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Infected prosthetic heart valves are a common cause of endocarditis, accounting for about a fifth of all cases recorded in one multinational register. Sixty one medical centres in 28 countries contributed to the register, recording details of all cases of infective endocarditis as they came in. Analysis of entries made over the five years up to 2005 found a higher than expected 21% (556/2670) of cases had an infected prosthetic heart valve. Almost half of these patients (272/556) needed surgery. Just over one fifth (127/556) died while in hospital.
Staphylococcus aureus was the leading cause of infected prosthetic valves in this observational study, closely followed by coagulase negative Staphylococcus. About a third of all infections on prosthetic valves were linked to contact with healthcare services (203/556). Of these, 43% were thought to be caused by an intravascular device such as an indwelling catheter. Infections picked up during contact with health services were associated with an increased risk of death (adjusted odds ratio, 1.62, 95% CI 1.08 to 2.44). Other predictors of poor outcome were old age; S aureus infection; and complications such as heart failure, intracardiac abscess, or stroke.