The role of microorganisms in acute infectious destruction of heart valves (literature review)

Infectious endocarditis (IE) is a relatively rare disease and was previously most often caused by viridans group streptococci. Due to the slow development of these microorganisms, the condition was termed “subacute bacterial endocarditis”, reflecting its prolonged clinical course ranging from weeks to months for most patients. However, there has been a significant shift in the microbiology of IE in recent years, with an increasing frequency of staphylococci being identified as the predominant pathogens. For IE caused by Staphylococcus aureus, an acute clinical course is characteristic, often accompanied by the development of sepsis. Furthermore, there is an increase in cases of IE caused by enterococci, leading to treatment complexities and unfavorable outcomes. Unlike other infectious and cardiovascular diseases, the high mortality rate associated with IE has not changed over the past decades. Even in specialized medical centers, surgeries performed for IE continue to have the highest mortality rate among all heart valve diseases. Late diagnosis of the disease, prolonged ineffective conservative therapy, irreversible destructive changes, and myocardial reserve depletion primarily contribute to unsatisfactory outcomes of surgical treatment for IE. This review focuses on the main causative agents of IE and their impact on the speed of heart valve destruction.