(Circulation. 2000;102:2842.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Risk Factors for Infective Endocarditis
Oral Hygiene and Nondental Exposures
From the Department of Biostatistics and Epidemiology and Center for Clinical Epidemiology and Biostatistics (B.L.S., E.A., J.A.B., J.L.K.) and Division of General Internal Medicine (B.L.S.), Schools of Medicine and Dental Medicine (R.S.F.), University of Pennsylvania, Philadelphia, Pa; Department of Medicine (E.A., M.E.L., O.M.K., D.K.), MCP Hahnemann School of Medicine, Philadelphia, Pa; Veterans Affairs Medical Center (R.S.F.), Philadelphia, Pa; and Department of Epidemiology and Preventive Medicine (P.D.S.), University of Maryland, Baltimore, Md.
Correspondence to Brian L. Strom, MD, MPH, Room 824 Blockley Hall, University of Pennsylvania, Philadelphia, PA 19104-6021. E-mail Bstrom{at}cceb.med.upenn.edu
Background—The risks of infective endocarditis (IE) associated with various conditions and procedures are poorly defined.
Methods and Results—This was a population-based case-control study conducted in 54 Philadelphia, Pa–area hospitals from 1988 to 1990. Community-acquired IE cases unassociated with intravenous drug use were compared with matched community residents. Subjects were interviewed for risk factors. Diagnoses were confirmed by expert review of medical record abstracts with risk factor data removed. Cases were more likely than controls to suffer from prior severe kidney disease (adjusted OR [95% CI]=16.9 [1.5 to 193], P=0.02) and diabetes mellitus (adjusted OR [95% CI]=2.7 [1.4 to 5.2], P=0.004). Cases infected with skin flora had received intravenous fluids more often (adjusted OR [95% CI]=6.7 [1.1 to 41], P=0.04) and had more often had a previous skin infection (adjusted OR [95% CI]=3.5 [0.7 to 17], P=0.11). No association was seen with pulmonary, gastrointestinal, cardiac, or genitourinary procedures or with surgery. Edentulous patients had a lower risk of IE from dental flora than patients who had teeth but did not floss. Daily flossing was associated with a borderline decreased IE risk.
Conclusions—Within the limits of the available sample size, the data showed that IE patients differ from people without IE with regard to certain important risk factors but not regarding recent procedures.
Key Words: endocarditis • heart diseases • infection
This article has been cited by other articles:
 |
|
 |
|
  N. Brooks Prophylactic antibiotic treatment to prevent infective endocarditis: new guidance from the National Institute for Health and Clinical Excellence Heart, May 1, 2009; 95(9): 774 - 780. [Full Text] [PDF]
|
|
|
|
 |
|
 W. Wilson, K. A. Taubert, M. Gewitz, P. B. Lockhart, L. M. Baddour, M. Levison, A. Bolger, C. H. Cabell, M. Takahashi, R. S. Baltimore, et al. Prevention of Infective Endocarditis: Guidelines From the American Heart Association: A Guideline From the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group Circulation, October 9, 2007; 116(15): 1736 - 1754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Kato, K. Tajima, S. Terasawa, K. Tanaka, A. Usui, and Y. Ueda Results of Isolated Valve Replacement in Hemodialysis Patients Asian Cardiovasc Thorac Ann, October 1, 2007; 15(5): 386 - 391. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Nucifora, L. P. Badano, P. Viale, P. Gianfagna, G. Allocca, D. Montanaro, U. Livi, and P. M. Fioretti Infective endocarditis in chronic haemodialysis patients: an increasing clinical challenge Eur. Heart J., October 1, 2007; 28(19): 2307 - 2312. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. O. Bonow, B. A. Carabello, K. Chatterjee, A. C. de Leon Jr, D. P. Faxon, M. D. Freed, W. H. Gaasch, B. W. Lytle, R. A. Nishimura, P. T. O'Gara, et al. ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease) Developed in Collaboration With the Society of Cardiovascular Anesthesiologists Endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons J. Am. Coll. Cardiol., August 1, 2006; 48(3): e1 - e148. [Full Text] [PDF]
|
|
|
|
 |
|
 M. C. Farinas, A. Perez-Vazquez, C. Farinas-Alvarez, J. D. Garcia-Palomo, J. M. Bernal, J. M. Revuelta, and J. Gonzalez-Macias Risk Factors of Prosthetic Valve Endocarditis: A Case-Control Study Ann. Thorac. Surg., April 1, 2006; 81(4): 1284 - 1290. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lydakis, S. Apostolakis, N. Lydataki, E. Tzortzakakis, and G. Komis Stroke-Complicated Endocarditis with Positive Lupus Anticoagulant: A Case Report Angiology, July 1, 2005; 56(4): 503 - 506. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Ishihara, A. Nabuchi, R. Ito, K. Miyachi, H. K. Kuramitsu, and K. Okuda Correlation between Detection Rates of Periodontopathic Bacterial DNA in Carotid Coronary Stenotic Artery Plaque and in Dental Plaque Samples J. Clin. Microbiol., March 1, 2004; 42(3): 1313 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Spies, J. R. Madison, and I. J. Schatz Infective Endocarditis in Patients With End-stage Renal Disease: Clinical Presentation and Outcome Arch Intern Med, January 12, 2004; 164(1): 71 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Cabell, E. Abrutyn, and A. W. Karchmer Bacterial Endocarditis: The Disease, Treatment, and Prevention Circulation, May 27, 2003; 107 (20): e185 - e187. [Full Text] [PDF]
|
|
|
|
|
|
W. T. Brinkman, W. H. Williams, R. A. Guyton, E. L. Jones, and J. M. Craver Valve replacement in patients on chronic renal dialysis: implications for valve prosthesis selection Ann. Thorac. Surg., July 1, 2002; 74(1): 37 - 42. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Management of infective endocarditis DTB, April 1, 2002; 40(4): 26 - 30. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. H. Cabell, J. G. Jollis, G. E. Peterson, G. R. Corey, D. J. Anderson, D. J. Sexton, C. W. Woods, L. B. Reller, T. Ryan, and V. G. Fowler Jr Changing Patient Characteristics and the Effect on Mortality in Endocarditis Arch Intern Med, January 14, 2002; 162(1): 90 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Mylonakis and S. B. Calderwood Infective Endocarditis in Adults N. Engl. J. Med., November 1, 2001; 345(18): 1318 - 1330. [Full Text] [PDF]
|
|
|
|
|
|
J. K. Perloff and C. A. Warnes Challenges Posed by Adults With Repaired Congenital Heart Disease Circulation, May 29, 2001; 103(21): 2637 - 2643. [Full Text] [PDF]
|
|
|
|
 |
|
 Identifiable Risk Factors for Infective Endocarditis Still Elusive Journal Watch Infectious Diseases, January 26, 2001; 2001(126): 3 - 3. [Full Text]
|
|