a positive trendP <0.001
When looking at specific incidence rate ratio, there was a positive trend of IE incidence rate between 2002 and 2016 ( P <0.001), with annual percent change (APC) of 1.8% (95% CI, 1.7–1.9) across the United States; however, the trend was nonlinear with a decrease of incidence rate ratio between 2002 and 2008, followed by increasing incidence rate ratio between 2009 and 2016.