PT  - JOURNAL ARTICLE
AU  - Keys, Thomas F.
TI  - Early-onset prosthetic valve endocarditis
DP  - 1993 Nov 01
TA  - Cleveland Clinic Journal of Medicine
PG  - 455--459
VI  - 60
IP  - 6
4099  - http://www.ccjm.org/content/60/6/455.short
4100  - http://www.ccjm.org/content/60/6/455.full
SO  - Cleve Clin J Med1993 Nov 01; 60
AB  - BACKGROUND Endocarditis following cardiac valve implantation is a rare but serious complication.OBJECTIVE To determine the risk and outcome of early-onset prosthetic valve endocarditis (EO-PVE) in adult patients at The Cleveland Clinic.METHODS Retrospective review of a 5-year case series of patients who acquired bloodstream infections within 60 days of surgery identified through a prospective surveillance program.RESULTS Sixty-eight of approximately 2100 patients acquired bloodstream infections; 16 (24%) contracted EO-PVE and 52 (76%) did not. Risk factors for EO-PVE included younger age, at least three sets of positive blood culture results, and an organism other than a gram-negative bacillus. The majority of patients with EO-PVE had a recognized source of infection (wound or vascular catheter site), but no infections were attributed to a pulmonary or urinary tract site. Eleven patients (69%) were cured, including six who underwent emergent second operations.CONCLUSION Patients with multiple blood cultures positive for organisms other than gram-negative bacilli are at risk of EO-PVE, even when a primary wound infection or vascular catheter site infection is recognized and treated.