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Blood culture-negative infective endocarditis: a worse outcome? Results from a large multicentre retrospective

Lorenzo Roberto Suardi1, Arístides de Alarcón2, María Victoria García3

  • 1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy/Infectious Diseases Unit, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.

Infectious Diseases (London, England)
|May 26, 2021
PubMed

Insights

Blood cultures negative infective endocarditis (BCNIE) did not increase in-hospital mortality in this Spanish cohort. Key mortality factors included not undergoing surgery, septic shock, age over 65, and complicated endocarditis.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Clinical Microbiology

Background:

  • Infective endocarditis (IE) poses significant mortality risks.
  • Blood cultures negative infective endocarditis (BCNIE) presents diagnostic challenges.
  • Assessing BCNIE's impact on in-hospital mortality is crucial for patient management.

Purpose of the Study:

  • To evaluate the association between BCNIE and in-hospital mortality.
  • To identify factors influencing mortality in IE patients.

Main Methods:

  • Prospective multicentre study with retrospective analysis of a Spanish adult IE cohort.
  • Exclusion of cardiac implantable device infections.
  • Comparison of in-hospital mortality between blood culture-positive IE and BCNIE groups.

Main Results:

  • BCNIE accounted for 8.3% of 1001 IE cases.
  • Alternative diagnoses for BCNIE included Coxiella burnetii and Tropheryma whipplei.
  • No statistical difference in all-cause in-hospital mortality between BCNIE and blood culture-positive groups.
  • BCNIE was not associated with increased mortality in Cox regression models.

Conclusions:

  • BCNIE was not linked to higher in-hospital mortality in this cohort.
  • Factors significantly associated with mortality were: not receiving surgery, septic shock, age >65 years, and complicated IE.
  • Multivariate analysis confirmed these mortality predictors.
Abstract

Keywords:
Infective endocarditisblood culturesdiagnosismortalitynegative

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