• Heart · Apr 2009

    Multicenter Study Comparative Study

    Coagulase-negative staphylococcal prosthetic valve endocarditis--a contemporary update based on the International Collaboration on Endocarditis: prospective cohort study.

    • V H Chu, J M Miro, B Hoen, C H Cabell, P A Pappas, P Jones, M E Stryjewski, I Anguera, S Braun, P Muñoz, P Commerford, P Tornos, J Francis, M Oyonarte, C Selton-Suty, A J Morris, G Habib, B Almirante, D J Sexton, G R Corey, V G Fowler, and International Collaboration on Endocarditis-Prospective Cohort Study Group.
    • Duke University Medical Center, Durham, NC 27710, USA. chu00009@mc.duke.edu
    • Heart. 2009 Apr 1; 95 (7): 570-6.

    ObjectiveTo describe the contemporary features of coagulase-negative staphylococcal (CoNS) prosthetic valve endocarditis (PVE).DesignObservational study of prospectively collected data from a multinational cohort of patients with infective endocarditis. Patients with CoNS PVE were compared to patients with Staphylococcus aureus and viridans streptococcal (VGS) PVE.SettingThe International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS) is a contemporary cohort of patients with infective endocarditis from 61 centres in 28 countries.PatientsAdult patients in the ICE-PCS with definite PVE and no history of injecting drug use from June 2000 to August 2005 were included.InterventionsNone.Main Outcome MeasuresHeart failure, intracardiac abscess, death.ResultsCoNS caused 16% (n = 86) of 537 cases of definite non-injecting drug use-associated PVE. Nearly one-half (n = 33/69, 48%) of patients with CoNS PVE presented between 60 days and 365 days of valve implantation. The rate of intracardiac abscess was significantly higher in patients with CoNS PVE (38%) than in patients with either S aureus (23%, p = 0.03) or VGS (20%, p = 0.05) PVE. The rate of abscess was particularly high in early (50%) and intermediate (52%) CoNS PVE. In-hospital mortality was 24% for CoNS PVE, 36% for S aureus PVE (p = 0.09) and 9.1% for VGS PVE (p = 0.08). Meticillin resistance was present in 68% of CoNS strains.ConclusionsNearly one-half of CoNS PVE cases occur between 60 days and 365 days of prosthetic valve implantation. CoNS PVE is associated with a high rate of meticillin resistance and significant valvular complications.

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