Bacterial Endocarditis Following Cardiac Surgery

Abstract

Intracardiac surgery for rheumatic and congenital heart disease entails direct trauma to both normal and abnormal endocardium. This communication inquires into the incidence and nature of the endocardial infections that develop subsequent to this injury. On the basis of an examination of 2,263 patients operated upon for acquired and congenital heart disease during a 5-year period terminating in November 1955, bacterial endocarditis appears to be an infrequent complication of surgery, is caused by organisms not so commonly encountered in unoperated patients, and is characterized by a clinical pattern quite different from that ordinarily associated with bacterial endocarditis. The rate of attrition in this group of patients is high, and unquestionably is related to the antibiotic resistance of the unusual organisms and the severity of the basic heart disease.

Bacteraemia after open-heart surgery

“…An increasing incidence of Gram-negative infection in hospital practice is now a well-recognized phenomenon and antibiotics undoubtedly contribute to this. The increased incidence of Gram-negative bacillaemias since the introduction of antibacterial agents is reported by Denton et al (1957) and Finland, Jones, and Barnes (1959) while others have recorded rapid Gram-negative colonization of various sites (Redman and Lockey, 1967;Mummery, Bradley, and Jeffries, 1971;Devetski, Tillman, Norsen, and Lepper, 1963;Montgomerie, Doak, Taylor, and North, 1970). The resistance of the patient influences the type of organism.…”

Micrococcus in the blood

“…BACTERAEMIA secondary to endocarditis as a complication of cardiac surgery occurs after some 0.9% of operations (Denton et al, 1957;Lord et al, 1961). The group of organisms most frequently implicated in infections on artificial valves are the coagulase-negative cocci (Braimbridge, 1969), usually Staphylococcus epidermidis (Speller and Mitchell, 1973).…”

Prosthetic valve endocarditis: a review of 24 cases

“…Since the onset of cardiac valve replacement, prosthetic endocarditis shortly after operation has been an important, life-threatening complication (Denton et al, 1957). The incidence was 7-12% (Lord et a!., 1961;Stein et al, 1966) before the introduction of non-wettable sutures; shorter operating times and routine antistaphylococcal antibiotic prophylaxis reduced the rate of infection to 1-2% (Stein et al, 1966).…”