Hospital-acquired infective endocarditis.
Nosocomial endocarditis occurred in 22 patients who were discharged from a university hospital, a veterans' hospital, and a community hospital during the period of January 1976 to December 1985. Nosocomial episodes were 14.3% of the total endocarditis cases seen. Fourteen (63.6%) of 22 nosocomial endocarditis episodes occurred in patients over the age of 60 years, compared with 39 (29.5%) of 132 episodes of community-acquired endocarditis during the same period. Nosocomial endocarditis was due predominantly to Staphylococcus aureus or coagulase-negative staphylococci (77.4%) and, less often, to streptococci (13.6%). Intravascular devices were the source of bacteremia in ten (45.5%) of the nosocomial endocarditis episodes. The overall mortality rate was 40.9%, 50% in patients over the age of 60 years. Improved care of intravascular devices or prophylaxis before procedures could probably have prevented endocarditis in 12 of the 22 patients.
Terpenning
M S
MS
Department of Internal Medicine, Veterans Administration Medical Center, Ann Arbor, MI 48105.
Buggy
B P
BP
Kauffman
C A
CA
D002408:Catheters, Indwelling / Q000009:adverse effects; D003428:Cross Infection / Q000209:etiology*; D004696:Endocarditis / Q000209:etiology*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013203:Staphylococcal Infections; D013525:Surgical Instruments / Q000009:adverse effects