Hospital-Acquired Infective Endocarditis

Terpenning, Margaret S.; Buggy, Brian P.; Kauffman, Carol A.

doi:10.1001/archinte.1988.00380070095022

Cited by 95 publications

(24 citation statements)

References 17 publications

(2 reference statements)

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“…Coagulase negative staphylococci are well recognised pathogens in venous access infections, and the reported incidence of these organisms in hospital acquired infective endocarditis ranges from 3–7%,5 7 9 although it is inexplicably high (64%) in the series reported by Terpennning et al 6…”

Section: Discussionmentioning

confidence: 99%

Hospital acquired native valve endocarditis: analysis of 22 cases presenting over 11 years

Lamas

Eykyn

1998

Heart

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Objective-To analyse hospital acquired infective endocarditis cases with respect to age, sex, clinical, laboratory, and echocardiographic features, predisposition, complications, surgery, mortality, and diagnostic criteria. Design-Prospective cohort study. Setting-Teaching hospital. Patients-A series of 200 patients with infective endocarditis presenting over 11 years, 168 with native valve infective endocarditis, of whom 22 acquired this infection in hospital. Results-22 (14%) of the 168 cases of native valve infection were hospital acquired. The most common pathogens were staphylococci (77%). Two thirds of patients had no cardiac predisposition; one third had end stage renal disease. The most common source of infection was vascular access sites (73%). Eleven patients died. In 11 cases, infective endocarditis was proven pathologically (six at necropsy, five during surgery) and analysis of these showed that 45% were classed as probable by the Beth Israel criteria, 73% as definite by the Duke criteria, and 91% as definite by our suggested modifications of the Duke criteria. Figures for the 11 cases not proven pathologically were 27%, 73%, and 91%, respectively. Five of the 22 cases (22%) were rejected by the Beth Israel criteria but none were rejected by the Duke criteria with or without our modifications. Conclusions-Hospital acquired infective endocarditis is diYcult to diagnose. The Duke criteria have improved diagnostic sensitivity and our modifications have improved it further. Mortality is high but has been reduced by surgery. This serious infection could, in many cases, be prevented by improved care of intravascular lines and prompt removal when obviously infected. (Heart 1998;79:442-447)

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Section: Discussionmentioning

confidence: 99%

Hospital acquired native valve endocarditis: analysis of 22 cases presenting over 11 years

Lamas

Eykyn

1998

Heart

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“…All patients with a IVDR BSI must be monitored closely for at least six weeks after completing therapy, especially if they have had high-grade bacteremia or candidemia, to detect late-appearing endocarditis, 38,84,90 retinitis 84,91 or other metastatic infection, such as vertebral osteomyelitis.…”

Section: Anti-infective Therapymentioning

confidence: 99%

Infections in the Neutropenic Patient— New Views of an Old Problem

Donowitz¹,

Maki²,

Crnich³

et al. 2001

Hematology

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Infection in the neutropenic patient has remained a major clinical challenge for over three decades. While diagnostic and therapeutic interventions have improved greatly during this period, increases in the number of patients with neutropenia, changes in the etiologic agents involved, and growing antibiotic resistance have continued to be problematic.The evolving etiology of infections in this patient population is reviewed by Dr. Donowitz. Presently accepted antibiotic regimens and practices are discussed, along with ongoing controversies.In Section II, Drs. Maki and Crnich discuss linerelated infection, which is a major infectious source in the neutropenic. Defining true line-related bloodstream infection remains a challenge despite the fact that various methods to do so exist. Means of prevention of line related infection, diagnosis, and therapy are reviewed.Fungal infection continues to perplex the infectious disease clinician and hematologist/ oncologist. Diagnosis is difficult, and many fungal infections will lead to increased mortality even with rapid diagnosis and therapy. In Section III, Dr. Pappas reviews the major fungal etiologies of infection in the neutropenic patient and the new anti-fungals that are available to treat them.Finally, Dr. Rolston reviews the possibility of outpatient management of neutropenic fever. Recognizing that neutropenics represent a heterogeneous group of patients, identification of who can be treated as an outpatient and with what antibiotics are discussed.

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“…Between 1965 and 1991, more than half of the reported outbreaks of nosocomial bacteremia or candidemia were associated in some manner with intravascular access (37,39). One-third to onehalf of episodes of nosocomial endocarditis have been traced to infected intravascular catheters (21,61). Approximately 250,000 cases of nosocomial intravascular catheter-related bloodstream infections (BSIs) occur in the United States each year, resulting in a mortality of between 12 to 25% with an estimated cost of treatment per episode of approximately $25,000 (35,45).…”

mentioning

confidence: 99%

Using Bacteriophages To Reduce Formation of Catheter-Associated Biofilms byStaphylococcus epidermidis

Curtin

Donlan

2006

Antimicrob Agents Chemother

239

169

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Use of indwelling catheters is often compromised as a result of biofilm formation. This study investigated if hydrogel-coated catheters pretreated with a coagulase-negative bacteriophage would reduce Staphylococcus epidermidis biofilm formation. Biofilms were developed on hydrogel-coated silicone catheters installed in a modified drip flow reactor. Catheter segments were pretreated with the lytic S. epidermidis bacteriophage 456 by exposing the catheter lumen to a 10-log-PFU/ml culture of the bacteriophage for 1 h at 37°C prior to biofilm formation. The untreated mean biofilm cell count was 7.01 ؎ 0.47 log CFU/cm 2 of catheter. Bacteriophage treatment with and without supplemental divalent cations resulted in log-CFU/cm 2 reductions of 4.47 (P < 0.0001) and 2.34 (P ‫؍‬ 0.001), respectively. Divalent cation supplementation without bacteriophage treatment provided a 0.67-log-CFU/cm 2 reduction (P ‫؍‬ 0.053). Treatment of hydrogel-coated silicone catheters with an S. epidermidis bacteriophage in an in vitro model system significantly reduced viable biofilm formation by S. epidermidis over a 24-h exposure period, suggesting the potential of bacteriophage for mitigating biofilm formation on indwelling catheters and reducing the incidence of catheter-related infections.

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Hospital-Acquired Infective Endocarditis

Cited by 95 publications

References 17 publications

Hospital acquired native valve endocarditis: analysis of 22 cases presenting over 11 years

Hospital acquired native valve endocarditis: analysis of 22 cases presenting over 11 years

Infections in the Neutropenic Patient— New Views of an Old Problem

Using Bacteriophages To Reduce Formation of Catheter-Associated Biofilms byStaphylococcus epidermidis

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