 1 year (21pts) and older than (>)1 year (90pts).
Results: The most common microorganisms in both groups were: staphylococcus aureus. In pts <1 year: candida albicans (p 0.0000003),enterococcus (p 0.003) meanwhile in pts >1 year the second most frequent microorganism was streptococcus viridans (p0.006).
A congenital heart defect was found in 64 pts and no heart lesion was documented in 47.
The localization of the vegetations were predominantly in the right heart in pts <1 year and in the left heart in the older group (p 0.0000001)
Adverse events were diagnosed in 70%. In pts <1 year: uncontrolled infection (p 0.001) related to candida albicans(p 0.001). In the older group: progressive heart failure (p0.003) and systemic embolizations(p0.008).
Overall mortality was 9%. It was greater in the younger group 19% than in the older 6% (p0.07). Eight pts had no previous heart lesion (p0.001), and the microorganism found was a staphylococcus aureus (p0.02)
Conclusions:
Predictors of mortality were:
- Abscence of previous cardiac lesion
- Presence of a staphylococcus aureus.
In pts < 1 year morbidity was related to uncontrolled infection and to the presence of candida albicans. In the older group morbidity was related to progressive heart failure, systemic embolizations and the presence of vegetations in the left heart.