A patient with a prosthetic hea valve develops endocarditis eight months after Valve replacement. Most likely organisms responsible is
High-Yield Explanation
Ref Harrison 19 th ed pg 816 Prosthetic valve endocarditis (PVE) arising within 2 months of valve surgery is generally nosocomial, the result of intraoperative contami- nation of the prosthesis or a bacteremic postoperative complication. This nosocomial origin is reflected in the primary microbial causes: S. aureus, CoNS, facultative gram-negative bacilli, diphtheroids, and fungi. The poals of entry and organisms causing cases beginning >12 months after surgery are similar to those in community-acquired NVE. PVE due to CoNS that presents 2-12 months after surgery often represents delayed-onset nosocomial infection. Regardless of the time of onset after surgery, at least 68-85% of CoNS strains that cause PVE are resistant to methicillin.