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Other risk factors for endocarditis

Immunosuppression: this can be caused by anything from medications to malnutrition and general unhealthiness.
Prosthetic implants: artificial heart valves or pacemakers can provide a safe haven for bacteria.
Dental cleaning: bacteria from the mouth can enter the bloodstream through bleeding gums.
Any open wounds: just like with drug injections, serious cuts can provide bacteria with a direct entry to the bloodstream and heart.




Drug infections: an update
Bacterial heart infections causing record deaths

02/09/17
By Ryan Lessard news@hippopress.com



 The rise in often-deadly infections caused by intravenous heroin and fentanyl use, first reported by the Hippo in the Aug. 18, 2016, issue, has continued unabated. Between 2006 and 2015, there were four deaths caused by endocarditis, a bacterial infection of the heart’s valves; in 2016 alone, there were 11.

Of the 11 cases in 2016, six were female and five were male. Five were between the ages 20 to 29, two were aged 30 to 39 and four were aged 40 to 49.
Endocarditis is fatal if left untreated. Treatment entails four to six weeks of intravenous antibiotics, but clinicians say many addicts either won’t seek treatment or stay for the full regimen of antibiotics. If the bacteria isn’t fully killed off, it resurfaces again.
In the most advanced cases, the bacteria can damage the heart valves enough to require surgery to replace them with artificial valves. 
Having an artificial valve is itself a risk factor for future endocarditis infections, and if drug users return to using unsafe needles and reinfect themselves, doctors may not be able to safely replace the valves a second time.
Numbers provided by Catholic Medical Center in Manchester show that total endocarditis cases have risen 250 percent over the past five years — and that the rise has been driven by opioid drug use. In 2011, only three of the total 25 inpatient endocarditis cases involved people using opioids. By 2016, 51 of the total 87 cases involved opioid use, the vast majority.
Where heart valve surgeries for drug-related endocarditis once happened once or twice a year, they are now as common as once or twice a month, according to CMC cardiologist Jonathan Eddinger. 
Over the past several months, CMC has worked to ensure its patients get addiction treatment parallel to their medical treatment in order to make sure they remain healthy once they’re discharged from the hospital.
To that end, CMC has assembled a team of clinicians, ethicists, nurses, surgeons, cardiologists and more to manage these cases.
“It just behooves us to set these people up with a successful program so they don’t use again,” Eddinger said.
For the first time, on Feb. 1, Eddinger went to speak to a recovery support group at HOPE for New Hampshire Recovery in Manchester about the risks of endocarditis.





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