Nosocomial infective endocarditis

Nosocomial infective endocarditis (NIE) is a rare complication of nosocomial bacteraemia; however, it is an infection of great importance because of its high mortality and because in many cases it is potentially preventable. Whilst many aspects of NIE are similar to community-acquired infective endocarditis (CIE), there are important differences between the two, most notably the predisposing factors, microbial aetiology and prognosis. The diagnosis of NIE is often difficult as many patients have severe underlying disease and coexistent infection elsewhere. Many of these infections could potentially be prevented by the identification of high risk patients, careful assessment of positive blood cultures and effective treatment of bacteraemia in high risk patients. The use of prophylactic antimicrobials in the prevention of infective endocarditis is unproven, however, it is recommended that prophylaxis be considered for certain invasive hospital-based procedures.