Early-onset prosthetic valve endocarditis definition revisited: Prospective study and literature review

to determine prosthetic valve endocarditis (PVE) annual incidence and to evaluate its current classification based on the epidemiological distribution of identified agents, and their sensitivity profile.Between 1997 and 2014, consecutive cases of PVE within the first year of valve surgery were included in a prospective cohort study. Incidence, demographic, clinical, microbiological and in-hospital mortality data of PVE patients were recorded.172 cases of PVE were included, and the global annual incidence of PVE was 1.7%. Most PVE cases occurred within 120days after surgery (76.7%). After this period, there was a reduction in resistant microrganisms (64.4% vs. 32.3%, respectively, p=0.007) and a rise in the incidence of Streptococcus spp (1.9% vs. 23.5%: p=0.007). In a literature review, 646 cases of PVE with identified etiology were identified, of which 264 (41%) cases were caused by coagulase negative Staphylococcus and 43 (7%) by Streptococcus spp. This concurs with our findings.Most PVE cases occurred within 120days after valve surgery, and the same etiological agents were identified in this period. The current cut-off level of 365days for classification of early-onset PVE should be revisited.