Document Detail


Risk of endocarditis among patients with prosthetic valves and Staphylococcus aureus bacteremia.
MedLine Citation:
PMID:  15745719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Staphylococcus aureus is a common cause of bacteremia and of native valve infective endocarditis. However, the risk of endocarditis in patients with a prosthetic valve who develop S. aureus bacteremia is unclear. The aim of this study was to define the risk of prosthetic valve endocarditis in patients with S. aureus bacteremia. SUBJECTS AND METHODS: All patients with a prosthetic valve or ring who developed S. aureus bacteremia during the 94-month study period were prospectively evaluated. The modified Duke criteria were used for the diagnosis of endocarditis. Patients were followed up for 12 weeks after the initial diagnosis of S. aureus bacteremia. RESULTS: The overall rate of definite prosthetic valve endocarditis among the study patients was 26/51 (51%). The risk of endocarditis was similar in patients with late (>or=12 months after valve implantation) vs. early S. aureus bacteremia (<12 months after prosthetic valve implantation) (50% vs. 52%, P=1.0), mitral vs. aortic prostheses (62% vs. 48%, P=0.24), and mechanical vs. bioprosthetic valves (62% vs. 44%, P=0.29). The 12-week mortality was higher among patients with definite vs. possible endocarditis (62% vs. 28%, P=0.019). CONCLUSION: In this investigation, approximately half of all patients with prosthetic valves who developed S. aureus bacteremia had definite endocarditis. The risk of endocarditis was independent of the type, location, or age of the prosthetic valve. The mortality of prosthetic valve endocarditis is high. All patients with a prosthetic valve who develop S. aureus bacteremia should be aggressively screened and followed for endocarditis.
Authors:
Fadi El-Ahdab; Daniel Kelly Benjamin; Andrew Wang; Christopher H Cabell; Vivian H Chu; Martin E Stryjewski; G Ralph Corey; Daniel J Sexton; L Barth Reller; Vance G Fowler
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  118     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-04     Completed Date:  2005-03-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Descriptor/Qualifier:
Bacteremia / microbiology*
Endocarditis, Bacterial / microbiology*,  mortality
Female
Heart Valve Prosthesis / adverse effects*,  microbiology
Humans
Logistic Models
Male
Middle Aged
Prospective Studies
Prosthesis-Related Infections / microbiology*
Staphylococcal Infections* / mortality
Staphylococcus aureus
Grant Support
ID/Acronym/Agency:
K23 HL70861/HL/NHLBI NIH HHS; R01 AI059111/AI/NIAID NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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