Prosthetic valve endocarditis occurring >120 days post-surgery had a lower incidence of resistant microorganisms compared to cases within 120 days (32.3% vs 64.4%; p=0.007).
Cohort (n=172)
The microbiological profile of prosthetic valve endocarditis shifts significantly after 120 days, suggesting the current 365-day definition for early-onset PVE should be shortened.
Absolute Event Rate: 32.3% vs 64.4%
p-value: p=0.007
OBJECTIVE: To determine the annual incidence of prosthetic valve endocarditis (PVE) and to evaluate its current classification based on the epidemiological distribution of agents identified and their sensitivity profiles. METHODS: Consecutive cases of PVE occurring within the first year of valve surgery during the period 1997-2014 were included in this prospective cohort study. Incidence, demographic, clinical, microbiological, and in-hospital mortality data of these PVE patients were recorded. RESULTS: One hundred and seventy-two cases of PVE were included, and the global annual incidence of PVE was 1.7%. Most PVE cases occurred within 120days after surgery (76.7%). After this period, there was a reduction in resistant microorganisms (64.4% vs. 32.3%, respectively; p=0.007) and an increase in the incidence of Streptococcus spp (1.9% vs. 23.5%; p=0.007). A literature review revealed 646 cases of PVE with an identified etiology, of which 264 (41%) were caused by coagulase-negative staphylococci and 43 (7%) by Streptococcus spp. This is in agreement with the current study findings. CONCLUSIONS: Most PVE cases occurred within 120days after valve surgery, and the same etiological agents were identified in this period. The current cut-off level of 365days for the classification of early-onset PVE should be revisited.
Siciliano et al. (2017) conducted a cohort in Prosthetic valve endocarditis (n=172). PVE occurring >120 days after surgery vs. PVE occurring ≤120 days after surgery was evaluated on Incidence of resistant microorganisms (p=0.007). Prosthetic valve endocarditis occurring >120 days post-surgery had a lower incidence of resistant microorganisms compared to cases within 120 days (32.3% vs 64.4%; p=0.007).