Hospital-Acquired Infective Endocarditis

doi:10.1001/archinte.1988.00380070095022

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Vol. 148 No. 7, July 1988

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Hospital-Acquired Infective Endocarditis

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

Arch Intern Med. 1988;148(7):1601-1603.

Abstract

• Nosocomial endocarditis occurred in 22 patients who weredischarged from a university hospital, a veterans' hospital,and a community hospital during the period of January 1976 toDecember 1985. Nosocomial episodes were 14.3% of the total endocarditiscases seen. Fourteen (63.6%) of 22 nosocomial endocarditis episodesoccurred in patients over the age of 60 years, compared with39 (29.5%) of 132 episodes of community-acquired endocarditisduring the same period. Nosocomial endocarditis was due predominantlyto Staphylococcus aureus or coagulase-negative staphylococci(77.4%) and, less often, to streptococci (13.6%). Intravasculardevices were the source of bacteremia in ten (45.5%) of thenosocomial endocarditis episodes. The overall mortality ratewas 40.9%, 50% in patients over the age of 60 years. Improvedcare of intravascular devices or prophylaxis before procedurescould probably have prevented endocarditis in 12 of the 22 patients.

(Arch Intern Med 1988;148:1601-1603)

Author Affiliations

From the Divisions of Infectious Diseases and Geriatrics, Department of Internal Medicine, Veterans Administration Medical Center and University of Michigan Medical School, Ann Arbor (Drs Terpenning and Kauffman), and the Division of Infectious Diseases and the Department of Internal Medicine, St Luke's Medical Center, Milwaukee (Dr Buggy).

Footnotes

Accepted for publication March 1, 1988.

Reprint requests to Veterans Administration Medical Center,2215 Fuller Rd, Ann Arbor, MI 48105 (Dr Kauffman).

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