Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia: The value of screening with echocardiography

Rasmus V. Rasmussen*, Ulla Høst, Magnus Arpi, Christian Hassager, Helle K. Johansen, Eva Korup, Henrik C. Schønheyder, Jens Berning, Sabine Gill, Flemming S. Rosenvinge, Vance G. Fowler, Jacob E. Møller, Robert L. Skov, Carsten T. Larsen, Thomas F. Hansen, Shan Mard, Jesper Smit, Paal S. Andersen, Niels E. Bruun

*Corresponding author af dette arbejde

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    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. Corresponding author.

    Sider (fra-til)414-420
    Antal sider7
    TidsskriftEuropean Journal of Echocardiography
    Udgave nummer6
    StatusUdgivet - 1 jun. 2011


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