Journal
of Hospital
Infection
(1991)
19, 283-296
Letters
to the Editor
Sir,
Pseudomonas
aeruginosa
endocarditis
us of the ever-present threat posed by Finkelstein et al.’ remind Pseudomonas aeruginosa in hospitalized patients, with an interesting report of endocarditis, one of the rare complications of infection due to this organism. However, I think two of the statements in their final paragraph need clarifying. They state that valve replacement was required because of severe valve damage, not for control of infection, and that the finding of sterile vegetations suggests that medical treatment alone may occasionally be curative. In my experience valve replacement in endocarditis is quite commonly required, usually for haemodynamic reasons, and the removed valves are almost always bacteriologically sterile. The difficulty is often to persuade clinical colleagues that surgery is required, rather than altering doses or choices of antibiotics. Antibiotics are highly effective in sterilizing vegetations, unless these have progressed to abscess formation. They are completely ineffective in repairing structural damage to the valves. M. Sheppard
Department of Microbiology, Mayday University Hospital, Thornton Heath, Surrey CR7 7YE References
1. Finkelstein endocarditis.
R, Boulus M, Markievitcz M. Hospital-acquired J Hasp Infect 1991; 18: 161-163.
Pseudomonas
aeruginosa
Sir, Theatre
overshoes
and operating
theatre
floor
bacterial
counts
The conclusions drawn from the results of the recent paper of Humphreys et al. in the Journal (17: 117-123), are not substantiated by the authors’ data. No mention is made of the number of visitors to the theatre compared Ol95-6701/91~120283+14
603.00!0
283
of Hospital
Infection
(1991)
19, 283-296
Letters
to the Editor
Sir,
Pseudomonas
aeruginosa
endocarditis
us of the ever-present threat posed by Finkelstein et al.’ remind Pseudomonas aeruginosa in hospitalized patients, with an interesting report of endocarditis, one of the rare complications of infection due to this organism. However, I think two of the statements in their final paragraph need clarifying. They state that valve replacement was required because of severe valve damage, not for control of infection, and that the finding of sterile vegetations suggests that medical treatment alone may occasionally be curative. In my experience valve replacement in endocarditis is quite commonly required, usually for haemodynamic reasons, and the removed valves are almost always bacteriologically sterile. The difficulty is often to persuade clinical colleagues that surgery is required, rather than altering doses or choices of antibiotics. Antibiotics are highly effective in sterilizing vegetations, unless these have progressed to abscess formation. They are completely ineffective in repairing structural damage to the valves. M. Sheppard
Department of Microbiology, Mayday University Hospital, Thornton Heath, Surrey CR7 7YE References
1. Finkelstein endocarditis.
R, Boulus M, Markievitcz M. Hospital-acquired J Hasp Infect 1991; 18: 161-163.
Pseudomonas
aeruginosa
Sir, Theatre
overshoes
and operating
theatre
floor
bacterial
counts
The conclusions drawn from the results of the recent paper of Humphreys et al. in the Journal (17: 117-123), are not substantiated by the authors’ data. No mention is made of the number of visitors to the theatre compared Ol95-6701/91~120283+14
603.00!0
283
