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Infective endocarditis in the premature neonate
S A Pearlman1, S Higgins, S Eppes
1Division of Neonatology, Christiana Hospital, Newark, Delaware 19718, USA.
Clinical Pediatrics
|December 29, 1998
Summary
Infective endocarditis (IE) in newborns is rare but potentially fatal. This study found a 4.3% incidence in high-risk neonates, with prompt treatment improving survival rates.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Infectious Diseases
Background:
- Infective endocarditis (IE) is rarely diagnosed in neonates and historically carries a high mortality rate.
- Previous literature suggests a low incidence of IE in newborns.
Purpose of the Study:
- To describe the characteristics and outcomes of infective endocarditis in a cohort of high-risk neonates.
- To determine the incidence and identify common microorganisms and echocardiographic findings in neonatal IE.
Main Methods:
- Retrospective review of 11 high-risk neonates diagnosed with infective endocarditis.
- Analysis of patient demographics, causative microorganisms, echocardiographic findings, and treatment outcomes.
Main Results:
- The incidence of IE in this high-risk neonatal population was 4.3 cases per 100 patients.
- Common pathogens included Gram-positive bacteria (S. aureus, coagulase-negative Staphylococcus) and Gram-negative bacteria (Klebsiella pneumoniae, Enterobacter cloacae).
- Lesion locations were left-sided (4), right-sided (5), and bilateral (2).
Conclusions:
- Infective endocarditis may be more common in high-risk neonates than previously recognized.
- Prompt diagnosis and treatment are crucial for improving survival, achieving a 45% survival rate in this cohort.
- Further prospective studies are needed to confirm the true incidence and identify at-risk neonates.