{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:15:42Z","timestamp":1784034942748,"version":"3.55.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T00:00:00Z","timestamp":1714608000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009402","name":"Mekelle University","doi-asserted-by":"publisher","award":["CRPO\/MU\/Medium\/CHS\/8\/2019-2021"],"award-info":[{"award-number":["CRPO\/MU\/Medium\/CHS\/8\/2019-2021"]}],"id":[{"id":"10.13039\/501100009402","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nInfective endocarditis (IE) is a continuously evolving disease with a high mortality rate despite different advances in treatment. In Ethiopia, there is a paucity of data regarding IE. Therefore, this study is aimed at assessing IE-related in-hospital mortality and characterization of IE patients based on their microbiological, clinical features, and management profiles in the Ayder Comprehensive Specified Hospital (ACSH).<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nWe conducted a hospital-based prospective follow-up study with all consecutive sampling techniques for suspected infective endocarditis patients admitted to ACSH from January 2020 to February 2022. Echocardiography was performed, and three sets of blood samples for blood culture were taken as per the standard protocol. We also performed isolation of microbial etiologies and antimicrobial susceptibility tests. The data was analyzed using STATA version 16. Stepwise logistic regression was run to identify predictors of in-hospital mortality. Effects were measured through the odds ratio at the 5% level of significance.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nSeventy-four cases of suspected infective endocarditis were investigated; of these, 54 episodes fulfilled modified Duke\u2019s criteria. Rheumatic heart disease (RHD) (85.2%) was the most common underlying heart disease. Murmur (94.4%), fever (68.5%), and pallor (57.4%) were the most common clinical findings. Vegetation was present in 96.3% of episodes. Blood culture was positive only in 7 (13%) episodes. Complications occurred in 41 (75.9%) cases, with congestive heart failure being the most common. All patients were managed medically, with no surgical intervention. The in-hospital mortality was 14 (25.9%). IE-related in-hospital mortality was significantly associated with surgery recommendation and myalgia clinical symptoms.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nIE occurred relatively in a younger population, with RHD as the most common underlying heart disease. There was a high rate of culture-negative endocarditis, and the majority of patients were treated empirically. Mortality was high. The establishment of cardiac surgery and strengthening microbiology services should be given top priority.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0300322","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T17:22:51Z","timestamp":1714670571000},"page":"e0300322","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predictors of infective endocarditis associated in-hospital mortality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia: Microbiological,clinical features, and management profiles"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2795-8046","authenticated-orcid":true,"given":"Hagazi","family":"Tesfay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yemane","family":"Weldu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4556-2579","authenticated-orcid":true,"given":"Mohamedawel Mohamedniguss","family":"Ebrahim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraha","family":"Hailu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-0500","authenticated-orcid":true,"given":"Kibreab","family":"Gidey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teklay","family":"Gebrehaweria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Berhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zekarias","family":"Gessesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagos","family":"Kahsay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mezmur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kidan","family":"Fisseha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aregawi","family":"Haileselassie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemayehu","family":"Bayray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"key":"pone.0300322.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12872-017-0729-5","article-title":"Short-and long-term outcomes in infective endocarditis patients: a systematic review and meta-analysis","volume":"17","author":"TM Abegaz","year":"2017","journal-title":"BMC Cardiovascular Disorders"},{"issue":"3","key":"pone.0300322.ref002","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.ehj.2003.11.008","article-title":"Guidelines on prevention, diagnosis and treatment of infective endocarditis executive summary: the Task Force on Infective Endocarditis of the European Society of Cardiology","volume":"25","author":"D Horstkotte","year":"2004","journal-title":"European heart journal"},{"issue":"2","key":"pone.0300322.ref003","doi-asserted-by":"crossref","first-page":"252","DOI":"10.21037\/cdt.2019.06.03","article-title":"Infective endocarditis in South Africa","volume":"10","author":"AJ Pecoraro","year":"2020","journal-title":"Cardiovascular Diagnosis and Therapy"},{"key":"pone.0300322.ref004","doi-asserted-by":"crossref","DOI":"10.11604\/pamj.2015.20.75.4696","article-title":"Infective endocarditis in Ethiopian children: a hospital based review of cases in Addis Ababa","volume":"20","author":"T Moges","year":"2015","journal-title":"The Pan African Medical