close Icon

Hospital practices influence the pattern of infective endocarditis.

Dwyer DE, Chen SC, Wright EJ, Crimmins D, Collignon PJ, Sorrell TC

  • Journal The Medical journal of Australia

  • Published 07 Jul 1994

  • Volume 160

  • ISSUE 11

  • Pagination 709-13, 716-8


To identify factors contributing to infective endocarditis at a major teaching hospital.

Retrospective review of clinical records of patients diagnosed with endocarditis by standard case definitions with respect to causative organisms, clinical features and outcome.

One hundred and ninety-three episodes of endocarditis seen between 1979 and 1992 at Westmead Hospital, Sydney, were reviewed. In the 174 cases where the causative organism was isolated, 75 (43%) were Staphylococcus aureus and 50 (29%) were viridans streptococci. Nosocomial acquisition and/or inter-hospital transfer accounted for 83 episodes; 48 (58%) S. aureus (P < 0.001) and nine (11%) viridans streptococci (P < 0.001). In cases from the local community, viridans streptococci were more common than S. aureus (37% versus 25%); these included 18 episodes (14 S. aureus) in intravenous drug users.

We conclude that, compared with community-acquired infections, the aetiology of endocarditis in a large teaching hospital is influenced strongly by the prevalence of nosocomial endocarditis and the need for interhospital transfer of complicated cases.