Risk for infective endocarditis in bacteremia with Gram positive cocci
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ORIGINAL PAPER
Risk for infective endocarditis in bacteremia with Gram positive cocci Malene Højgaard Andersen1 · Sarah Louise Kjølhede Holle1 · Christine Falk Klein1 · Niels Eske Bruun5,6,7 · Magnus Arpi2 · Henning Bundgaard3 · Niels Tønder4 · Kasper Karmark Iversen1 Received: 4 March 2020 / Accepted: 9 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Infective endocarditis (IE) is a serious complication of bacteremia and is most often caused by Gram positive cocci. We investigated the prevalence of IE in patients where echocardiography was encouraged when bacteremia with Gram positive cocci was present. Methods The study included patients with Gram positive cocci bacteremia hospitalized at two Danish hospitals between March and December 2016. Information concerning echocardiography, demographics and bacterial species was collected from the patients’ medical files. Patients without echocardiography were followed for 6 months in order to confirm or reject possible IE. Results The study included 585 patients with Gram positive cocci bacteremia, and echocardiography was performed in 414 (71%) of them. The prevalence of IE in patients with high risk bacteremia, i.e. Staphylococcus aureus, non-beta-hemolytic streptococci, Enterococcus faecalis, and coagulase-negative staphylococci was 16%. Patients with Enterococcus faecalis had the highest prevalence of IE (33%) followed by non-beta-hemolytic streptococci (23%) and Staphylococcus aureus (12%). Among low risk bacteremia the prevalence of IE was 1%. The mean age of patients with IE was 74 years (SD 12.9) and 71% were male. Conclusion These findings strongly support routine echocardiography in patients with high risk bacteremia and non-performance of echocardiography in patients with low risk bacteremia. Keywords Infective endocarditis · Echocardiography · TTE · TEE · Gram positive bacteremia · Blood culture
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s15010-020-01504-6) contains supplementary material, which is available to authorized users. 1
Department of Cardiology, Herlev-Gentofte hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, 2730 Copenhagen, Denmark
2
Department of Clinical Microbiology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, 2730 Copenhagen, Denmark
3
Department of Cardiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen East, Denmark
4
Magnus Arpi [email protected]
Department of Cardiology, Nordsjaellands Hospital, University of Copenhagen, Dyrehavevej 29, Hilleroed, 3400 Copenhagen, Denmark
5
Henning Bundgaard [email protected]
Department of Cardiology, Zealand University Hospital, Roskilde, Denmark
6
Niels Tønder [email protected]
Clinical Institute, University of Copenhagen, Copenhagen, Denmark
7
Clinical Institute, University of Aalborg, Aalborg, Denmark
* Malene Højgaard Andersen [email protected] *
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