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The prevalence of persistent bacteraemia in patients with a non-staphylococcal infective endocarditis, a

Thomas W van der Vaart1, Marjon Stuifzand2, S Matthijs Boekholdt3

  • 1Department of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht University, Utrecht, the Netherlands.

International Journal of Cardiology
|August 24, 2022
PubMed

Insights

Persistent bacteraemia in non-staphylococcal infective endocarditis (IE) is rare, particularly in streptococcal IE. Follow-up blood cultures (FUBCs) are less valuable in these cases, especially for native valve endocarditis.

Area of Science:

  • Infectious Diseases
  • Cardiology
  • Microbiology

Background:

  • Current guidelines recommend follow-up blood cultures (FUBCs) for persistent bacteraemia in infective endocarditis (IE).
  • The prevalence and prognostic value of persistent bacteraemia in non-staphylococcal IE are not well understood.
  • Staphylococcus aureus IE frequently shows persistent bacteraemia, unlike other forms of IE.

Purpose of the Study:

  • To determine the prevalence of persistent bacteraemia in non-staphylococcal IE.
  • To evaluate the prognostic value of persistent bacteraemia in non-staphylococcal IE.
  • To assess the utility of FUBCs in managing non-staphylococcal IE.

Main Methods:

  • Retrospective analysis of patients with definite non-staphylococcal endocarditis.
  • Utilized data from two university hospital endocarditis registries.
  • Applied modified Duke Criteria for diagnosis.

Main Results:

  • Persistent bacteraemia (48h post-antibiotics) was rare (4.4%) in non-staphylococcal IE.
  • Prosthetic valve endocarditis (PVE) showed higher rates (7.1%) compared to native valve endocarditis (2.2%).
  • No persistent bacteraemia was found in streptococcal, HACEK, or Cutibacterium IE; Enterococcus faecalis and non-HACEK Gram-negatives were implicated.

Conclusions:

  • Persistent bacteraemia is uncommon in non-staphylococcal IE and primarily linked to specific resilient microorganisms.
  • FUBCs have limited yield in streptococcal endocarditis and may warrant re-evaluation.
  • Findings suggest tailored monitoring strategies for non-staphylococcal IE based on causative pathogens and valve type.
Abstract

Keywords:
BacteraemiaBlood culturesInfective endocarditis

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