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Prevalence of Infective Endocarditis in Enterococcus faecalis Bacteremia

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@article{1445ecaa9f90426a86abcd258f6277f6,
title = "Prevalence of Infective Endocarditis in Enterococcus faecalis Bacteremia",
abstract = "BACKGROUND: Enterococcus faecalis is the third most frequent cause of infective endocarditis (IE). Despite this, no systematic prospective echocardiography studies have examined the prevalence of IE in patients with E. faecalis bacteremia.OBJECTIVES: This study sought to determine the prevalence of IE in patients with E. faecalis bacteremia. The secondary objective was to identify predictors of IE.METHODS: From January 1, 2014, to December 31, 2016, a prospective multicenter study was conducted with echocardiography in consecutive patients with E. faecalis bacteremia. Predictors of IE were assessed using multivariate logistic regression with backward elimination.RESULTS: A total of 344 patients with E. faecalis bacteremia were included, all examined using echocardiography, including transesophageal echocardiography in 74{\%} of the cases. The patients had a mean age of 74.2 years, and 73.5{\%} were men. Definite endocarditis was diagnosed in 90 patients, resulting in a prevalence of 26.1 ± 4.6{\%} (95{\%} confidence interval [CI]). Risk factors for IE were prosthetic heart valve (odds ratio [OR]: 3.93; 95{\%} CI: 1.76 to 8.77; p = 0.001), community acquisition (OR: 3.35; 95{\%} CI: 1.74 to 6.46; p < 0.001), ≥3 positive blood culture bottles (OR: 3.69; 95{\%} CI: 1.88 to 7.23; p < 0.001), unknown portal of entry (OR: 2.36; 95{\%} CI: 1.26 to 4.40; p = 0.007), monomicrobial bacteremia (OR: 2.73; 95{\%} CI: 1.23 to 6.05; p = 0.013), and immunosuppression (OR: 2.82; 95{\%} CI: 1.20 to 6.58; p = 0.017).CONCLUSIONS: This study revealed a high prevalence of 26{\%} definite IE in patients with E. faecalis bacteremia, suggesting that echocardiography should be considered in all patients with E. faecalis bacteremia.",
author = "Anders Dahl and Kasper Iversen and Niels Tonder and Nis Hoest and Magnus Arpi and Morten Dalsgaard and Mahtab Chehri and Soerensen, {Lars L} and Soren Fanoe and Soeren Junge and Ulla Hoest and Nana Valeur and Lauridsen, {Trine K} and Emil Fosbol and Thomas Hoi-Hansen and Bruun, {Niels E}",
note = "Copyright {\circledC} 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2019",
doi = "10.1016/j.jacc.2019.04.059",
language = "English",
volume = "74",
pages = "193--201",
journal = "American College of Cardiology. Journal",
issn = "0735-1097",
publisher = "Elsevier Inc",
number = "2",

}

RIS

TY - JOUR

T1 - Prevalence of Infective Endocarditis in Enterococcus faecalis Bacteremia

AU - Dahl, Anders

AU - Iversen, Kasper

AU - Tonder, Niels

AU - Hoest, Nis

AU - Arpi, Magnus

AU - Dalsgaard, Morten

AU - Chehri, Mahtab

AU - Soerensen, Lars L

AU - Fanoe, Soren

AU - Junge, Soeren

AU - Hoest, Ulla

AU - Valeur, Nana

AU - Lauridsen, Trine K

AU - Fosbol, Emil

AU - Hoi-Hansen, Thomas

AU - Bruun, Niels E

N1 - Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Enterococcus faecalis is the third most frequent cause of infective endocarditis (IE). Despite this, no systematic prospective echocardiography studies have examined the prevalence of IE in patients with E. faecalis bacteremia.OBJECTIVES: This study sought to determine the prevalence of IE in patients with E. faecalis bacteremia. The secondary objective was to identify predictors of IE.METHODS: From January 1, 2014, to December 31, 2016, a prospective multicenter study was conducted with echocardiography in consecutive patients with E. faecalis bacteremia. Predictors of IE were assessed using multivariate logistic regression with backward elimination.RESULTS: A total of 344 patients with E. faecalis bacteremia were included, all examined using echocardiography, including transesophageal echocardiography in 74% of the cases. The patients had a mean age of 74.2 years, and 73.5% were men. Definite endocarditis was diagnosed in 90 patients, resulting in a prevalence of 26.1 ± 4.6% (95% confidence interval [CI]). Risk factors for IE were prosthetic heart valve (odds ratio [OR]: 3.93; 95% CI: 1.76 to 8.77; p = 0.001), community acquisition (OR: 3.35; 95% CI: 1.74 to 6.46; p < 0.001), ≥3 positive blood culture bottles (OR: 3.69; 95% CI: 1.88 to 7.23; p < 0.001), unknown portal of entry (OR: 2.36; 95% CI: 1.26 to 4.40; p = 0.007), monomicrobial bacteremia (OR: 2.73; 95% CI: 1.23 to 6.05; p = 0.013), and immunosuppression (OR: 2.82; 95% CI: 1.20 to 6.58; p = 0.017).CONCLUSIONS: This study revealed a high prevalence of 26% definite IE in patients with E. faecalis bacteremia, suggesting that echocardiography should be considered in all patients with E. faecalis bacteremia.

AB - BACKGROUND: Enterococcus faecalis is the third most frequent cause of infective endocarditis (IE). Despite this, no systematic prospective echocardiography studies have examined the prevalence of IE in patients with E. faecalis bacteremia.OBJECTIVES: This study sought to determine the prevalence of IE in patients with E. faecalis bacteremia. The secondary objective was to identify predictors of IE.METHODS: From January 1, 2014, to December 31, 2016, a prospective multicenter study was conducted with echocardiography in consecutive patients with E. faecalis bacteremia. Predictors of IE were assessed using multivariate logistic regression with backward elimination.RESULTS: A total of 344 patients with E. faecalis bacteremia were included, all examined using echocardiography, including transesophageal echocardiography in 74% of the cases. The patients had a mean age of 74.2 years, and 73.5% were men. Definite endocarditis was diagnosed in 90 patients, resulting in a prevalence of 26.1 ± 4.6% (95% confidence interval [CI]). Risk factors for IE were prosthetic heart valve (odds ratio [OR]: 3.93; 95% CI: 1.76 to 8.77; p = 0.001), community acquisition (OR: 3.35; 95% CI: 1.74 to 6.46; p < 0.001), ≥3 positive blood culture bottles (OR: 3.69; 95% CI: 1.88 to 7.23; p < 0.001), unknown portal of entry (OR: 2.36; 95% CI: 1.26 to 4.40; p = 0.007), monomicrobial bacteremia (OR: 2.73; 95% CI: 1.23 to 6.05; p = 0.013), and immunosuppression (OR: 2.82; 95% CI: 1.20 to 6.58; p = 0.017).CONCLUSIONS: This study revealed a high prevalence of 26% definite IE in patients with E. faecalis bacteremia, suggesting that echocardiography should be considered in all patients with E. faecalis bacteremia.

U2 - 10.1016/j.jacc.2019.04.059

DO - 10.1016/j.jacc.2019.04.059

M3 - Journal article

VL - 74

SP - 193

EP - 201

JO - American College of Cardiology. Journal

JF - American College of Cardiology. Journal

SN - 0735-1097

IS - 2

ER -

ID: 57567197