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.
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: Kati Seidl; Arnold S Bayer; Vance G Fowler; James A McKinnell; Wessam Abdel Hady; George Sakoulas; Michael R Yeaman; Yan Q Xiong Journal: Antimicrob Agents Chemother Date: 2010-11-22 Impact factor: 5.191
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Authors: Rasmus V Rasmussen; Ulla Høst; Magnus Arpi; Christian Hassager; Helle K Johansen; Eva Korup; Henrik C Schønheyder; Jens Berning; Sabine Gill; Flemming S Rosenvinge; Vance G Fowler; Jacob E Møller; Robert L Skov; Carsten T Larsen; Thomas F Hansen; Shan Mard; Jesper Smit; Paal S Andersen; Niels E Bruun Journal: Eur J Echocardiogr Date: 2011-06
Authors: N J Verkaik; H A Boelens; C P de Vogel; M Tavakol; L G M Bode; H A Verbrugh; A van Belkum; W J B van Wamel Journal: Eur J Clin Microbiol Infect Dis Date: 2010-02-26 Impact factor: 3.267
Authors: Yan Q Xiong; Vance G Fowler; Michael R Yeaman; Francoise Perdreau-Remington; Barry N Kreiswirth; Arnold S Bayer Journal: J Infect Dis Date: 2009-01-15 Impact factor: 5.226