Sustained Bacteremia in Patients with Prosthetic Cardiac Valves

Abstract

In 22 patients with prosthetic heart valves, 24 episodes of sustained bacteremia were analyzed to discover criteria that might help differentiate those bacteremias with (11 patients) and those without (13 patients) proved infection of the prosthetic valves. In nine of the patients with prosthetic-valve infection positive blood cultures developed 25 or more days after the operation (median, 60 days), with gram-positive organisms (10 of 11), no obvious source for bacteremia (11 of 11) and new or changing murmurs (10 of 11). The group without proved valvular infection had bacteremia earlier (median, 12 days), with gram-negative bacilli (nine of 13), and had obvious possible sources of bacteremia (12 of 13). Changes in murmurs did not develop.