Bacteriology

In the study of Levine et al. [27] endocarditis was caused by Staphylococcus aureus in 60.8% of the cases, streptococci in 16.2% of cases, Pseudomonas aeruginosa, in 13.5% of cases, mixed bacteria in 8.1% of cases and Corynebacterium JK in 1.4% of cases. Staphylococcus aureus endocarditis most frequently involved the tricuspid valve and streptococci infected left-sided valves significantly more often than other organisms (p = 0.001). Biventricular and multiple-valve infections were commonest in patients with Pseudomonas endocarditis (p = 0.05). In Miro's Spanish series [26] S. aureus was also the most common etiological agent, usually being sensitive to methicillin (MSSA). HIV-positive IVDU had a higher ratio of right-sided infective endocarditis and S. aureus infective endocarditis than HIV-negative IVDUs and the tricuspid valve was the most frequently affected (60-70%), followed by the mitral and aortic valves (20-30%) [26].

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