0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Staphylococcus epidermidis Causing Prosthetic Valve Endocarditis: Microbiologic and Clinical Observations as Guides to Therapy

ADOLF W. KARCHMER, M.D.; GORDON L. ARCHER, M.D.; and WILLIAM E. DISMUKES, M.D.
[+] Article and Author Information

Grant support: by Merrell Dow Pharmaceutical Company and grant R01HL19818, National Heart, Lung and Blood Institute (Dr. Archer).

▸Requests for reprints should be addressed to Adolf W. Karchmer, M.D.; Division of Infectious Diseases, New England Deaconess Hospital, 185 Pilgrim Road; Boston, MA 02215.


Boston, Massachusetts; Richmond, Virginia; and Birmingham, Alabama


© 1983 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1983;98(4):447-455. doi:10.7326/0003-4819-98-4-447
Text Size: A A A

Seventy-five episodes of prosthetic valve endocarditis from Staphylococcus epidermidis were studied retrospectively. Methicillin-resistant isolates caused 53 (87%) of 61 infections occurring within 1 year of surgery but only two of the nine after 1 year (p < 0.001). Resistance to methicillin was heterogeneic and extended to the cephalosporins. Of 55 isolates, 43 (78%) were susceptible to gentamicin and all to vancomycin and rifampin. In 55 patients, prosthetic valve endocarditis was complicated by tissue invasion or valve dysfunction. Among these 55 patients, 30 of the 32 who were cured needed surgery. Prosthetic valve endocarditis from methicillin-resistant S. epidermidis was cured in 21 of 26 patients treated with vancomycin and 10 of 20 treated with beta-lactam antibiotic therapy (p = 0.055). Cure rates of patients treated with vancomycin but not betalactam antibiotics were increased by the addition of rifampin or gentamicin to therapy. Prosthetic valve endocarditis from methicillin-resistant S. epidermidis should be treated with vancomycin plus rifampin, or an aminoglycoside. Surgical intervention is important in treating complications of prosthetic valve endocarditis.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)