Enterococcal endocarditis: 107 cases from the international collaboration on endocarditis merged database.

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Native valve endocarditis (NVE) is a serious infection affecting heart valves.
• Enterococcus species are increasingly recognized as significant pathogens in NVE.
• Understanding the specific characteristics of enterococcal NVE is crucial for patient management.

Purpose of the Study:

• To delineate the clinical features and outcomes of left-sided native valve endocarditis caused by Enterococcus.
• To compare enterococcal endocarditis with NVE caused by other common pathogens.

Main Methods:

• Analysis of patients with left-sided NVE from the International Collaboration on Endocarditis-Merged Database.
• Comparison of demographic, clinical, and outcome data between enterococcal and non-enterococcal NVE.
• Multivariable regression to assess Enterococcus as an independent predictor of mortality.

Main Results:

• Enterococcal NVE occurred predominantly in elderly males, often involving the aortic valve.
• Heart failure was more common than embolic events in enterococcal NVE.
• Enterococcal NVE demonstrated similar rates of nosocomial acquisition, heart failure, embolization, surgery, and mortality compared to non-enterococcal NVE, but was associated with lower mortality (OR 0.49).
• Compared to Streptococcus, enterococcal NVE had higher rates of nosocomial acquisition and heart failure.
• Compared to Staphylococcus aureus, enterococcal NVE had lower rates of embolization and mortality.

Conclusions:

• Enterococcal native valve endocarditis presents with a distinct clinical profile.
• Enterococcal NVE is associated with a favorable prognosis, characterized by relatively low short-term mortality.