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Temporal trends varied by age, sex, and season, but on average IE incidence increased over time ( = .021). Enterococcal IE increased the most ( = .018), while IE appeared to increase but mostly in the winter months ( = .018). Between 1996 and 2018, the incidence of VGS IE was relatively stable, with no statistically significant difference in the trends before and after the 2007 AHA IE prevention guidelines. Overall, IE incidence, and specifically enterococcal IE, increased over time, while IE was seasonally dependent. There was no st
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