Non-β-hemolytic Streptococcal Bacteremia in Patients With Heart Valve Prosthesis-Is It Always Infective Endocarditis?

Area of Science:

• Infectious Diseases
• Cardiology
• Microbiology

Background:

• Non-β-hemolytic streptococci are common causes of infective endocarditis (IE).
• Patients with heart valve prostheses (HVP) are at increased risk for IE.
• Non-β-hemolytic streptococcal bacteremia (NBHSB) in HVP patients warrants careful evaluation.

Purpose of the Study:

• To determine the risk of IE in patients with HVP and NBHSB.
• To investigate the rate of NBHSB relapse based on antibiotic treatment duration.

Main Methods:

• Retrospective population-based study of adults with HVP and NBHSB (2015-2018).
• Data collected from medical records using a predefined protocol.
• IE diagnosis based on European Society of Cardiology 2015 criteria.

Main Results:

• 110 NBHSB episodes in 89 HVP patients were analyzed.
• Definite IE occurred in 36% of episodes; possible IE in 64%.
• Seven NBHSB relapses were observed, primarily in patients with possible IE and short antibiotic courses (<14 days).

Conclusions:

• Patients with NBHSB and HVP have a significant risk for IE.
• Thorough investigation and appropriate antibiotic treatment duration are crucial for managing these patients.
• Short-course antibiotic therapy may be associated with an increased risk of NBHSB relapse.