Rinaldo Focaccia Siciliano1, Alfredo Jose Mansur2, Jussara Bianchi Castelli2, Vanessa Arias2, Max Grinberg2, Matthew E Levison3, Tania Mara Varejao Strabelli2. 1. Heart Institute (InCor), University of Sao Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Bloco 1, sala CCIH, Cerqueira Cesar, Sao Paulo, SP 05403-000, Brazil. Electronic address: rinaldo_focaccia@uol.com.br. 2. Heart Institute (InCor), University of Sao Paulo Medical School, Av. Dr. Eneas de Carvalho Aguiar, 44, Bloco 1, sala CCIH, Cerqueira Cesar, Sao Paulo, SP 05403-000, Brazil. 3. Division of Infectious Diseases, Drexel University College of Medicine, Philadelphia, USA.
Abstract
OBJECTIVES: We studied the clinical characteristics, in-hospital mortality, and long-term prognosis of patients with culture-negative endocarditis. METHODS: In total, 221 episodes of definite endocarditis were studied (2004-2009). We compared the clinical, laboratory, and echocardiography characteristics and the survival rates of patients with culture-negative and culture-positive endocarditis. Survival after hospital discharge was evaluated using the Kaplan-Meier method and coefficient of mortality comparisons. RESULTS: Culture-negative endocarditis occurred in 51/221 (23.1%) episodes. Compared with the culture-positive endocarditis patients, the time elapsed between admission and initiation of antibiotic therapy was longer in patients with culture-negative endocarditis (p<0.001), and these patients also had lower C-reactive protein levels at admission (p<0.001). In-hospital mortality rates were not different between culture-negative and culture-positive patients. After hospital discharge, there was also no significant difference between groups in survival curves (p=0.471). Severe sepsis (adjusted prevalence ratio 3.32, p=0.010) and diabetes mellitus (adjusted prevalence ratio 2.32, p=0.009) were independently associated with in-hospital death in culture-negative patients. CONCLUSIONS: Culture-negative endocarditis patients presented with lower levels of C-reactive protein at admission and required more time for initiation of antibiotic therapy, although there was no difference in in-hospital mortality or long-term survival between culture-negative and culture-positive endocarditis patients. Diabetes mellitus and severe sepsis were associated with in-hospital death in patients with culture-negative endocarditis.
OBJECTIVES: We studied the clinical characteristics, in-hospital mortality, and long-term prognosis of patients with culture-negative endocarditis. METHODS: In total, 221 episodes of definite endocarditis were studied (2004-2009). We compared the clinical, laboratory, and echocardiography characteristics and the survival rates of patients with culture-negative and culture-positive endocarditis. Survival after hospital discharge was evaluated using the Kaplan-Meier method and coefficient of mortality comparisons. RESULTS: Culture-negative endocarditis occurred in 51/221 (23.1%) episodes. Compared with the culture-positive endocarditispatients, the time elapsed between admission and initiation of antibiotic therapy was longer in patients with culture-negative endocarditis (p<0.001), and these patients also had lower C-reactive protein levels at admission (p<0.001). In-hospital mortality rates were not different between culture-negative and culture-positive patients. After hospital discharge, there was also no significant difference between groups in survival curves (p=0.471). Severe sepsis (adjusted prevalence ratio 3.32, p=0.010) and diabetes mellitus (adjusted prevalence ratio 2.32, p=0.009) were independently associated with in-hospital death in culture-negative patients. CONCLUSIONS: Culture-negative endocarditispatients presented with lower levels of C-reactive protein at admission and required more time for initiation of antibiotic therapy, although there was no difference in in-hospital mortality or long-term survival between culture-negative and culture-positive endocarditispatients. Diabetes mellitus and severe sepsis were associated with in-hospital death in patients with culture-negative endocarditis.
Authors: Kathryn P Sutherland; Brett Berry; Andrew Park; Dustin W Kemp; Keri M Kemp; Erin K Lipp; James W Porter Journal: Philos Trans R Soc Lond B Biol Sci Date: 2016-03-05 Impact factor: 6.237
Authors: Se Ju Lee; Jung Ho Kim; Hi Jae Lee; Ki Hyun Lee; Eun Hwa Lee; Yae Jee Baek; Jin Nam Kim; Jin Young Ahn; Su Jin Jeong; Nam Su Ku; Seung Hyun Lee; Jun Yong Choi; Joon Sup Yeom; Young Goo Song Journal: Antibiotics (Basel) Date: 2021-12-01