Malene Højgaard Andersen1, Sarah Louise Kjølhede Holle2, Christine Falk Klein2, Niels Eske Bruun3,4,5, Magnus Arpi6, Henning Bundgaard7, Niels Tønder8, Kasper Karmark Iversen9. 1. Department of Cardiology, Herlev-Gentofte hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark. maleneha90@hotmail.com. 2. Department of Cardiology, Herlev-Gentofte hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark. 3. Department of Cardiology, Zealand University Hospital, Roskilde, Denmark. 4. Clinical Institute, University of Copenhagen, Copenhagen, Denmark. 5. Clinical Institute, University of Aalborg, Aalborg, Denmark. 6. Department of Clinical Microbiology, Herlev-Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark. 7. Department of Cardiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen East, Denmark. 8. Department of Cardiology, Nordsjaellands Hospital, University of Copenhagen, Dyrehavevej 29, Hilleroed, 3400, Copenhagen, Denmark. 9. Department of Cardiology, Herlev-Gentofte hospital, University of Copenhagen, Herlev Ringvej 75, Herlev, 2730, Copenhagen, Denmark. Kasper.karmark.iversen@regionh.dk.
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.
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.
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