Hospital practices influence the pattern of infective endocarditis

D. E. Dwyer, S. C.A. Chen, E. J. Wright, D. Crimmins, P. J. Collignon, T. C. Sorrell

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Objective: To identify factors contributing to infective endocarditis at a major teaching hospital. Methods: Retrospective review of clinical records of patients diagnosed with endocarditis by standard case definitions with respect to causative organisms, clinical features and outcome. Results: One hundred and ninety-three episodes of endocarditis seen between 1979 and 1992 at Westmead Hospital, Sydney, were reviewed. In the 174 cases where the causative organism was isolated, 75 (43%) were Staphylococcus aureus and 50 (29%) were viridans streptococci. Nosocomial acquisition and/or inter-hospital transfer accounted for 83 episodes; 48 (58%) S. aureus (P < 0.001) and nine (11%) viridans streptococci (P < 0.001). In cases from the local community, viridans streptococci were more common than S. aureus (37% versus 25%); these included 18 episodes (14 S. aureus) in intravenous drug users. Conclusion: We conclude that, compared with community-acquired infections, the aetiology of endocarditis in a large teaching hospital is influenced strongly by the prevalence of nosocomial endocarditis and the need for inter-hospital transfer of complicated cases.

Original languageEnglish
Pages (from-to)709-710+712
JournalThe Medical Journal of Australia
Issue number11
Publication statusPublished - 1 Jan 1994

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