The Impact of Hospital-Acquired Infections on the Microbial Etiology and Prognosis of Late-Onset Prosthetic Valve Endocarditis

Epidemiology of Infective Endocarditis in Spain in the Last 20 Years

“…17 This trend was confirmed by a Spanish study indicating a fall in early prosthetic endocarditis from 0.94% between 1970 and 1986 to 0.34% between 1987 and 2003. 18 However, Alonso-Valle et al 19 report no change in the incidence of early and late prosthetic endocarditis between 1986 and 2005. The incidence of pacemaker endocarditis and other device endocarditis has increased markedly, 20 representing approximately 3% of cases in the series from Hospital Vall d'Hebron.…”

Contemporary management of prosthetic valve endocarditis: principals and future outlook

“…This infection typically occurs at the sewing ring at the annulus resulting in perivalvular abscess, dehiscence and fistulae [8]. These pathogens are often nosocomial organisms and classically staphylococcal organisms (e.g., Staphylococcus aureus and coagulase-negative staphylococcus species) [9][10][11]. Late PVE (occurring longer than 1 year after surgery) involves infection that is hypothesized to resemble a pathogenesis more consistent with NVE [11].…”

Risk factors and Pathogenesis in the Development of Prosthetic ValveEndocarditis

“…Methicillin-resistant organisms are more frequent in E0-PVE than in L0-PVE.The most common organisms isolated from L0-PVE are streptococci of S.viridans group and Enterococcus spp. In some university-affiliated hospitals, enterococci have surpassed S.viridan organisms and thus are the third most common etiologic agent of PVE [35].Group D streptococci are an emerging cause of infective endocarditis in some European countries particularly in France [4].For rural residents, the frequency of group D streptococcal infective endocarditis was twice as high as that of oral streptococci; it was also higher in mixed rural and urban populations than in urban regions [36]The disparity in the rank order of microbial causes of infective endocarditis between countries is great [36].The cumulative risk of developing PVE is highest within initial 12 months after replacement surgery, with peak during the first 2 months. During the time between implantation and complete endothelialization, patients are vulnerable to PVE.…”

“…Allograft aortic root replacement is valuable technique in the complex setting of PVE with involvement of the periannular region [52] Mortality in PVE. Prognostic factors identified by multivariate analysis is independently associated with higher mortality rate [5].These factors have been completely or partially confirmed by several groups [34,35].The type of valve, the position of the prosthesis, and time of onset of infection have not been identified as independent factors to mortality [5,35].…”