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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Rasmussen, RV; Høst, U; Arpi, M; Hassager, C; Johansen, HK; Korup, E; Schønheyder, HC; Berning, J; Gill, S; Rosenvinge, FS; Fowler, VG; Møller, JE; Skov, RL; Larsen, CT; Hansen, TF; Mard, S; Smit, J; Andersen, PS; Bruun, NE

Published Date

  • June 2011

Published In

Volume / Issue

  • 12 / 6

Start / End Page

  • 414 - 420

PubMed ID

  • 21685200

Pubmed Central ID

  • 21685200

Electronic International Standard Serial Number (EISSN)

  • 1532-2114

Digital Object Identifier (DOI)

  • 10.1093/ejechocard/jer023

Language

  • eng

Conference Location

  • England