Abstract
The outcome of patients developing early bacteremia was investigated in 890 patients following cardiac valve replacement over a ten-year period. Thirty-two patients developed bacteremia during the hospital recovery period from valve replacement (3.6%). Sixty per cent of the organisms involved were gram-negative. Twenty-one of 23 patients had white blood counts greater than 14,000 at the time of positive blood culture. Nine patients died, seven of septic complications. Only two patients developed endocarditis. No patient with bacteremia diagnosed within ten days of surgery developed endocarditis, however two patients developed gram-negative sepsis in this period. The diagnosis and treatment of bacteremia requires continual vigilance if significant mortality and morbidity are to be averted.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Blakemore W. S., McGarrity G. J., Thurer R. J., Wallace H. W., MacVaugh H., 3rd, Coriell L. L. Infection by air-borne bacteria with cardiopulmonary bypass. Surgery. 1971 Dec;70(6):830–838. [PubMed] [Google Scholar]
- Buxton A. E., Anderson R. L., Klimek J., Quintiliani R. Failure of disposable domes to prevent septicemia acquired from contaminated pressure transducers. Chest. 1978 Nov;74(5):508–513. doi: 10.1378/chest.74.5.508. [DOI] [PubMed] [Google Scholar]
- Dismukes W. E., Karchmer A. W., Buckley M. J., Austen W. G., Swartz M. N. Prosthetic valve endocarditis. Analysis of 38 cases. Circulation. 1973 Aug;48(2):365–377. doi: 10.1161/01.cir.48.2.365. [DOI] [PubMed] [Google Scholar]
- GERACI J. E., DALE A. J., McGOON D. C. Bacterial endocarditis and endarteritis following cardiac operations. Wis Med J. 1963 Jul;62:302–315. [PubMed] [Google Scholar]
- Goldmann D. A., Hopkins C. C., Karchmer A. W., Abel R. M., McEnany M. T., Akins C., Buckley M. J., Moellering R. C., Jr Cephalothin prophylaxis in cardiac valve surgery. A prospective, double-blind comparison of two-day and six-day regimens. J Thorac Cardiovasc Surg. 1977 Mar;73(3):470–479. [PubMed] [Google Scholar]
- Kluge R. M., Calia F. M., McLaughlin J. S., Hornick R. B. Sources of contamination in open heart surgery. JAMA. 1974 Dec 4;230(10):1415–1418. [PubMed] [Google Scholar]
- Le Frock J., Ellis C. A., Klainer A. S., Weinstein L. Transient bacteremia associated with barium enema. Arch Intern Med. 1975 Jun;135(6):835–837. doi: 10.1001/archinte.135.6.835. [DOI] [PubMed] [Google Scholar]
- LeFrock J. L., Ellis C. A., Turchik J. B., Weinstein L. Transient bacteremia associated with sigmoidoscopy. N Engl J Med. 1973 Aug 30;289(9):467–469. doi: 10.1056/NEJM197308302890908. [DOI] [PubMed] [Google Scholar]
- Lockey E., Gonzalez-Lavin L., Ray I., Chen R. Bacteraemia after open-heart surgery. Thorax. 1973 Mar;28(2):183–187. doi: 10.1136/thx.28.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MacGregor R. R., Beaty H. N. Evaluation of positive blood cultures. Guidelines for early differentiation of contaminated from valid positive cultures. Arch Intern Med. 1972 Jul;130(1):84–87. [PubMed] [Google Scholar]
- Magilligan D. J., Jr, Quinn E. L., Davila J. C. Bacteremia, endocarditis, and the Hancock valve. Ann Thorac Surg. 1977 Dec;24(6):508–518. doi: 10.1016/s0003-4975(10)63449-2. [DOI] [PubMed] [Google Scholar]
- Masur H., Johnson W. D., Jr Prosthetic valve endocarditis. J Thorac Cardiovasc Surg. 1980 Jul;80(1):31–37. [PubMed] [Google Scholar]
- Myerowitz P. D., Caswell K., Lindsay W. G., Nicoloff D. M. Antibiotic prophylaxis for open-heart surgery. J Thorac Cardiovasc Surg. 1977 Apr;73(4):625–629. [PubMed] [Google Scholar]
- Robinson P. J., Rosen S. M. Pyrexial reactions during haemodialysis. Br Med J. 1971 Mar 6;1(5748):528–530. doi: 10.1136/bmj.1.5748.528. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sande M. A., Johnson W. D., Jr, Hook E. W., Kaye D. Sustained bacteremia in patients with prosthetic cardiac valves. N Engl J Med. 1972 May 18;286(20):1067–1070. doi: 10.1056/NEJM197205182862001. [DOI] [PubMed] [Google Scholar]
- Sullivan N. M., Sutter V. L., Mims M. M., Marsh V. H., Finegold S. M. Clinical aspects of bacteremia after manipulation of the genitourinary tract. J Infect Dis. 1973 Jan;127(1):49–55. doi: 10.1093/infdis/127.1.49. [DOI] [PubMed] [Google Scholar]
- Weinstein R. A., Emori T. G., Anderson R. L., Stamm W. E. Pressure transducers as a source of bacteremia after open heart surgery. Report of an outbreak and guidelines for prevention. Chest. 1976 Mar;69(3):338–344. doi: 10.1378/chest.69.3.338. [DOI] [PubMed] [Google Scholar]