Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

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Damlin, A.Karolinska Institutet (author)

Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study

Article/chapterEnglish2019

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2019-12-16
Springer Science and Business Media LLC,2019

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LIBRIS-ID:oai:gup.ub.gu.se/290684
https://gup.ub.gu.se/publication/290684URI
https://doi.org/10.1186/s12879-019-4682-zDOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:142934439URI

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Language:English

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Subject category:art swepub-publicationtype

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Background: The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. Methods: In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher's exact test was used for comparisons between categorical variables, and student's t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results: The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions: Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Infective endocarditis
Echocardiography
Heart valves
Diagnostics
Cardiac imaging
health-care professionals
international collaboration
staphylococcus-aureus
antimicrobial therapy
management
diagnosis
complications
guidelines
statement
surgery
Infectious Diseases

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Westling, K.Karolinska Institutet (author)
Maret, E.Karolinska Institutet (author)
Lundborg, C. S.Karolinska Institutet (author)
Caidahl, Kenneth,1949Karolinska Institutet,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xcaike (author)
Eriksson, M. J. (author)
Karolinska InstitutetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin (creator_code:org_t)

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In:BMC Infectious Diseases: Springer Science and Business Media LLC191471-2334

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By the author/editor: Damlin, A.; Westling, K.; Maret, E.; Lundborg, C. S.; Caidahl, Kenneth ...; Eriksson, M. J.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Infectious Medic ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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By the university: University of Gothenburg; Karolinska Institutet

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