Fernandez-Hidalgo et al listed criteria for Health Care-Associated Infective Endocarditis (HAIE). The authors are from Hospital Universitari Vall d'Hebron and Universitat Autonoma de Barcelona in Spain.

Criteria for nosocomial HAIE - one of the following:

(1) no evidence of infective endocarditis at the time of hospital admission AND onset of symptoms > 48 hours after admission

(2) onset of symptoms within 6 months after hospital discharge


Criteria for nosocomial HAIE - one or more of the following diagnostic or therapeutic manipulations within 6 months before symptoms onset:

(1) long-term central venous catheter placement

(2) arteriovenous fistula for hemodialysis or apheresis (may be autologous or prosthetic)

(3) cardiac or arterial catheterization

(4) placement of pacemaker or other intravascular device

(5) acupuncture

(6) urologic procedure

(7) gynecologic procedure

(8) dental or digestive procedure



• Noso is Greek for "disease".

• Comial is from the Greek komeion which indicates "to take care of".


Issues with the definitions:

(1) Making the diagnosis of HAIE based on a blood culture collected after 48 hours when one drawn sooner would have been positive.

(2) A person may have other reasons for infective endocarditis within the 6 months after hospital discharge. The definition could be modified to include "without other explanations."

(3) "Nosohusial" has been defined as related to home health care. Here it is being used for infections acquired after non-hospital, ambulatory procedures.

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