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Hospital-Acquired Infective Endocarditis: Should the Definition Be Broadened?
Ronen Ben-Ami, Michael Giladi, Yehuda Carmeli, Ruth Orni-Wasserlauf and Yardena Siegman-Igra
Clinical Infectious Diseases
Vol. 38, No. 6 (Mar. 15, 2004), pp. 843-850
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4483843
Page Count: 8
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Hospital-acquired infective endocarditis (IE) is a growing health-care problem. Hospital-acquired IE, according to the commonly used definition, is IE manifesting ≥72 h after admission to the hospital or within several weeks after a hospital-based invasive procedure. To assess the validity of this definition, we evaluated 87 episodes of IE, with special attention to recent hospitalizations. The incidence rate of IE in the 6-month period after discharge from the hospital was 27 cases per 100,000 person-years, compared with 1.1 cases per 100,000 person-years in a population with no recent hospitalizations. Furthermore, episodes of IE manifesting during this 6-month period were notable for a high proportion of typically hospital-acquired pathogens (26% vs. 0%; P = .001) and a low proportion of viridans streptococci (0% vs. 36%; P < .001), compared with community-acquired episodes that did not involve recent hospitalization. We conclude that characteristics of hospital-acquired IE extend to episodes arising within 6 months after discharge from the hospital and suggest that the definition of hospital-acquired IE be broadened to include these episodes.
Clinical Infectious Diseases © 2004 Oxford University Press