Epidemiology

• 31% S.aureus
• 17% oral Streps
• 11% CoNS
• Other:
  • E.faecalis
  • H ACEKs
  • Other Gram-Neg (% Non-HACEK Gm-; Assc. with IVDU):
    • 43% Serratia spp.
    • 21% Pseudomonas aeruginosa
    • 14% Klebsiella spp.
  • Fungi
• Strep phylogeny:

Native Valve Endocarditis (~75%):

• S.aureus, Streptotocci, E.faecalis

Prosthetic Valve Endocarditis (~25%):

• Early: Hospital Gm-negs
• Late: Staphylococci, Streptococci, Enterococcus spp.

Cardiac Implantable Electronic Devices (CIED)

• AKA Pacemaker infection

Prevention

History

• 1955: AHA produce guidelines recommending the use of ABx Prophylaxis (AP) to reduce the risk of IE following IDPs (Invasive Dental Procedures)