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- Title
Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia: the value of screening with echocardiography.
- Authors
Rasmussen, Rasmus V.; Høst, Ulla; Arpi, Magnus; Hassager, Christian; Johansen, Helle K.; Korup, Eva; Schønheyder, Henrik C.; Berning, Jens; Gill, Sabine; Rosenvinge, Flemming S.; Fowler, Vance G.; Møller, Jacob E.; Skov, Robert L.; Larsen, Carsten T.; Hansen, Thomas F.; Mard, Shan; Smit, Jesper; Andersen, Paal S.; Bruun, Niels E.
- Abstract
Aims Staphylococcus aureus infective endocarditis (IE) is a critical medical condition associated with a high morbidity and mortality. In the present study, we prospectively evaluated the importance of screening with echocardiography in an unselected S. aureus bacteraemia (SAB) population. Methods and results From 1 January 2009 to 31 August 2010, a total of 244 patients with SAB at six Danish hospitals underwent screening echocardiography. The inclusion rate was 73% of all eligible patients (n= 336), and 53 of the 244 included patients (22%; 95% CI: 17–27%) were diagnosed with definite IE. In patients with native heart valves the prevalence was 19% (95% CI: 14–25%) compared with 38% (95% CI: 20–55%) in patients with prosthetic heart valves and/or cardiac rhythm management devices (P= 0.02). No difference was found between Main Regional Hospitals and Tertiary Cardiac Hospitals, 20 vs. 23%, respectively (NS). The prevalence of IE in high-risk patients with one or more predisposing condition or clinical evidence of IE were significantly higher compared with low-risk patients with no additional risk factors (38 vs. 5%; P < 0.001). IE was associated with a higher 6 months mortality, 14(26%) vs. 28(15%) in SAB patients without IE, respectively (P < 0.05). Conclusion SAB patients carry a high risk for development of IE, which is associated with a worse prognosis compared with uncomplicated SAB. The presenting symptoms and clinical findings associated with IE are often non-specific and echocardiography should always be considered as part of the initial evaluation of SAB patients.
- Subjects
DENMARK; BACTEREMIA; CHI-squared test; CONFIDENCE intervals; ECHOCARDIOGRAPHY; FISHER exact test; INFECTIVE endocarditis; MULTIVARIATE analysis; RESEARCH funding; STAPHYLOCOCCUS aureus; STATISTICS; T-test (Statistics); U-statistics; LOGISTIC regression analysis; DATA analysis software; DESCRIPTIVE statistics; LOG-rank test; PREVENTION
- Publication
European Journal of Echocardiography, 2011, Vol 12, Issue 6, p414
- ISSN
1525-2167
- Publication type
Article
- DOI
10.1093/ejechocard/jer023