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2026, Number 2

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Enf Infec Microbiol 2026; 46 (2)

Infective endocarditis in Mexico: a literature review and a comparison with recent cases

Escobedo-Sánchez R, Rodríguez-Luna DA, Vázquez-León M, Aguirre-Díaz SA, Esparza-Ahumada S, Pérez-Gómez HR, González-Díaz E, Morfin-Otero R, Jaimes-Bravo RF, Rodríguez-Noriega E

Language: Spanish
References: 38
Page: 66-75
PDF size: 202.58 Kb.


ABSTRACT

background. Infective endocarditis is a significant clinical problem in middle-income countries, where its epidemiological and microbiological characteristics often differ from those reported in international studies. However, information derived from regional registries remains limited.
objective. To compare recent cases of infective endocarditis treated at the Hospital Civil de Guadalajara Fray Antonio Alcalde with previously published Mexican series.
methods. A descriptive, retrospective study was conducted, including cases of infective endocarditis treated between March 1, 2023, and July 1, 2024. Additionally, a narrative review of the literature was performed to comprehensively analyze the available evidence on infective endocarditis, including its historical evolution, epidemiological changes, diagnostic advances, therapeutic strategies, and prognostic factors.
results. A total of 79 cases were reviewed, of which 46 met the modified Duke criteria for infective endocarditis. The mean age was 37.9 years (range: 16-73), with a predominance of males (29 patients, 63%). The most frequent comorbidities were diabetes mellitus in 23 patients (50%), arterial hypertension in 26 (56.5%), and chronic kidney disease in 24 (52.3%). Native valve involvement predominated in 26 cases, prosthetic valve involvement in four cases, and 16 cases were associated with hemodialysis. The isolated pathogens included Staphylococcus aureus in 20 cases, coagulase-negative staphylococci in 11, streptococci in six, Klebsiella pneumoniae in three, Escherichia coli in three, Pseudomonas aeruginosa in one, Enterobacter cloacae in one, and Stenotrophomonas maltophilia in one. Transthoracic echocardiography was performed in 43 patients (93.4%), with vegetations larger than 10 mm identified in 33 cases (76.7%). The most frequently affected valves were the mitral (16 cases), aortic (12), and tricuspid (12). In-hospital mortality was 26% (12 patients).
conclusions. The findings confirm that infective endocarditis in Mexico has undergone a significant epidemiological transition, evolving from a disease primarily associated with streptococci and structural valvular disease to one dominated by Staphylococcus aureus, closely linked to healthcare exposure, comorbidities such as chronic kidney disease, and high-risk populations. Despite advances in diagnostic and therapeutic strategies, mortality remains high, underscoring the importance of timely diagnosis, appropriate risk stratification, and early access to surgical treatment when indicated.


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