Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective Spanish cohort study

2021 ◽  
pp. 1-9
Author(s):  
Lorenzo Roberto Suardi ◽  
Arístides de Alarcón ◽  
María Victoria García ◽  
Antonio Plata Ciezar ◽  
Carmen Hidalgo Tenorio ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Culture Negative ◽  
Spanish Cohort

scholarly journals Blood culture time to positivity in non-β-hemolytic streptococcal bacteremia as a predictor of infective endocarditis—a retrospective cohort study

2021 ◽  
Author(s):  
David Krus ◽  
Fredrik Kahn ◽  
Bo Nilson ◽  
Torgny Sunnerhagen ◽  
Magnus Rasmussen
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Culture Time ◽  
Time To Positivity

AbstractNon-β-hemolytic streptococci (NBHS) cause infective endocarditis (IE) and a short blood culture time to positivity (TTP) is associated with risk of IE in bacteremia with other pathogens. In this retrospective population-based cohort study, we investigate if TTP is associated to IE or mortality. Of 263 episodes with NBHS bacteremia, 28 represented IE and the median TTP did not differ significantly between episodes with IE (15 h) and non-IE (15 h) (p=0.51). TTP was similar among those who survived and those who died within 30 days. However, TTP significantly differed when comparing the different streptococcal groups (p<0.001).

scholarly journals Association between echocardiographic manifestations and bacterial infections in patients with infective endocarditis: a cohort study

2019 ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling ◽  
Eva Maret ◽  
Cecilia Stålsby Lundborg ◽  
Kenneth Caidahl ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Bacterial Infections ◽  
National Registry ◽  
University Hospital ◽  
Categorical Variables ◽  
Group B Streptococci ◽  
Coagulase Negative Staphylococci ◽  
Cardiac Manifestations

Abstract Abstract Background The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for direct visualization of IE-induced cardiac manifestations. We investigated correlations between bacterial infections and IE manifestations diagnosed by ECHO. Methods In this cohort study, data from patients aged 18 years or above, with definite or possible IE admitted at the Karolinska University Hospital between 2008-2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR were excluded. IE manifestations diagnosed by ECHO and risk factors were obtained from the registry. Chi-squared test and two-sided Fisher’s exact test was used for comparisons between categorical variables, and student’s ttest was used for continuous numerical variables; two-sided and skewed variables were log-transformed before these analyses. Multivariable analyses were performed using logistic regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P< 0.05 was considered significant. Results The most common bacteria were Staphylococcus aureus(n= 268, 47%) and viridans group streptococci (n= 127, 22%). The most common manifestations were vegetation in the mitral (n = 222, 36%), aortic (n = 214, 34%), and tricuspid valves (n = 117, 19%). Correlations were seen between aortic valve vegetation and coagulase-negative staphylococci (CoNS) and Enterococcus faecalis, between mitral valve vegetation and group B streptococci, tricuspid valve vegetation, andS.aureus, and between perivalvular abscesses and CoNS (all P< 0.05). Conclusions Correlations were found between certain bacteria and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.

scholarly journals Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

2019 ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling ◽  
Eva Maret ◽  
Cecilia Stålsby Lundborg ◽  
Kenneth Caidahl ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Bacterial Infections ◽  
Electronic Device ◽  
Bacterial Species ◽  
University Hospital ◽  
Categorical Variables ◽  
Coagulase Negative Staphylococci ◽  
Cardiac Manifestations

Abstract Abstract Background The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated correlations between bacterial infections and IE manifestations diagnosed by ECHO. Methods In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher’s exact test was used for comparisons between categorical variables, and student’s t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Correlations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions Correlations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.

scholarly journals Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
A. Damlin ◽  
K. Westling ◽  
E. Maret ◽  
C. Stålsby Lundborg ◽  
K. Caidahl ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Bacterial Infections ◽  
Electronic Device ◽  
Bacterial Species ◽  
University Hospital ◽  
Categorical Variables ◽  
Coagulase Negative Staphylococci ◽  
Cardiac Manifestations