Journal"},{"issue":"1","key":"pone.0300322.ref005","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.gheart.2014.01.002","article-title":"Global and regional burden of infective endocarditis, 1990\u20132010: a systematic review of the literature","volume":"9","author":"AAB Abdulhak","year":"2014","journal-title":"Global Heart"},{"key":"pone.0300322.ref006","first-page":"309","article-title":"Guidelines in review: comparison of ESC and AHA guidance for the diagnosis and management of infective endocarditis in adults","author":"Springer","year":"2019","journal-title":"Are the differences clinically relevant? The European perspective"},{"issue":"15","key":"pone.0300322.ref007","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1161\/CIR.0000000000000296","article-title":"Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association","volume":"132","author":"LM Baddour","year":"2015","journal-title":"Circulation"},{"issue":"2","key":"pone.0300322.ref008","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0167-5273(01)00374-6","article-title":"Infective endocarditis in children\u2014incidence, pattern, diagnosis and management in a developing country","volume":"78","author":"M Sadiq","year":"2001","journal-title":"International Journal of cardiology"},{"issue":"1","key":"pone.0300322.ref009","doi-asserted-by":"crossref","first-page":"26","DOI":"10.4103\/jcecho.jcecho_49_17","article-title":"European society of cardiology-proposed diagnostic echocardiographic algorithm in elective patients with clinical suspicion of infective endocarditis: diagnostic yield and prognostic implications in clinical practice","volume":"28","author":"A Barbieri","year":"2018","journal-title":"Journal of Cardiovascular Echography"},{"issue":"2","key":"pone.0300322.ref010","first-page":"64","article-title":"Role of echocardiography in the diagnosis and management of infective endocarditis","volume":"12","author":"H Al Hashimi","year":"2004","journal-title":"Netherlands Heart Journal"},{"issue":"3","key":"pone.0300322.ref011","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1001\/jama.1967.03130160073013","article-title":"Studies on the bacteremia of bacterial endocarditis","volume":"202","author":"W. AS","year":"1967","journal-title":"JAMA: The Journal of the American Medical Association"},{"issue":"1","key":"pone.0300322.ref012","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1016\/S2214-109X(21)00400-9","article-title":"Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis","volume":"10","author":"JJ Noubiap","year":"2022","journal-title":"The Lancet Global Health"},{"key":"pone.0300322.ref013","first-page":"1","article-title":"Clinical features and outcomes of infective endocarditis in Egypt: an 11-year experience at a tertiary care facility","volume":"71","author":"HH Rizk","year":"2019","journal-title":"The Egyptian Heart Journal"},{"issue":"4","key":"pone.0300322.ref014","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.ehj.2013.01.004","article-title":"Study of infective endocarditis in Alexandria main university hospitals","volume":"65","author":"M Sadaka","year":"2013","journal-title":"The Egyptian Heart Journal"},{"issue":"1","key":"pone.0300322.ref015","first-page":"2","article-title":"Clinical features and outcome of infective endocarditis in yemeni patients treated with empirical antibiotic therapy","volume":"11","author":"A-A Khaled","year":"2010","journal-title":"Heart views: the official journal of the Gulf Heart Association"},{"issue":"1","key":"pone.0300322.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2334-11-48","article-title":"Increasing incidence and mortality of infective endocarditis: a population-based study through a record-linkage system","volume":"11","author":"U Fedeli","year":"2011","journal-title":"BMC infectious diseases"},{"issue":"1","key":"pone.0300322.ref017","doi-asserted-by":"crossref","first-page":"77","DOI":"10.4269\/ajtmh.16-0514","article-title":"Infective endocarditis in French West Indies: a 13-year observational study","volume":"97","author":"E Fernandes","year":"2017","journal-title":"The American journal of tropical medicine and hygiene"},{"issue":"8","key":"pone.0300322.ref018","doi-asserted-by":"crossref","first-page":"592","DOI":"10.7196\/SAMJ.2019.v109i8.13888","article-title":"The changing landscape of infective endocarditis in South Africa","volume":"109","author":"C Viljoen","year":"2019","journal-title":"South African Medical Journal"},{"issue":"11","key":"pone.0300322.ref019","first-page":"525","article-title":"Infective endocarditis in childhood: a seven-year experience","volume":"45","author":"W Liew","year":"2004","journal-title":"Singapore medical journal"},{"issue":"2","key":"pone.0300322.ref020","first-page":"63","article-title":"Braunwald\u2019s heart disease: a textbook of cardiovascular medicine","volume":"5","author":"DP Zipes","year":"2018","journal-title":"BMH Medical Journal-ISSN 2348\u2013392X"},{"issue":"2","key":"pone.0300322.ref021","doi-asserted-by":"crossref","first-page":"145","DOI":"10.7196\/SAMJ.2016.v106i2.10327","article-title":"An approach to a patient with infective endocarditis: CME","volume":"106","author":"J Hitzeroth","year":"2016","journal-title":"South African Medical Journal"},{"key":"pone.0300322.ref022","article-title":"The global, regional, and national burden and trends of infective endocarditis from 1990 to 2019: results from the global burden of disease study 2019","volume":"9","author":"H Chen","year":"2022","journal-title":"Frontiers in Medicine"},{"issue":"11","key":"pone.0300322.ref023","doi-asserted-by":"crossref","first-page":"4875","DOI":"10.21037\/jtd.2019.10.45","article-title":"Infective endocarditis: