[Etiology of bacterial endocarditis in patients with congenital heart defects]

In 90 patients with various congenital heart diseases complicated by bacterial endocarditis multiple inoculations of the blood were practised. In 14 patients microbial cultures were planted postmortem with vegetation on the endocardium, valves and also from the thrombi in the cardiac chambers and from the spleen. In 42.3 per cent of the cases a growth of microorganisms was recorded; a relation between the frequency of the microbial growth and the severity of endocarditis could be then noted. Among the planted microorganisms it was Staphylococcus albus that prevailed and this prompted the authors to consider it to be one of the principal causative agents of bacterial endocarditis in congenital heart diseases at this time. A significant proportion of the isolated microorganisms showed low sensitivity to most antibiotics. A relative frequency of negative hemocultures may be due to the use of antibiotics, the presence of forms "fruste" and indolent of endocarditis, a great variety of causative agents (including 1-forms of the bacteria) and to localization of endocardial lesions to the right heart chambers.