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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
PubMed

Insights

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.

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