trends, surgical outcomes, and controversies","volume":"11","author":"M Jamil","year":"2019","journal-title":"Journal of Thoracic Disease"},{"issue":"1","key":"pone.0300322.ref024","doi-asserted-by":"crossref","first-page":"27","DOI":"10.21037\/cdt.2016.08.09","article-title":"Epidemiological and mortality trends in infective endocarditis, a 17-year population-based prospective study","volume":"7","author":"A Cresti","year":"2017","journal-title":"Cardiovascular diagnosis and therapy"},{"issue":"11","key":"pone.0300322.ref025","doi-asserted-by":"crossref","first-page":"e0166764","DOI":"10.1371\/journal.pone.0166764","article-title":"Characteristics of infective endocarditis in a tertiary hospital in East China","volume":"11","author":"H Xu","year":"2016","journal-title":"PloS one"},{"issue":"3","key":"pone.0300322.ref026","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1093\/qjmed\/hcg028","article-title":"Infective endocarditis in the Western Cape Province of South Africa: a three\u2010year prospective study","volume":"96","author":"C Koegelenberg","year":"2003","journal-title":"Qjm"},{"issue":"2","key":"pone.0300322.ref027","first-page":"149","article-title":"Patterns and Factors Associated with Cardiovascular Disorders at Ayder Comprehensive Specialized Hospital, Tigrai, Northern Ethiopia","volume":"1","author":"HT Haddish","year":"2019","journal-title":"East African Journal of Health Sciences"},{"issue":"2","key":"pone.0300322.ref028","doi-asserted-by":"crossref","DOI":"10.1136\/heartasia-2016-010829","article-title":"Spectrum of cardiovascular diseases in six main referral hospitals of Ethiopia","volume":"9","author":"D Yadeta","year":"2017","journal-title":"Heart Asia"},{"key":"pone.0300322.ref029","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s15010-012-0285-y","article-title":"Epidemiology, characteristics, and outcome of infective endocarditis in Italy: the Italian Study on Endocarditis","volume":"40","author":"S Leone","year":"2012","journal-title":"Infection"},{"issue":"1","key":"pone.0300322.ref030","doi-asserted-by":"crossref","first-page":"31","DOI":"10.7861\/clinmed.cme.20.1.1","article-title":"Infective endocarditis: A contemporary update","volume":"20","author":"R Rajani","year":"2020","journal-title":"Clinical medicine"},{"issue":"1","key":"pone.0300322.ref031","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-021-06527-4","article-title":"Nosocomial sepsis and drug susceptibility pattern among patients admitted to adult intensive care unit of Ayder Comprehensive Specialized Hospital, Northern Ethiopia","volume":"21","author":"TC Dawit","year":"2021","journal-title":"BMC Infectious Diseases"},{"issue":"1","key":"pone.0300322.ref032","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2334-13-545","article-title":"Profile of infective endocarditis observed from 2003\u20132010 in a single center in Italy","volume":"13","author":"L Ferraris","year":"2013","journal-title":"BMC infectious diseases"},{"issue":"5","key":"pone.0300322.ref033","article-title":"Infective endocarditis: preliminary results of a cohort study in the southern Italian population","volume":"12","author":"N Serra","year":"2020","journal-title":"Cureus"},{"key":"pone.0300322.ref034","article-title":"Clinical and economic burden of hospitalizations for infective endocarditis in the United States","author":"M Alkhouli","year":"2020","journal-title":"Mayo Clinic Proceedings"},{"key":"pone.0300322.ref035","doi-asserted-by":"crossref","first-page":"e359","DOI":"10.1016\/j.ijid.2009.08.022","article-title":"Endocarditis due to Gram-negative bacteria","volume":"14","author":"V Krcmery","year":"2010","journal-title":"International Journal of Infectious Diseases"},{"key":"pone.0300322.ref036","doi-asserted-by":"crossref","first-page":"641243","DOI":"10.3389\/fmed.2021.641243","article-title":"Current challenges in the management of infective endocarditis","volume":"8","author":"G Cuervo","year":"2021","journal-title":"Frontiers in medicine"},{"key":"pone.0300322.ref037","doi-asserted-by":"crossref","first-page":"3075","DOI":"10.1093\/eurheartj\/ehv319","article-title":"The Task Force for the Management of infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). 2015 ESC Guidelines for the management of infective endocarditis","volume":"36","author":"G Habib","year":"2015","journal-title":"Eur Heart J"},{"issue":"2","key":"pone.0300322.ref038","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.ijcard.2003.10.043","article-title":"Characteristics of infective endocarditis in a developing country-clinical profile and outcome in 192 Indian patients, 1992\u20132001","volume":"98","author":"N Garg","year":"2005","journal-title":"International journal of cardiology"},{"issue":"1","key":"pone.0300322.ref039","article-title":"Infective endocarditis following COVID-19 pneumonia: about two cases","volume":"40","author":"A El Ouarradi","year":"2021","journal-title":"Pan African Medical Journal"},{"key":"pone.0300322.ref040","article-title":"Infective endocarditis in Principal Hospital of Dakar: a retrospective study of 42 cases over 10 years","volume":"26","author":"DM Ba","year":"2017","journal-title":"The Pan African Medical Journal"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0300322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T17:23:48Z","timestamp":1714670628000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0300322"}},"subtitle":[],"editor":[{"given":"Andrea","family":"Marino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,5,2]]},"references-count":40,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0300322","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,2]]}}}