Nosocomial cardiac infections.

Area of Science:

• Cardiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Nosocomial cardiac infections are rare but serious complications, including infective endocarditis and infections of cardiac devices.
• These infections are associated with high morbidity and mortality, particularly in older patients following recent invasive procedures.

Purpose of the Study:

• To review the epidemiology, risk factors, pathogens, diagnosis, and management of nosocomial cardiac infections.
• To highlight the increasing role of Candida species in these infections.

Main Methods:

• Review of literature on nosocomial cardiac infections.
• Analysis of risk factors, implicated pathogens (Staphylococcus aureus, S. epidermidis, Candida spp.), and diagnostic criteria.
• Discussion of therapeutic strategies including antibiotics and surgery.

Main Results:

• Key risk factors include bacteraemia from intravascular devices, genitourinary/gastrointestinal procedures, and surgical site infections.
• Staphylococcus aureus is common in native valve endocarditis, while S. epidermidis dominates foreign body infections.
• Candida species are an increasing cause of nosocomial cardiac infections.

Conclusions:

• Diagnosis is challenging due to patient comorbidities and requires positive blood cultures and transesophageal echocardiography.
• Treatment involves a combination of antibiotics and surgical removal of infected foreign bodies.
• Prophylaxis should focus on preventing and treating bacteraemia and adhering to guidelines for invasive procedures in high-risk individuals.