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Related Concept Videos

Endocarditis I: Introduction01:25

Endocarditis I: Introduction

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Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

Endocarditis II: Clinical Features of Infective Endocarditis

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

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Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
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Endocarditis IV: Nursing Management01:29

Endocarditis IV: Nursing Management

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Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
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Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic01:26

Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic

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Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
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Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

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The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
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Related Experiment Video

Updated: Jan 7, 2026

An In Vitro Model of a Parallel-Plate Perfusion System to Study Bacterial Adherence to Graft Tissues
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Prevalence and Risk Factors for Non-HACEK Gram-negative Bacillus Endocarditis: A Retrospective Analysis.

Jason H Park1, Edwin Chen2, Divyia E Joseph2

  • 1Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

The Canadian Journal of Cardiology
|December 31, 2025
PubMed
Summary

Infective endocarditis (IE) is more common with Serratia marcescens and Pseudomonas aeruginosa bacteremia than Enterobacteriaceae. Risk is highest in patients with injection drug use history and prosthetic valves.

Keywords:
bacteremiadiagnosisechocardiogramendocarditisgram-negative bacilliinjection drug use

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Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Infective endocarditis (IE) from non-HACEK gram-negative bacilli (GNB) presents diagnostic challenges and high mortality.
  • Understanding IE prevalence variations among GNB is crucial for risk stratification.

Purpose of the Study:

  • To characterize IE prevalence in patients with specific GNB bacteremia.
  • To identify risk factors associated with GNB IE.
  • To assess diagnostic echocardiography practices in high-risk patients.

Main Methods:

  • Retrospective cohort study of adult patients with GNB bacteremia (Enterobacter cloacae, Escherichia coli, Klebsiella spp., Pseudomonas aeruginosa, Serratia marcescens) from 2018-2022.
  • Chart review for clinical data, IE risk factors, and IE diagnosis.
  • Analysis of IE prevalence based on GNB species and patient characteristics.

Main Results:

  • 1.2% (82/6678) of patients with GNB bacteremia developed IE.
  • Serratia marcescens and Pseudomonas aeruginosa bacteremia showed higher IE prevalence than Enterobacteriaceae.
  • Injection drug use (IDU) and prosthetic valves significantly increased IE risk (43.1% and 19.5% respectively).

Conclusions:

  • Serratia marcescens and Pseudomonas aeruginosa are associated with higher IE prevalence compared to Enterobacteriaceae.
  • Patients with a history of IDU and prosthetic valves face the most significant risk.
  • Clinical practice shows variability in diagnostic echocardiography use for high-risk GNB IE patients.