Sandra Chamat1, Anders Dahl2, Lauge Klement Moltke Østergaard3, Magnus Arpi4, Emil Fosbøl3, Jonas Boel4, Louise Bruun Oestergaard2, Trine K Lauridsen2, Gunnar Gislason5, Christian Torp-Pedersen6, Niels Eske Bruun7. 1. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark; Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark. 2. Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark. 3. Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen Ø, Denmark. 4. Department of Clinical Microbiology, Copenhagen University Hospital HerlevGentofte, Herlev, Denmark. 5. Department of Cardiology, Copenhagen University Hospital Herlev-Gentofte, Hellerup, Denmark; The Danish Heart Foundation, Copenhagen, Denmark. 6. Department of Cardiology and Clinical Research, Nordsjaellands Hospital, Hillerød, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. 7. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark; Institute of Clinical Medicine, Copenhagen University; Clinical Institute, Aalborg University, Aalborg, Denmark.
Abstract
Background: Streptococci frequently cause infective endocarditis (IE), yet the prevalence of IE in patients with bloodstream infections (BSIs) caused by different streptococcal species is unknown. We aimed to investigate the prevalence of IE at species level in patients with streptococcal BSIs. Methods: We investigated all patients with streptococcal BSIs, from 2008 to 2017, in the Capital Region of Denmark. Data were crosslinked with Danish nationwide registries for identification of concomitant hospitalization with IE. In a multivariable logistic regression analysis, we investigated the risk of IE according to streptococcal species adjusted for age, sex, ≥3 positive blood culture bottles, native valve disease, prosthetic valve, previous IE and cardiac device. Results: Among 6,506 cases with streptococcal BSIs (mean age 68.1 years (SD 16.2), 52.8% men) the IE prevalence was 7.1% (95% CI: 6.5-7.8%). The lowest IE prevalence was found with S. pneumoniae 1.2% (0.8-1.6%) and S. pyogenes 1.9% (0.9-3.3%). An intermediary IE prevalence was found with S. anginosus 4.8% (3.0-7.3%), S. salivarius 5.8% (2.9-10.1%) and S. agalactiae 9.1% (6.6-12.1%). The highest IE prevalence was found with S. mitis/oralis 19.4% (15.6-23.5%), S. gallolyticus (formerly S. bovis) 30.2% (24.3-36.7%), S. sanguinis 34.6% (26.6-43.3%), S. gordonii 44.2% (34.0-54.8%) and S. mutans 47.9% (33.3-62.8%). In multivariable analysis using S. pneumoniae as reference, all species except S. pyogenes were associated with significantly higher IE risk, with the highest risk found with S. gallolyticus OR 31.0 (18.8-51.1), S. mitis/oralis OR 31.6 (19.8-50.5), S. sanguinis OR 59.1 (32.6-107), S. gordonii OR 80.8 (43.9-149) and S. mutans OR 81.3 (37.6-176). Conclusions: The prevalence of IE in streptococcal BSI is species dependent with S. mutans, S. gordonii, S. sanguinis, S. gallolyticus and S. mitis/oralis having the highest IE prevalence and the highest associated IE risk after adjusting for IE risk factors.
Background: Streptococci frequently cause infective endocarditis (IE), yet the prevalence of IE in patients with bloodstream infections (BSIs) caused by different streptococcal species is unknown. We aimed to investigate the prevalence of IE at species level in patients with streptococcal BSIs. Methods: We investigated all patients with streptococcal BSIs, from 2008 to 2017, in the Capital Region of Denmark. Data were crosslinked with Danish nationwide registries for identification of concomitant hospitalization with IE. In a multivariable logistic regression analysis, we investigated the risk of IE according to streptococcal species adjusted for age, sex, ≥3 positive blood culture bottles, native valve disease, prosthetic valve, previous IE and cardiac device. Results: Among 6,506 cases with streptococcal BSIs (mean age 68.1 years (SD 16.2), 52.8% men) the IE prevalence was 7.1% (95% CI: 6.5-7.8%). The lowest IE prevalence was found with S. pneumoniae 1.2% (0.8-1.6%) and S. pyogenes 1.9% (0.9-3.3%). An intermediary IE prevalence was found with S. anginosus 4.8% (3.0-7.3%), S. salivarius 5.8% (2.9-10.1%) and S. agalactiae 9.1% (6.6-12.1%). The highest IE prevalence was found with S. mitis/oralis 19.4% (15.6-23.5%), S. gallolyticus (formerly S. bovis) 30.2% (24.3-36.7%), S. sanguinis 34.6% (26.6-43.3%), S. gordonii 44.2% (34.0-54.8%) and S. mutans 47.9% (33.3-62.8%). In multivariable analysis using S. pneumoniae as reference, all species except S. pyogenes were associated with significantly higher IE risk, with the highest risk found with S. gallolyticus OR 31.0 (18.8-51.1), S. mitis/oralis OR 31.6 (19.8-50.5), S. sanguinis OR 59.1 (32.6-107), S. gordonii OR 80.8 (43.9-149) and S. mutans OR 81.3 (37.6-176). Conclusions: The prevalence of IE in streptococcal BSI is species dependent with S. mutans, S. gordonii, S. sanguinis, S. gallolyticus and S. mitis/oralis having the highest IE prevalence and the highest associated IE risk after adjusting for IE risk factors.
