| Endocarditis complicating central venous catheter bloodstream infections: a unique form of health care associated endocarditis. | |
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MedLine Citation:
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PMID: 20014189 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Endocarditis complicating central venous catheter blood stream infection (CVC-BSI) is a serious complication and is being seen with increasing frequency. METHODS: All patients discharged from our institution with International Classification of Disease (ICD-9) codes of endocarditis and CVC-BSI were identified. The medical records of those meeting our inclusion criteria were reviewed. RESULTS: From October 1, 1998 until December 31, 2006, 24 patients were identified with inpatient mortality of 20.8%. Nine cases were nosocomial and 15 were non-nosocomial. The most common comorbidities were diabetes mellitus (45.8%), chronic kidney disease (58.4%), prior valvular abnormalities (37.5%), and multiple prior hospitalizations (65.2%). There were 13 external lines, 9 tunneled lines, and 2 implantable ports. Responsible microorganisms included Staphylococcus aureus in 54.6%, coagulase-negative staphylococci in 37.5%, Candida species (spp.) in 16.6%, and enterococci in 12.5%. Five cases were polymicrobial. The line tip was within the right atrium (RA) in 37.5%, the superior vena cava (SVC)-RA junction in 20.8%, the SVC in 33.3%, and the pulmonary artery in 4.2% of patients. Sites of endocardial involvement were the aortic valve in 6 patients, mitral valve in 7 patients, tricuspid valve in 6 patients, right atrial wall in 11 patients, and pacemaker wire in 2 patients. Isolated right-sided involvement occurred in 50% of cases, isolated left-sided in 33.4%, and bilateral involvement in 16.6%. Transesophageal echocardiography (TEE) was necessary for diagnosis in 10 cases (41.6%). CONCLUSIONS: Endocarditis complicating CVC-BSI more often involves right-sided structures, with catheter tips in or near the right atrium, frequently requires TEE for diagnosis, and has significant inpatient mortality. |
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Authors:
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Michael P Chrissoheris; Claudia Libertin; Ronan G Ali; Andre Ghantous; Amenuve Bekui; Thomas Donohue |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 32 ISSN: 1932-8737 ISO Abbreviation: Clin Cardiol Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-28 Completed Date: 2010-04-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: E48-54 Citation Subset: IM |
Copyright Information:
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Copyright 2009 Wiley Periodicals, Inc. |
Affiliation:
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Section of Cardiology Hospital of Saint Raphael, New Haven, CT 06511, USA. mchrissoheris@srhs.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
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therapeutic use Bacteremia / etiology* Catheter-Related Infections / complications*, therapy Catheterization, Central Venous / adverse effects* Comorbidity Cross Infection / complications Echocardiography, Transesophageal Endocarditis, Bacterial / complications*, diagnosis, therapy Female Heart Atria / microbiology, ultrasonography Heart Valves / microbiology, ultrasonography Humans Male Middle Aged Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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