Abstract Background The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. Methods In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher’s exact test was used for comparisons between categorical variables, and student’s t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.

scholarly journals A Curious Case of Blood-Culture-Negative Infective Endocarditis

2018 ◽  
Vol 32 (1) ◽  
pp. e3-e5
Author(s):  
Satoru Fujii ◽  
Elena Tugaleva ◽  
Michael W.A. Chu ◽  
Daniel Bainbridge
Keyword(s):  
Infective Endocarditis ◽  
Blood Culture ◽  
Culture Negative

scholarly journals Evaluation of Laboratory Predictors for In-Hospital Mortality in Infective Endocarditis and Negative Blood Culture Pattern Characteristics

Pathogens ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 551
Author(s):  
Ana-Maria Buburuz ◽  
Antoniu Petris ◽  
Irina Iuliana Costache ◽  
Igor Jelihovschi ◽  
Catalina Arsenescu-Georgescu ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Blood Culture ◽  
Blood Cell ◽  
Hospital Mortality ◽  
Cell Count ◽  
Neutrophil Count ◽  
Hospital Death ◽  
Blood Cell Count ◽  
Positive Groups ◽  
Culture Negative

Objective: This study aimed to identify possible differences between blood culture-negative and blood culture-positive groups of infective endocarditis (IE), and explore the associations between biological parameters and in-hospital mortality. Methods: This was a retrospective study of patients hospitalized for IE between 2007 and 2017. Epidemiological, clinical and paraclinical characteristics, by blood culture-negative and positive groups, were collected. The best predictors of in-hospital mortality based on the receiver-operating characteristic (ROC) analysis and AUC (area under the curve) results were identified. Results: A total of 126 IE patients were included, 54% with negative blood cultures at admission. Overall, the in-hospital mortality was 28.6%, higher in the blood culture-negative than positive group (17.5% vs. 11.1%, p = 0.207). A significant increase in the Model for End-Stage Liver Disease Excluding International Normalized Ratio (MELD-XI) score was observed in the blood culture-negative group (p = 0.004), but no baseline characteristics differed between the groups. The best laboratory predictors of in-hospital death in the total study group were the neutrophil count (AUC = 0.824), white blood cell count (AUC = 0.724) and MELD-XI score (AUC = 0.700). Conclusion: Classic laboratory parameters, such as the white blood cell count and neutrophil count, were associated with in-hospital mortality in infective endocarditis. In addition, MELD-XI was a good predictor of in-hospital death.

scholarly journals Blood Cultures for the Diagnosis of Infective Endocarditis: What Is the Benefit of Prolonged Incubation?

2021 ◽  
Vol 10 (24) ◽  
pp. 5824
Author(s):  
Vincent Fihman ◽  
Hélène Faury ◽  
Amina Moussafeur ◽  
Raphaelle Huguet ◽  
Adrien Galy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Retrospective Cohort ◽  
Blood Cultures ◽  
University Hospital ◽  
Infectious Endocarditis ◽  
Prolonged Incubation ◽  
Cutibacterium Acnes

To assess the need for prolonged incubation of blood culture bottles beyond five days for the diagnosis of infectious endocarditis (IE), we conducted a retrospective cohort study of 6109 sets of two blood culture bottles involving 1211 patients admitted to the Henri Mondor University Hospital for suspicion of IE between 1 January 2016 and 31 December 2019. Among the 322 patients with IE, 194 had positive blood cultures in our centre. Only one patient with a time-to-positivity blood culture of more than 120 h (5 days) was found. The main cause for the 22 patients with positive blood cultures after five days was contamination with Cutibacterium acnes. Our results do not support extending the duration of incubation of blood culture bottles beyond five days for the diagnosis of infectious endocarditis, with the exception of patients with risk factors for C. acnes infection.

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