Entities:
Keywords:
streptococcal bloodstream infection; streptococcal species
Authors: Kemal Solakyildirim; Yi Li; Arnold S Bayer; Paul M Sullam; Yan Q Xiong; Carlito B Lebrilla; Barbara A Bensing Journal: Glycobiology Date: 2021-12-18 Impact factor: 5.954
Authors: Gurdeep Chahal; Macarena P Quintana-Hayashi; Meztlli O Gaytán; John Benktander; Medea Padra; Samantha J King; Sara K Linden Journal: Front Cell Infect Microbiol Date: 2022-06-17 Impact factor: 6.073
Authors: Emily A Siegrist; Minkey Wungwattana; Leyla Azis; Patricia Stogsdill; Wendy Y Craig; Kristina E Rokas Journal: Open Forum Infect Dis Date: 2020-11-07 Impact factor: 3.835
Authors: Nosheen Afzal Qureshi; Syeda Marriam Bakhtiar; Muhammad Faheem; Mohibullah Shah; Ahmed Bari; Hafiz M Mahmood; Muhammad Sohaib; Ramzi A Mothana; Riaz Ullah; Syed Babar Jamal Journal: Front Genet Date: 2021-03-25 Impact factor: 4.599
Authors: Lars Lind; Jesus A Araujo; Aaron Barchowsky; Scott Belcher; Brian R Berridge; Nipavan Chiamvimonvat; Weihsueh A Chiu; Vincent J Cogliano; Sarah Elmore; Aimen K Farraj; Aldrin V Gomes; Cliona M McHale; Kathleen B Meyer-Tamaki; Nikki Gillum Posnack; Hugo M Vargas; Xi Yang; Lauren Zeise; Changcheng Zhou; Martyn T Smith Journal: Environ Health Perspect Date: 2021-09-24 Impact factor: 9.031
Authors: Cristina Di Carluccio; Rosa Ester Forgione; Andrea Bosso; Shinji Yokoyama; Yoshiyuki Manabe; Elio Pizzo; Antonio Molinaro; Koichi Fukase; Marco Fragai; Barbara A Bensing; Roberta Marchetti; Alba Silipo Journal: RSC Chem Biol Date: 2021-10-18
Authors: Sandra Chamat-Hedemand; Niels Eske Bruun; Lauge Østergaard; Magnus Arpi; Emil Fosbøl; Jonas Boel; Louise Bruun Oestergaard; Trine K Lauridsen; Gunnar Gislason; Christian Torp-Pedersen; Anders Dahl Journal: BMC Infect Dis Date: 2021-07-16 Impact factor: 3.090
Authors: Francesc Escrihuela-Vidal; Luis Eduardo López-Cortés; Laura Escolà-Vergé; Arístides De Alarcón González; Guillermo Cuervo; Antonio Sánchez-Porto; Nuria Fernández-Hidalgo; Rafael Luque; Miguel Montejo; José M Miró; Miguel Ángel Goenaga; Patricia Muñoz; Maricela Valerio; Marco Ripa; Dolores Sousa-Regueiro; Mercé Gurguí; María Carmen Fariñas-Alvarez; Lourdes Mateu; Elisa García Vázquez; Juan Gálvez-Acebal; Jordi Carratalà Journal: Open Forum Infect Dis Date: 2021-03-29 Impact factor: 3.835