Nosocomial enterococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteraemia

. Fernández‐Guerrero ML, Herrero L, Bellver M, Gadea I, Roblas RF, de Górgolas M (Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Spain). Nosocomial enterococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteraemia. J Intern Med 2002; 252: 510–515. Objectives. Enterococci are a major leading cause of infectious endocarditis and also a common cause of hospital‐acquired bacteraemia, which is not believed to represent a serious hazard for the endocarditis. The incidence and risk factors for infectious endocarditis in patients with hospital‐acquired enterococcal bacteraemia is determined. Methods. Prospective analysis of 116 patients with enterococcal bacteraemia admitted to medical or surgical wards of a tertiary‐care, university affiliated hospital during a period of 5 years. Echocardiography was performed when indicated by clinical criteria. Results. Seventy‐five (61.4%) episodes were hospital‐acquired and 47 (38.5%) were community‐acquired. Most patients had one or more underlying chronic diseases and major abdominal (58.6%) or genitourinary (38.6%) surgery. Seventeen patients (14.6%) developed enterococcal endocarditis. By univariate analysis the risk factors associated with endocarditis were community‐acquired infection (P 0.012); monomicrobial bacteraemia (P 0.006); three or more positive blood cultures (P