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Nosocomial Endocarditis

Published online by Cambridge University Press:  02 January 2015

Gerald Friedland ,
C. Fordam von Reyn ,
Barry Levy ,
Robert Arbeit ,
Priscilla Dasse  and
Clyde Crumpacker
Gerald Friedland*
Affiliation:
Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, Division of Infectious Diseases, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts
C. Fordam von Reyn
Affiliation:
Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, Division of Infectious Diseases, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts
Barry Levy
Affiliation:
Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, Division of Infectious Diseases, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts
Robert Arbeit
Affiliation:
Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, Division of Infectious Diseases, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts
Priscilla Dasse
Affiliation:
Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, Division of Infectious Diseases, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts
Clyde Crumpacker
Affiliation:
Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of Beth Israel Hospital, Division of Infectious Diseases, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston, Massachusetts
*
Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 111 East 210th Street, Bronx, NY 10467
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Abstract

We analyzed 14 cases of nosocomial infective endocarditis which occurred over a seven-year period at the Beth Israel Hospital in Boston, and compared them with 90 cases of community-acquired endocarditis. Patients with nosocomial endocarditis were older, more often female, and had a greater incidence of underlying valvular heart disease and bacteremia precipitating invasive procedures (93% v 50%, P < .05). Forty-three percent of patients had infection at the site of prosthetic valves or intracardiac prosthetic material. The disease carried a significantly higher mortality than community-acquired endocarditis (43% v 11%, P < .01). The clinical presentation was acute and the infecting organisms reflected the site of origin of bacteremia, with staphylococci from skin and enterococci from urinary sources. Half of the cases in this series may have been prevented by the application of currently recommended preventive and therapeutic practices. Nosocomial endocarditis occurs in a definable sub-population of hospitalized patients and is potentially preventable.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 6 , June 1984 , pp. 284 - 288
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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