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Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia.

Publication ,  Journal Article
Kaasch, AJ; Fowler, VG; Rieg, S; Peyerl-Hoffmann, G; Birkholz, H; Hellmich, M; Kern, WV; Seifert, H
Published in: Clin Infect Dis
July 1, 2011

BACKGROUND: Infective endocarditis (IE) is a severe complication in patients with nosocomial Staphylococcus aureus bacteremia (SAB). We sought to develop and validate criteria to identify patients at low risk for the development of IE in whom transesophageal echocardiography (TEE) might be dispensable. METHODS: Consecutive patients with nosocomial SAB from independent cohorts in Europe (Invasive S. aureus Infection Cohort [INSTINCT]) and North America (S. aureus Bacteremia Group [SABG]) were evaluated for the presence of clinical criteria predicting an increased risk for the development of IE (ie, prolonged bacteremia of >4 days' duration, presence of a permanent intracardiac device, hemodialysis dependency, spinal infection, and nonvertebral osteomyelitis). Patients were observed closely for clinical signs and symptoms of IE during hospitalization and a 3-month follow-up period. RESULTS: IE was present in 13 (4.3%) of 304 patients in the INSTINCT cohort and in 40 (9.3%) of 432 patients in the SABG cohort. Within 14 days after the first positive blood culture result, echocardiography was performed in 39.8% and 57.4% of patients in the INSTINCT and SABG cohorts, respectively. In patients with IE, the most common clinical prediction criteria present were prolonged bacteremia (69.2% vs 90% for INSTINCT vs SABG, respectively) and presence of a permanent intracardiac device (53.8% vs 32.5%). In total, 13 of 13 patients in the INSTINCT cohort and 39 of 40 patients in the SABG cohort with documented IE fulfilled at least 1 criterion (sensitivity, 100% vs. 97.5%; negative predictive value, 100% vs 99.2%). CONCLUSIONS: A simple criteria set for patients with nosocomial SAB can identify patients at low risk of IE. Patients who meet these criteria may not routinely require TEE.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

July 1, 2011

Volume

53

Issue

1

Start / End Page

1 / 9

Location

United States

Related Subject Headings

  • Staphylococcus aureus
  • Staphylococcal Infections
  • Reproducibility of Results
  • Practice Guidelines as Topic
  • North America
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Female
 

Citation

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Kaasch, A. J., Fowler, V. G., Rieg, S., Peyerl-Hoffmann, G., Birkholz, H., Hellmich, M., … Seifert, H. (2011). Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia. Clin Infect Dis, 53(1), 1–9. https://doi.org/10.1093/cid/cir320
Kaasch, Achim J., Vance G. Fowler, Siegbert Rieg, Gabriele Peyerl-Hoffmann, Hanna Birkholz, Martin Hellmich, Winfried V. Kern, and Harald Seifert. “Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia.Clin Infect Dis 53, no. 1 (July 1, 2011): 1–9. https://doi.org/10.1093/cid/cir320.
Kaasch AJ, Fowler VG, Rieg S, Peyerl-Hoffmann G, Birkholz H, Hellmich M, et al. Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia. Clin Infect Dis. 2011 Jul 1;53(1):1–9.
Kaasch, Achim J., et al. “Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia.Clin Infect Dis, vol. 53, no. 1, July 2011, pp. 1–9. Pubmed, doi:10.1093/cid/cir320.
Kaasch AJ, Fowler VG, Rieg S, Peyerl-Hoffmann G, Birkholz H, Hellmich M, Kern WV, Seifert H. Use of a simple criteria set for guiding echocardiography in nosocomial Staphylococcus aureus bacteremia. Clin Infect Dis. 2011 Jul 1;53(1):1–9.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

July 1, 2011

Volume

53

Issue

1

Start / End Page

1 / 9

Location

United States

Related Subject Headings

  • Staphylococcus aureus
  • Staphylococcal Infections
  • Reproducibility of Results
  • Practice Guidelines as Topic
  • North America
  • Middle Aged
  • Microbiology
  • Male
  • Humans
  • Female