Risk for Endocarditis in Bacteremia With Streptococcus -Like Bacteria: A Retrospective Population-Based Cohort Study

Risk for Endocarditis in Bacteremia With Streptococcus -Like Bacteria: A Retrospective Population-Based Cohort Study

Many genera and species of -like bacteria (SLB) can cause infective endocarditis (IE), but little is known about the epidemiology of and the risk factors for IE in SLB-bacteremia. The aim of the study was to analyze this in a cohort of patients with SLB-bacteremia, focusing on , , , and We also eval...

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Bibliographic Details
Published in:Open forum infectious diseases Vol. 6; no. 10; p. ofz437
Main Authors: Berge, Andreas, Kronberg, Karin, Sunnerhagen, Torgny, Nilson, Bo H K, Giske, Christian G, Rasmussen, Magnus
Format: Journal Article
Language:English
Published: United States Oxford University Press 01-10-2019
Subjects:
bacteremia
Basic Medicine
Clinical Medicine
echocardiography
endocarditis
Infectious Medicine
Infektionsmedicin
Klinisk medicin
Major
management score
Medical and Health Sciences
Medicin och hälsovetenskap
Medicinska och farmaceutiska grundvetenskaper
Microbiology in the medical area
Mikrobiologi inom det medicinska området
management score
endocarditis
echocardiography
bacteremia
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Summary:Many genera and species of -like bacteria (SLB) can cause infective endocarditis (IE), but little is known about the epidemiology of and the risk factors for IE in SLB-bacteremia. The aim of the study was to analyze this in a cohort of patients with SLB-bacteremia, focusing on , , , and We also evaluated whether published scoring systems generated for other Gram-positive bacteria known to cause IE (HANDOC for streptococci and NOVA and DENOVA for enterococci) could be used in SLB bacteremia to decide whether transesophageal echocardiography (TEE) could be omitted. Positive blood cultures with SLB were retrieved from population-based registries in Sweden (3.2 million inhabitants), from January 2012 to December 2017. Clinical data were collected from medical records. Risk factors for IE were analyzed and the performances of the scoring systems were calculated. The incidence of bacteremia with the 4 SLB genera was 30 episodes/1 000 000 population per year, of which contributed with 18. Among 568 episodes of bacteremia, 32 cases of IE were identified (5.6%). Infective endocarditis was most common in bacteremia with (4 of 19) followed by (9 of 124), (6 of 87), and (13 of 338). NOVA had 100% sensitivity to identify IE but a low specificity (15%). For HANDOC and DENOVA, the sensitivities were 97% and 91%, respectively, whereas specificities were 85% and 90%, respectively, and numbers needed to screen were 3.6 and 2.8, respectively. Bacteremia with these SLB is relatively rare, and the decision whether TEE should be performed or not could be based on either HANDOC or DENOVA.
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ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofz437