Nosocomial infective endocarditis: should the definition be extended to 6 months after discharge

• Published in: Clinical microbiology and infection Vol. 14; no. 10; pp. 970 - 973
• Main Authors: Peetermans, W.E., Hill, E.E., Herijgers, P, Claus, P, Herregods, M.-C., Verhaegen, J, Vanderschueren, S
• Format: Journal Article
• Language: English
• Published: Oxford, UK Elsevier Ltd 01.10.2008; Blackwell Publishing Ltd; Blackwell
• Subjects: Aged; Biological and medical sciences; Cardiology. Vascular system; Community-acquired; Cross Infection - diagnosis; definition; Endocardial and cardiac valvular diseases; Endocarditis - diagnosis; Female; General aspects; Heart; Human infectious diseases. Experimental studies and models; Humans; Infectious diseases; infective endocarditis; Male; Medical sciences; nosocomial; Staphylococcal Infections - diagnosis; Streptococcal Infections - diagnosis; Time Factors; Community-acquired; definition; infective endocarditis; nosocomial; Nosocomial infection; Community acquired infection; Heart disease; Endocardial disease; Endocarditis; Definition; Cardiovascular disease; Discharge
• ISSN: 1198-743X; 1469-0691
• DOI: 10.1111/j.1469-0691.2008.02057.x

Because the microbiology and patient population of infective endocarditis (IE) have evolved, the traditional definition of nosocomial IE may require revision. The question of whether this definition should be extended to 6 months after discharge was explored, and a high rate of episodes with nosocomial pathogens (coagulase-negative staphylococci) and a low rate of episodes with community pathogens (streptococci) in the extended nosocomial group were found. Therefore, modification of the traditional definition is proposed, distinguishing between early (as traditionally described) and late nosocomial IE (IE in association with a significant invasive procedure performed during a hospitalization between 8 weeks and 6 months before the onset of symptoms).