What is the pathogenesis of infective endocarditis on prosthetic material?
Pathogenesis of infective endocarditis (IE) on prosthetic material includes perivalvular infection that involves the sewing ring, which is commonplace among patients with prosthetic valve endocarditis, particularly mechanical valves. Biofilm formation can be operative in infection of prosthetic valves, similar to infection of a broad array of indwelling cardiovascular and noncardiovascular devices. Both antimicrobial agents and immune cells have difficulty in penetrating biofilm, and because of metabolic changes of infecting organisms in biofilm, the ability of antimicrobial agents to kill biofilm-associated organisms is greatly reduced. Because of this, infection relapse at a prosthetic valve site is thought to be increased.