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Risk factors for early onset prosthetic valve endocarditis: a case-control study.

R Q Garrido1, B Pessanha2, N Andrade2

  • 1Infection Control Department, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil; Universidade Estácio de Sá, Rio de Janeiro, Brazil; Medical School, Universidade Federal Fluminense, Centro, Niterói, Rio de Janeiro, Brazil.

The Journal of Hospital Infection
|July 21, 2018
PubMed
Summary
This summary is machine-generated.

Early onset prosthetic valve endocarditis (EO-PVE) is linked to postoperative infections and invasive procedures. Reinforcing infection control can help reduce the incidence of this rare complication after cardiac valve surgery.

Keywords:
Cardiac surgeryEarly onset endocarditisNosocomial infectionProsthetic endocarditisProsthetic valveRisk factors

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Surgical Outcomes

Background:

  • Early onset prosthetic valve endocarditis (EO-PVE) is a rare complication following cardiac valve surgery.
  • It is classified as a healthcare-associated infection, often due to prosthesis contamination during surgery or in the early postoperative phase.

Purpose of the Study:

  • To identify factors associated with the development of EO-PVE.
  • To understand the risks contributing to prosthetic valve endocarditis acquisition.

Main Methods:

  • A nested case-control study was conducted between 2006 and 2016.
  • Cases (definite EO-PVE within 12 months of valve replacement) were matched with controls by age, gender, and surgical details.

Main Results:

  • The median incidence of EO-PVE was 1.1% (26 cases out of 2496 surgeries).
  • Intraoperative risk factors included cryoprecipitate and plasma transfusions.
  • Postoperative factors included bloodstream infections, pneumonia, central line use, dialysis catheters, and re-operation, all significantly increasing EO-PVE risk.
  • Mortality at 12 months was substantially higher in cases (34.6%) compared to controls (6.4%).

Conclusions:

  • Patients who developed EO-PVE experienced more infections and invasive procedures postoperatively.
  • These factors likely contributed to the contamination of the prosthetic valve.
  • Implementing enhanced infection control practices is crucial for preventing EO-PVE.