Cited by 277Infective Endocarditis Diagnosis and ManagementCardiac Valve Diseases and TreatmentsNosocomial Infections in ICU

The DOI matches its Crossref record; 57 of the 58 references it cites were found in a registry or an index.

Health Care–Associated Native Valve Endocarditis: Importance of Non-nosocomial Acquisition

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Benito, Natividad, Miró, José M., de Lazzari, Elisa, Cabell, Christopher H., del Río, Ana, Altclas, Javier, Commerford, Patrick, Delahaye, Francois, Dragulescu, Stefan, Giamarellou, Helen, Habib, Gilbert, Kamarulzaman, Adeeba, Kumar, A. Sampath, Nacinovich, Francisco M., Suter, Fredy, Tribouilloy, Christophe, Venugopal, Krishnan, Moreno, Asuncion, Fowler, Vance G., and the ICE-PCS (International Collaboration on Endocarditis Prospective Cohort Study) Investigators*·2009·Annals of Internal Medicine

Abstract

BACKGROUND: The clinical profile and outcome of nosocomial and non-nosocomial health care-associated native valve endocarditis are not well defined. OBJECTIVE: To compare the characteristics and outcomes of community-associated and nosocomial and non-nosocomial health care-associated native valve endocarditis. DESIGN: Prospective cohort study. SETTING: 61 hospitals in 28 countries. PATIENTS: Patients with definite native valve endocarditis and no history of injection drug use who were enrolled in the ICE-PCS (International Collaboration on Endocarditis Prospective Cohort Study) from June 2000 to August 2005. MEASUREMENTS: Clinical and echocardiographic findings, microbiology, complications, and mortality. RESULTS: Health care-associated native valve endocarditis was present in 557 (34%) of 1622 patients (303 with nosocomial infection [54%] and 254 with non-nosocomial infection [46%]). Staphylococcus aureus was the most common cause of health care-associated infection (nosocomial, 47%; non-nosocomial, 42%; P = 0.30); a high proportion of patients had methicillin-resistant S. aureus (nosocomial, 57%; non-nosocomial, 41%; P = 0.014). Fewer patients with health care-associated native valve endocarditis had cardiac surgery (41% vs. 51% of community-associated cases; P < 0.001), but more of the former patients died (25% vs. 13%; P < 0.001). Multivariable analysis confirmed greater mortality associated with health care-associated native valve endocarditis (incidence risk ratio, 1.28 [95% CI, 1.02 to 1.59]). LIMITATIONS: Patients were treated at hospitals with cardiac surgery programs. The results may not be generalizable to patients receiving care in other types of facilities or to those with prosthetic valves or past injection drug use. CONCLUSION: More than one third of cases of native valve endocarditis in non-injection drug users involve contact with health care, and non-nosocomial infection is common, especially in the United States. Clinicians should recognize that outpatients with extensive out-of-hospital health care contacts who develop endocarditis have clinical characteristics and outcomes similar to those of patients with nosocomial infection. PRIMARY FUNDING SOURCE: None.

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  1. Centers for Disease Control and Prevention (CDC), 2004, MMWR Morb Mortal Wkly Rep, 53, 322

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Authors
Benito, N., Miró, J. M., de Lazzari, E., Cabell, C. H., del Río, A., Altclas, J., Commerford, P., Delahaye, F., Dragulescu, S., Giamarellou, H., Habib, G., Kamarulzaman, A., Kumar, A. S., Nacinovich, F. M., Suter, F., Tribouilloy, C., Venugopal, K., Moreno, A., Fowler, V. G., & and the ICE-PCS (International Collaboration on Endocarditis Prospective Cohort Study) Investigators*
Affiliations
  • Universitat Autònoma de Barcelona (ES)
  • From Hospital de la Santa Creu i Sant Pau, University Autónoma of Barcelona, and Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain; Duke University Medical Center, Durham, North Carolina; Sanatorio Mitre and Instituto Cardiovascular, Buenos Aires, Argentina; Groote Schuur Hospital, Cape Town, South Africa; Hôpital Louis Pradel, Lyon, Faculté de Médecine de Marseille, Marseille, and South Hospital Amiens, Amiens, France;
Venue
Annals of Internal Medicine
Published
2009-05-05
Volume
150
Issue
9
Pages
586-594
ISSN
  • 0003-4819 (ISSN-L)
  • 1539-3704
OpenAlex
W2147390013
Cited by
277
References
58
Citations by year
2026: 3 · 2025: 13 · 2024: 15 · 2023: 17 · 2022: 14 · 2021: 13 · 2020: 15 · 2019: 17 · 2018: 16 · 2017: 18 · 2016: 13 · 2015: 27 · 2014: 16 · 2013: 18 · 2012: 25
FWCI
13.65
Type
journal article
Language
en
Open access
Locations
  • Annals of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • HAL (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • IRIS (submittedVersion)
  • Pure Amsterdam UMC (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
Funders
National Institute of Allergy and Infectious Diseases (R01AI068804)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
Keywords
native valve endocarditis, nosocomial infections, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, mortality, cardiac surgery, infection source identification, echocardiographic findings
MeSH terms
Adult, Aged, Ambulatory Care, Cross Infection, Endocarditis, Bacterial, Female, Renal Dialysis, Humans, Male, Middle Aged, Prospective Studies, Risk Factors, Ultrasonography, Treatment Outcome, Community-Acquired Infections

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