Incidence and Risk of Developing Fungal Prosthetic Valve Endocarditis after Nosocomial Candidemia
Section snippets
Background
The Cleveland Clinic Foundation (CCF) is a 1,100-bed tertiary referral center with an active cardiothoracic surgical service. The Cardiac Valve Information Registry at CCF is a computerized database that contains information on all open-heart operations performed since 1970. Between 1985 and 1995, 6,661 patients underwent PHV replacement.
Case Definition
A case-patient was defined as any patient with a PHV implant hospitalized at the CCF with one or more blood culture growing yeast between January 1985 and
Results
From January 1, 1985, to April 1, 1995, 53 patients with fungemia in the presence of a prosthetic heart valve were identified. Nine patients were excluded; three had missing charts and in six patients the pathogens were not considered nosocomial (Cryptococcus [3], Histoplasma capsulatum [1], Chaetomium [1], and Saccharomyces [1]). Thus, 44 patients were included in the analysis. Thirty-three (75%) had fungemia without evidence of endocarditis (group 1, no PVE) and seven (16%) had evidence of
Discussion
Incidence rates of bloodstream infections attributable to Candida species have been increasing. The National Nosocomial Infection Survey found a 487% increase in Candida bloodstream infections in large teaching hospitals during the 10-year period 1980 to 1989. [2]A recent review of bloodstream infections in a 900-bed hospital found a 12-fold increase in rates of candidemia during the 12-year study period, mainly due to C. albicans.[3]Thus, the scenario of a patient with a PHV who becomes
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2022, Encyclopedia of Infection and ImmunityCandidemia and invasive candidiasis in adults: A narrative review
2016, European Journal of Internal MedicineCitation Excerpt :Prosthetic valves and short-term indwelling catheters are the more frequent risk factors among patients with a diagnosis of CE [38–43]. A retrospective study by Nasser et al. found that the risk of developing prosthetic valve endocarditis (PVE) after an episode of candidemia was 25% [44]. The patients were diagnosed some time after undergoing valve replacement, which suggests that the pathogenesis of this form of CE may involve two steps: 1) transient post-operative candidemia with colonization of the prosthesis; and 2) the subsequent formation of biofilm and the slow growth of vegetation [44,45].
Candidaemia after heart valve replacement surgery: Recurrence as prosthetic valve endocarditis is an expected over one-year complication
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2013, Revista Iberoamericana de MicologiaCitation Excerpt :Therefore, an echocardiogram is not recommended as routine work-up for all candidemia patients26 at baseline, but it should be considered in patients who have persistent candidemia for more than 72 h. In addition, as patients with prosthetic heart valves who develop candidemia are at notable risk of either having or developing Candida prosthetic valve endocarditis, an echocardiogram is recommended for this patient group at baseline.52 Other risk factors or predisposing conditions for fungal endocarditis in non-neutropenic patients include previous surgery, vascular lines, antibiotic use, and underlying heart disease.9,23,24
Mucocutaneous and Deeply Invasive Candidiasis
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