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 Moser & 3 others Henning Bundgaard, Lars Køber, Emil Loldrup Fosbøl

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

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.

Original languageEnglish
JournalEuropean Heart Journal
ISSN0195-668X
DOIs
Publication statusE-pub ahead of print - 30 May 2019

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Endocarditis
Enterococcus faecalis
Streptococcus
Infection
Coagulase
Staphylococcus
Staphylococcus aureus
Blood Culture
Registries

Cite this

Østergaard, Lauge ; Bruun, Niels Eske ; Voldstedlund, Marianne ; Arpi, Magnus ; Andersen, Christian Østergaard ; Schønheyder, Henrik C ; Lemming, Lars ; Rosenvinge, Flemming ; Valeur, Nana ; Søgaard, Peter ; Andersen, Paal Skytt ; Skov, Robert ; Chen, Ming ; Iversen, Kasper ; Gill, Sabine ; Lauridsen, Trine Kiilerich ; Dahl, Anders ; Oestergaard, Louise Bruun ; Povlsen, Jonas Agerlund ; Moser, Claus ; Bundgaard, Henning ; Køber, Lars ; Fosbøl, Emil Loldrup. / Prevalence of infective endocarditis in patients with positive blood cultures : a Danish nationwide study. In: European Heart Journal. 2019.
@article{b96573d424d04975ad1d060212f991c2,
title = "Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study",
abstract = "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.",
author = "Lauge {\O}stergaard and Bruun, {Niels Eske} and Marianne Voldstedlund and Magnus Arpi and Andersen, {Christian {\O}stergaard} and Sch{\o}nheyder, {Henrik C} and Lars Lemming and Flemming Rosenvinge and Nana Valeur and Peter S{\o}gaard and Andersen, {Paal Skytt} and Robert Skov and Ming Chen and Kasper Iversen and Sabine Gill and Lauridsen, {Trine Kiilerich} and Anders Dahl and Oestergaard, {Louise Bruun} and Povlsen, {Jonas Agerlund} and Claus Moser and Henning Bundgaard and Lars K{\o}ber and Fosb{\o}l, {Emil Loldrup}",
note = "Published on behalf of the European Society of Cardiology. All rights reserved. {\circledC} The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.",
year = "2019",
month = "5",
day = "30",
doi = "10.1093/eurheartj/ehz327",
language = "English",
journal = "European Heart Journal",
issn = "0195-668X",
publisher = "Oxford University Press",

}

Østergaard, L, Bruun, NE, Voldstedlund, M, Arpi, M, Andersen, CØ, Schønheyder, HC, Lemming, L, Rosenvinge, F, Valeur, N, Søgaard, P, Andersen, PS, Skov, R, Chen, M, Iversen, K, Gill, S, Lauridsen, TK, Dahl, A, Oestergaard, LB, Povlsen, JA, Moser, C, Bundgaard, H, Køber, L & Fosbøl, EL 2019, 'Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study', European Heart Journal. https://doi.org/10.1093/eurheartj/ehz327

Prevalence of infective endocarditis in patients with positive blood cultures : a Danish nationwide study. / Østergaard, Lauge; Bruun, Niels Eske; Voldstedlund, Marianne; Arpi, Magnus; Andersen, Christian Østergaard; Schønheyder, Henrik C; Lemming, Lars; Rosenvinge, Flemming; Valeur, Nana; Søgaard, Peter; Andersen, Paal Skytt; Skov, Robert; Chen, Ming; Iversen, Kasper; Gill, Sabine; Lauridsen, Trine Kiilerich; Dahl, Anders; Oestergaard, Louise Bruun; Povlsen, Jonas Agerlund; Moser, Claus; Bundgaard, Henning; Køber, Lars; Fosbøl, Emil Loldrup.

In: European Heart Journal, 30.05.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Prevalence of infective endocarditis in patients with positive blood cultures

T2 - a Danish nationwide study

AU - Østergaard, Lauge

AU - Bruun, Niels Eske

AU - Voldstedlund, Marianne

AU - Arpi, Magnus

AU - Andersen, Christian Østergaard

AU - Schønheyder, Henrik C

AU - Lemming, Lars

AU - Rosenvinge, Flemming

AU - Valeur, Nana

AU - Søgaard, Peter

AU - Andersen, Paal Skytt

AU - Skov, Robert

AU - Chen, Ming

AU - Iversen, Kasper

AU - Gill, Sabine

AU - Lauridsen, Trine Kiilerich

AU - Dahl, Anders

AU - Oestergaard, Louise Bruun

AU - Povlsen, Jonas Agerlund

AU - Moser, Claus

AU - Bundgaard, Henning

AU - Køber, Lars

AU - Fosbøl, Emil Loldrup

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.

PY - 2019/5/30

Y1 - 2019/5/30

N2 - 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.

AB - 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.

U2 - 10.1093/eurheartj/ehz327

DO - 10.1093/eurheartj/ehz327

M3 - Journal article

JO - European Heart Journal

JF - European Heart Journal

SN - 0195-668X

ER -