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Related Experiment Video

Updated: May 17, 2026

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
08:45

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Published on: April 18, 2025

Prioritizing echocardiography in Staphylococcus aureus bacteraemia.

Jubin P Joseph1, Tom R Meddows, Daniel P Webster

  • 1Oxford Heart Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 9DU, UK.

The Journal of Antimicrobial Chemotherapy
|November 1, 2012
PubMed
Summary

Echocardiography for Staphylococcus aureus bacteraemia (SAB) should prioritize patients with prosthetic valves or cardiac rhythm management (CRM) devices. Early imaging is crucial for these high-risk groups, while others may benefit from deferred or screening echocardiography.

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Infective endocarditis (IE) is a serious complication of Staphylococcus aureus bacteraemia (SAB).
  • Current guidelines recommend echocardiography for all SAB patients.
  • Resource allocation for echocardiography requires strategic assessment.

Purpose of the Study:

  • To evaluate echocardiography utilization for SAB patients at a tertiary referral center.
  • To identify patient subgroups most likely to have positive IE findings on echocardiography.
  • To inform resource prioritization for echocardiography in SAB management.

Main Methods:

  • Retrospective analysis of SAB cases between September 2006 and August 2011.
  • Inclusion of 668 patients with SAB, with 306 undergoing cardiac imaging.
  • Data collection on patient characteristics, cardiac devices, and echocardiographic findings.

Main Results:

  • Echocardiographic evidence of IE was found in 10.1% of imaged patients.
  • Prosthetic heart valves (32%) and cardiac rhythm management (CRM) devices (16%) were significant risk factors for IE.
  • In patients without prosthetic valves or CRM devices, IE was rare, particularly in line-related bacteraemia.

Conclusions:

  • Prioritize echocardiography for SAB patients with prosthetic heart valves or CRM devices.
  • Consider early transesophageal echocardiography for high-risk patients.
  • Deferred or transthoracic echocardiography may be appropriate for lower-risk patients, including those with line-related infections without specific risk factors.