Hospital-Acquired Bacterial Endocarditis

Recent awareness of the increasing incidence of hospital-acquired infections is reflected in a large body of medical literature. These experiences have indicated that hospitalization per se carries with it a definite risk of infection. The majority of reports have dealt with postoperative staphylococcal wound infections or postmanipulative urinary tract infections caused by Gram-negative microorganisms. Bacterial endocarditis as a less common manifestation of hospital-acquired infection has received comparatively little comment. Attention was drawn to this complication during review of 85 cases of bacterial endocarditis seen in a Veterans Administration Hospital over a ten-year period. Seventeen patients acquired endocardial infection during hospitalization. Not only does this figure represent an unusually high incidence, but the clinical course and subsequent mortality were such that it was thought worthwhile to review these cases separately and attempt to characterize the natural history of hospital-acquired bacterial endocarditis. Clinical Findings All case records of patients with the diagnosis