Nosocomial infective endocarditis

Nosocomial infective endocarditis (NIE) is a rare complication of nosocomia l bacteraemia; however, it is an infection of great importance because of i ts high mortality and because in many cases it is potentially preventable. Whilst many aspects of NIE are similar to community-acquired infective endo carditis (CIE), there are important differences between the two, most notab ly the predisposing factors, microbial aetiology and prognosis. The diagnos is of NIE is often difficult as many patients have severe underlying diseas e and coexistent infection elsewhere. Many of these infections could potent ially be prevented by the identification of high risk patients, careful ass essment of positive blood cultures and effective treatment of bacteraemia i n high risk patients. The use of prophylactic antimicrobials in the prevent ion of infective endocarditis is unproven, however, it is recommended that prophylaxis be considered for certain invasive hospital-based procedures.