Korean Circ J.  2006 Mar;36(3):236-241. 10.4070/kcj.2006.36.3.236.

Clinical Characteristics of Nosocomial Infective Endocarditis in a Tertiary Referral Hospital

• Yi MZ
• Lee SH
• Park CB
• Kim SD
• Kang SJ
• Song JM
• Kang DH
• Choi SH
• Kim NJ
• Kim YS
• Song JK

• KMID: 2029004
• DOI: http://doi.org/10.4070/kcj.2006.36.3.236

Abstract

BACKGROUND AND OBJECTIVES: Despite case reports of nosocomial infective endocarditis (NIE), the clinical characteristics of the hospital acquired infective endocarditis have not been investigated in Korea.
SUBJECTS AND METHODS
The clinical records of patients with infective endocarditis, treated at Asan Medical Center between January 1989 and December 2003, were retrospectively analyzed.
RESULTS
Of the 309 case of native-valve endocarditis, 17 (5.5%) cases were found to be NIE. The mean age of these 17 patients was 51+/-17 years, which included 9 women and 8 men. Staphylococcus aureus was the most frequent causative organism of NIE in 11 cases (65%), of which nine (82%) had methicillin-resistant strains. The prevalence of right-sided vegetation in NIE was higher than that of community acquired infective endocarditis (CIE)(29 vs. 10%, p<0.05); however, left-sided vegetation was observed in more than 70% of patients with NIE (12/17). Surgeries, with or without wound infection (59%) and insertion of a central venous catheter (29%), were the two most common possible sources of NIE. In hospital mortality was significantly higher in patients with NIE than in those with CIE (47 vs. 11%, p<0.001).
CONCLUSION
Patients with NIE, which comprises a minor portion of those with infective endocarditis, show unique clinical characteristics in terms of causative organisms, risk factors, sites of vegetation and in-hospital mortality.

Keyword

Infective endocarditis; Nosocomial infection

MeSH Terms

Central Venous Catheters
Chungcheongnam-do
Cross Infection
Endocarditis*
Female
Hospital Mortality
Humans
Korea
Male
Methicillin Resistance
Prevalence
Retrospective Studies
Risk Factors
Staphylococcus aureus
Tertiary Care Centers*
Wound Infection