Health care-associated native valve endocarditis: importance of non-nosocomial acquisition.

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Benito, Natividad (author)

Health care-associated native valve endocarditis: importance of non-nosocomial acquisition.

Article/chapterEnglish2009

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American College of Physicians,2009

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LIBRIS-ID:oai:gup.ub.gu.se/285402
https://gup.ub.gu.se/publication/285402URI
https://doi.org/10.7326/0003-4819-150-9-200905050-00004DOI

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Language:English

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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The clinical profile and outcome of nosocomial and non-nosocomial health care-associated native valve endocarditis are not well defined.To compare the characteristics and outcomes of community-associated and nosocomial and non-nosocomial health care-associated native valve endocarditis.Prospective cohort study.61 hospitals in 28 countries.Patients with definite native valve endocarditis and no history of injection drug use who were enrolled in the ICE-PCS (International Collaboration on Endocarditis Prospective Cohort Study) from June 2000 to August 2005.Clinical and echocardiographic findings, microbiology, complications, and mortality.Health care-associated native valve endocarditis was present in 557 (34%) of 1622 patients (303 with nosocomial infection [54%] and 254 with non-nosocomial infection [46%]). Staphylococcus aureus was the most common cause of health care-associated infection (nosocomial, 47%; non-nosocomial, 42%; P = 0.30); a high proportion of patients had methicillin-resistant S. aureus (nosocomial, 57%; non-nosocomial, 41%; P = 0.014). Fewer patients with health care-associated native valve endocarditis had cardiac surgery (41% vs. 51% of community-associated cases; P < 0.001), but more of the former patients died (25% vs. 13%; P < 0.001). Multivariable analysis confirmed greater mortality associated with health care-associated native valve endocarditis (incidence risk ratio, 1.28 [95% CI, 1.02 to 1.59]).Patients were treated at hospitals with cardiac surgery programs. The results may not be generalizable to patients receiving care in other types of facilities or to those with prosthetic valves or past injection drug use.More than one third of cases of native valve endocarditis in non-injection drug users involve contact with health care, and non-nosocomial infection is common, especially in the United States. Clinicians should recognize that outpatients with extensive out-of-hospital health care contacts who develop endocarditis have clinical characteristics and outcomes similar to those of patients with nosocomial infection.None.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
Adult
Aged
Ambulatory Care
Community-Acquired Infections
diagnostic imaging
epidemiology
microbiology
Cross Infection
diagnostic imaging
epidemiology
microbiology
Endocarditis
Bacterial
diagnostic imaging
epidemiology
microbiology
Female
Humans
Male
Middle Aged
Prospective Studies
Renal Dialysis
adverse effects
Risk Factors
Treatment Outcome
Ultrasonography

Added entries (persons, corporate bodies, meetings, titles ...)

Miró, José M (author)
de Lazzari, Elisa (author)
Cabell, Christopher H (author)
del Río, Ana (author)
Altclas, Javier (author)
Commerford, Patrick (author)
Delahaye, Francois (author)
Dragulescu, Stefan (author)
Giamarellou, Helen (author)
Habib, Gilbert (author)
Kamarulzaman, Adeeba (author)
Kumar, A Sampath (author)
Nacinovich, Francisco M (author)
Suter, Fredy (author)
Tribouilloy, Christophe (author)
Venugopal, Krishnan (author)
Moreno, Asuncion (author)
Fowler, Vance G (author)
Olaison, Lars,1949Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för infektionssjukdomar,Institute of Biomedicine, Department of Infectious Medicine(Swepub:gu)xolala (author)
Göteborgs universitetInstitutionen för biomedicin, avdelningen för infektionssjukdomar (creator_code:org_t)

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In:Annals of internal medicine: American College of Physicians150:9, s. 586-941539-37040003-4819

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