Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study

Lauge Østergaard, Niels Eske Bruun, Marianne Voldstedlund, Magnus Arpi, Christian Østergaard Andersen, Henrik C Schønheyder, Lars Lemming, Flemming Rosenvinge, Nana Valeur, Peter Søgaard, Paal Skytt Andersen, Robert Skov, Ming Chen, Kasper Iversen, Sabine Gill, Trine Kiilerich Lauridsen, Anders Dahl, Louise Bruun Oestergaard, Jonas Agerlund Povlsen, Claus MoserHenning Bundgaard, Lars Køber, Emil Loldrup Fosbøl

48 Citationer (Scopus)


AIMS: Increasing attention has been given to the risk of infective endocarditis (IE) in patients with certain blood stream infections (BSIs). Previous studies have been conducted on selected patient cohorts, yet unselected data are sparse. We aimed to investigate the prevalence of IE in BSIs with bacteria typically associated with IE.

METHODS AND RESULTS: By crosslinking nationwide registries from 2010 to 2017, we identified patients with BSIs typically associated with IE: Enterococcus faecalis (E. faecalis), Staphylococcus aureus (S. aureus), Streptococcus spp., and coagulase negative staphylococci (CoNS) and examined the concurrent IE prevalence. A trend test was used to examine temporal changes in the prevalence of IE. In total 69 021, distributed with 15 350, 16 726, 19 251, and 17 694 BSIs were identified in the periods of 2010-2011, 2012-2013, 2014-2015, and 2016-2017, respectively. Patients with E. faecalis had the highest prevalence of IE (16.7%) followed by S. aureus (10.1%), Streptococcus spp. (7.3%), and CoNS (1.6%). Throughout the study period, the prevalence of IE among patients with E. faecalis and Streptococcus spp. increased significantly (P = 0.0005 and P = 0.03, respectively). Male patients had a higher prevalence of IE for E. faecalis, Streptococcus spp., and CoNS compared with females. A significant increase in the prevalence of IE was seen for E. faecalis, Streptococcus spp., and CoNS with increasing age.

CONCLUSION: For E. faecalis BSI, 1 in 6 had IE, for S. aureus BSI 1 in 10 had IE, and for Streptococcus spp. 1 in 14 had IE. Our results suggest that screening for IE seems reasonable in patients with E. faecalis BSI, S. aureus BSI, or Streptococcus spp. BSI.

TidsskriftEuropean Heart Journal
Udgave nummer39
Sider (fra-til)3237-3244
Antal sider8
StatusUdgivet - 14 okt. 2019


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