Abstract 13604: Virulence of Staphylococcus Infection in Surgically Treated Patients With Endocarditis - A Multi-center Analysis

Introduction: Infective endocarditis (IE) caused by Staphylococcus species have been noted to increase and are believed to be associated with higher morbidity and mortality rates. Hypothesis: Staphylococcus species are more virulent compared to other commonly causative bacteria of IE. Methods: The database of the Clinical Multicenter Project for Analysis of Infective Endocarditis in Germany (CAMPAIGN), comprising 4917 consecutive patients (mean age 62.2±14.6 years) undergoing heart valve surgery, was retrospectively analyzed. Uni- and multivariable regression analyses were used for comparison and risk stratification. The Kaplan Meier method was used for long-term survival estimation of the respective groups. Results: Staphylococcus patients (n=1260) were significantly more morbid than the Non-Staphylocccus group (n=3657) with regard to NYHA IV (21.4% vs. 16.7%*), CAD (29.0% vs. 25.7%; p =0.027), arterial hypertension (64.8% vs. 45.8%*), diabetes (29.9% vs. 24.8%*), renal failure (47.5% vs. 35.2%*), COPD (12.8% vs. 9.9%; p =0.007), PAD (11.3% vs. 6.4%*), preoperative stroke (35.1% vs. 18.0%*) and need for mechanical ventilation (18.2% vs. 6.4%*). Overall, Staphylococcus infections were more prevalent on mitral (51.0% vs. 42.0%*) and tricuspid (9.4% vs. 4.4%*) valves and showed higher incidences of large vegetations (87.0% vs. 56.0%*), mitral regurgitation (62.5% vs. 41.5%*) and preoperative septic embolism (51.8% vs. 28.9%*). Postoperatively, need for tracheostomy (13.7% vs. 7.6%*) and dialysis (29.4% vs. 13.6%*) were also significantly increased. The 30-day mortality for Staphylococcus was significantly higher (21.3% vs. 15.9%*) and long-term survival was significantly worse ( Fig. 1 ). Conclusions: Staphylococcus endocarditis is associated with significantly worse outcome compared to IE by other commonly causative bacteria. Early surgery should be considered to avoid preoperative septic embolism, deterioration and death. *= p <0.0001

Prof. Cosey A. Wood (Chicago). - Puerperal Panophthalmitis due to septic Embolism. - (American Journ. Of Obstetrics, 1894, V, p. 635) - Postpartum panophthalmitis due to septic embolism

Little is known about the origin of panophthalmitis in puerperas; even scientists like Playfair and Garrigues set out in their textbooks that a disease, starting from the conjunctiva, penetrates deeply, piercing the vitreous cornea and cornea.

A Rare Case Report of Septic Embolism and Infective Endocarditis due to Nocardia farcinia from North India

Nocardia farcinia endocarditis is an extremely rare phenomenon. It is an opportunistic ubiquitously present pathogen in the environment. Here, we present an unusual case of septic embolism with infective endocarditis due to Nocardia spp. in a 55-year-old chronic alcoholic male. Radiological imaging techniques and microbiological investigations helped in the timely diagnosis. Timely institution of treatment based on sensitivity results resulted in favorable outcome in the patient.