Heart Infection Causing Fewer Hospitalizations, Researchers Say

THURSDAY, Sept. 19 (HealthDay News) -- Hospitalizations for a deadly heart infection that affects mainly older people have declined in recent years, a new study finds. This was seen even with recommendations for more limited use of antibiotics to prevent the illness, called endocarditis.

Specifically, endocarditis is inflammation of the inside living of the heart valve and chambers, according to the U.S. National Heart, Lung, and Blood Institute. The risk of endocarditis increases when people have surgery, and it's considered the most serious infection of the cardiovascular system.

There was a significant increase in rates of hospitalization for endocarditis in the 1990s, which led many doctors to prescribe antibiotics before dental procedures and certain types of surgery.

However, the American Heart Association has narrowed the recommended use of antibiotics to prevent endocarditis to only a subgroup of patients undergoing dental procedures.

In this study, Yale School of Medicine researchers looked at the annual rates of endocarditis-related hospitalizations and related outcomes among more than 262,000 Medicare patients 65 and older between 1999 and 2010.

An increase in hospitalizations for endocarditis occurred between 1999 and 2005, but there was a decline between 2006 and 2010, according to the study in the August Journal of the American College of Cardiology.

"We were surprised to see reduced rates of endocarditis hospitalizations during this time period," study first author Dr. Behnood Bikdeli, a postdoctoral associate in cardiovascular medicine, and an internal medicine resident, said in a Yale news release.

"This downward trend was consistent in all major study subgroups, but certain subgroups, including black participants, had higher hospitalization rates and worse outcomes in the study period," he added.

This racial disparity in outcomes, as well as reasons for the overall decline in hospitalizations, require further investigation, Bikdeli said.

"Clinicians should consider the risks and benefits of antibiotic use on a case-by-case basis and should share the information with their patients for appropriate decision making," he concluded.

More information

The U.S. National Heart, Lung, and Blood Institute has more about endocarditis.

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Georgia student with flesh-eating infection OKs more amputations

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ATLANTA (Reuters) - A Georgia college student fighting a rare flesh-eating bacterial infection mouthed "Let's do this" when told that her hands and remaining foot would have to be amputated, her father said on Friday.

Andy Copeland, Aimee Copeland's father, wrote in a Facebook posting that a doctor told the family on Thursday that "the hands were endangering Aimee's progress."

He said he told the doctors, "Do whatever it takes to give us the best chance to save Aimee's life."

Copeland then took his daughter's hands and, holding them up to her face, said, "Aimee, these hands are not healthy. They are hampering your progress."

He continued, "Your mind is beautiful, your heart is good and your spirit is strong. These hands can prevent your recovery from moving forward. The doctors want to amputate them and your foot today to assure your best possible chance of survival."

Aimee Copeland smiled, raised her hands and mouthed "Let's do this," her father wrote.

She was listed in critical condition on Friday, said Barclay Bishop, a spokeswoman for Doctors Hospital in Augusta, Georgia. Bishop declined to say whether doctors had amputated the hands and foot.

Copeland, 24, was kayaking and zip-lining along the Little Tallapoosa River near Carrollton, Georgia, on May 1 when the line broke and she cut her calf.

Emergency-room doctors closed the wound with 22 staples and released Copeland, a graduate student at West Georgia University.

But after her condition worsened, Copeland was diagnosed with necrotizing fasciitis, a bacterial infection that can destroy muscles, skin and tissue.

Surgeons amputated her left leg at the hip and struggled to save her hands and remaining foot.

Two other cases of flesh-eating infections have been reported recently in South Carolina. A new mother of twins in Greenville, Lana Kuykendall, 36, was in critical but stable condition on Thursday at Greenville Memorial Hospital, a hospital spokeswoman said.

And a former South Carolina fire chief, Glenn Pace, told a local television station he had been battling the disease since early April and had three surgeries on his foot.

Different bacteria can cause necrotizing fasciitis. The "flesh-eating" infection is not communicable.

(Editing By Cynthia Johnston and Xavier Briand)