The Role of Streptococci in Infective Endocarditis

Background and Objectives: Infective endocarditis (IE) is a serious and life-threatening inflammatory disease in which the endocardium (the inner lining of the heart), particularly the heart valves, becomes infected. This condition can lead to severe complications such as heart failure, embolism, and death. Streptococci, especially the viridans group streptococci, are among the most common and significant causative agents of IE. Identifying the risk factors associated with streptococcal endocarditis and gaining a better understanding of the disease’s epidemiology can help improve prevention and treatment strategies. This study aimed to investigate the factors associated with streptococcal infective endocarditis in the studied population and compare the findings with previous research in this field. Specifically, the study sought to determine the prevalence of viridans streptococci as a causative agent of endocarditis and examine the association between demographic and clinical factors and the occurrence of the disease.  Methods: In this cross-sectional study, data were retrospectively collected and analyzed from 100 patients diagnosed with streptococcal infective endocarditis who presented to the hospital during a defined time period. Information collected included demographic factors (age, gender), history of underlying diseases (cardiac diseases, diabetes, kidney disorders), risk factors (intravenous drug use, history of dental procedures), blood culture results, streptococcal species identification, and treatment outcomes. The data were analyzed using appropriate descriptive and analytical statistical methods. Chi- square tests and logistic regression were employed to examine the relationships between variables. A p-value of less than 0.05 was considered statistically significant.  Results: Viridans streptococci were identified as the most common causative agent of infective endocarditis (45%) among the patients studied. Data analysis revealed a statistically significant association between male gender (P=0.05) and history of cardiac disease (P=0.01) with the incidence of streptococcal infective endocarditis. In other words, men and individuals with a history of heart disease were more likely to develop streptococcal endocarditis. Other factors examined, such as age, diabetes, and history of dental procedures, did not show a significant association with the disease.  Conclusion: The findings of this study indicate that viridans streptococci remain the leading cause of infective endocarditis, with male gender and a history of cardiac disease identified as key risk factors. These results highlight the importance of oral hygiene, prevention in at-risk individuals, and early diagnosis and effective antibiotic treatment. Based on these findings, preventive measures should be more rigorously implemented among high-risk groups, particularly men and individuals with a history of cardiac disease. Future research should focus on investigating the potential mechanisms linking gender to endocarditis susceptibility, antibiotic resistance patterns in streptococci, and the evaluation of various prevention and treatment strategies.