P-934. Emerging Trends and Challenges in Pediatric Infective Endocarditis: Insights from a Single-Center Observational Study

Abstract Background Infective endocarditis (IE) in children is rare but challenging, with an incidence of 0.43–0.69 cases per 100,000 children–year. Risk factors include congenital and acquired heart diseases, as well as healthcare-associated acquisition via prosthetic devices Methods A prospective study was conducted at AIIMS Jodhpur's Department of Medicine from January 2021 to 2024. It included pediatric patients with suspected infective endocarditis (IE). Results In this study, the most common age for pediatric endocarditis was 16-20 years, representing 50% of the patients. Following that, the 11-15 years age group accounted for 20% of cases. Both the 0-5 years and 6-10 years age groups each constituted 15% of the patients. In the study, 65% of pediatric endocarditis cases were male, and 35% were female. Additionally, 60% of patients had a previous heart disease, while 35% did not. For endocarditis type, 15% were prosthetic IE, and 85% were native valve cases. In the study, the mitral valve was most commonly affected, accounting for 65% of pediatric endocarditis cases. The aortic valve was involved in 20% of cases, while the tricuspid valve was affected in 10%. A combination of aortic and pulmonary involvement was observed in 5% of the cases. In the study, culture-negative cases were the most common, accounting for 40% of pediatric endocarditis cases. Following that, both Streptococcus and Burkholderia each represented 15% of the infections. Staph aureus and Libmansack IE were each responsible for 10%, while Acinetobacter baumannii and Bartonella comprised 5% of the cases. In the study, 80% of pediatric endocarditis patients showed improvement, while 20% unfortunately expired. Conclusion This study emphasizes the diagnostic challenges of pediatric IE, with many cases culture-negative and caused by diverse organisms. Predominantly affecting adolescents and those with pre-existing heart conditions, IE in children presents multifaceted complexities, underscoring the need for improved diagnostic and treatment strategies to achieve successful outcomes. Disclosures All Authors: No reported disclosures