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Staphylococcal early-onset prosthetic valve endocarditis: a condition bound for surgery.
Antonio de Santis1, Eduardo Cukierkorn2, Flavio Tarasoutchi3
1Heart Valve Disease Division, Heart Institute (InCor), University of São Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, Sp, São Paulo, 05403-000, Brasil. antonio.santis@einstein.br.
BMC Infectious Diseases
|December 18, 2025
Summary
Staphylococcus aureus prosthetic valve endocarditis (SAPVE) significantly increases early-onset prosthetic valve endocarditis mortality. Prosthetic valve replacement improves survival, with most non-operated SAPVE patients dying from septic shock.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Early-onset prosthetic valve endocarditis (EO-PVE) is associated with poor in-hospital outcomes.
- Staphylococcus species are a major concern in EO-PVE due to high mortality rates.
Purpose of the Study:
- To comprehensively evaluate clinical characteristics of staphylococcal EO-PVE.
- To identify predictors of in-hospital mortality in staphylococcal EO-PVE.
Main Methods:
- Retrospective, single-center observational study (1997-2019).
- Analysis of 105 consecutive cases of left-heart staphylococcal EO-PVE.
- Evaluation of clinical data and mortality predictors.
Main Results:
- Coagulase-negative staphylococci (CoNS) PVE predominated (76%) over Staphylococcus aureus (SA) PVE (24%).
- In-hospital mortality was 49%, with SA-PVE having higher mortality (80% vs. 43%).
- SA-PVE was an independent risk factor for mortality (OR 10.2), while valve replacement improved survival (OR 0.2).
Conclusions:
- Staphylococcal EO-PVE, especially SA-PVE, is linked to increased in-hospital mortality.
- Prosthetic valve replacement significantly improves survival in staphylococcal EO-PVE.
- Surgical intervention is critical, as non-operated SA-PVE patients had universal mortality.
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