Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 1 de 1
Filter
Add more filters










Database
Language
Publication year range
1.
Clin Infect Dis ; 60(4): 528-35, 2015 02 15.
Article in English | MEDLINE | ID: mdl-25381321

ABSTRACT

BACKGROUND: Frequency of enterococcal bloodstream infection (E-BSI) is increasing, and the number of episodes complicated by infective endocarditis (IE) varies. Performing transesophageal echocardiography (TEE) in all patients with E-BSI is costly and time-consuming. Our objectives were to identify patients with E-BSI who are at very low risk of enterococcal IE (and therefore do not require TEE) and to compare the outcome of E-BSI in patients with/without IE. METHODS: Between September 2003 and October 2012, we performed a prospective cohort study (all patients with E-BSI) and a case-control study (patients with/without enterococcal IE) in our center. RESULTS: We detected 1515 patients with E-BSI and 65 with enterococcal IE (4.29% of all episodes of E-BSI, 16.7% of patients with E-BSI who underwent transthoracic echocardiography, and 35.5% of all patients with E-BSI who underwent TEE). We developed a bedside predictive score for enterococcal IE-Number of positive blood cultures, Origin of the bacteremia, previous Valve disease, Auscultation of heart murmur (NOVA) score-based on the following variables: Number of positive blood cultures (3/3 blood cultures or the majority if more than 3), 5 points; unknown Origin of bacteremia, 4 points; prior heart Valve disease, 2 points; Auscultation of a heart murmur, 1 point (receiver operating characteristic = 0.83). The best cutoff corresponded to a score ≥4 (sensitivity, 100%; specificity, 29%). A score <4 points suggested a very low risk for enterococcal IE and that TEE could be obviated. CONCLUSIONS: Enterococcal IE may be more frequent than generally thought. Depending on local prevalence of endocarditis, application of the NOVA score may safely obviate echocardiography in 14%-27% of patients with E-BSI.


Subject(s)
Bacteremia/complications , Echocardiography, Transesophageal , Endocarditis, Bacterial/diagnosis , Endocarditis, Bacterial/epidemiology , Enterococcus faecalis/isolation & purification , Enterococcus , Gram-Positive Bacterial Infections/diagnosis , Adolescent , Adult , Aged , Blood/microbiology , Case-Control Studies , Cohort Studies , Echocardiography, Transesophageal/statistics & numerical data , Endocarditis, Bacterial/diagnostic imaging , Enterococcus/isolation & purification , Female , Gram-Positive Bacterial Infections/diagnostic imaging , Gram-Positive Bacterial Infections/epidemiology , Heart Murmurs , Heart Valve Diseases , Humans , Logistic Models , Male , Middle Aged , Prospective Studies , Risk Factors , Spain , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...