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Short time to blood culture positivity in Enterococcus faecalis infective endocarditis

Oldberg, Karl LU orcid ; Thorén, Rebecca ; Nilson, Bo LU orcid ; Gilje, Patrik LU ; Inghammar, Malin LU and Rasmussen, Magnus LU (2021) In European Journal of Clinical Microbiology and Infectious Diseases 40. p.1657-1664
Abstract

Time to blood culture positivity (TTP) is an indirect measure of bacterial concentration in blood. A short TTP has been linked to the presence of infective endocarditis (IE) and to poor prognosis in Staphylococcus aureus bacteremia. We analyze factors influencing TTP in bacteremia with Enterococcus faecalis. This retrospective observational study of medical records included adults diagnosed with monomicrobial E. faecalis bacteremia between 2015 and 2018 in the Skåne region (Sweden). For each episode, the shortest TTP was recorded. Median TTP was compared between patients grouped based on age, sex, comorbidity, site of acquisition, and focus of infection. Using a dichotomized TTP (shorter or longer than 12 h), a multivariable logistic... (More)

Time to blood culture positivity (TTP) is an indirect measure of bacterial concentration in blood. A short TTP has been linked to the presence of infective endocarditis (IE) and to poor prognosis in Staphylococcus aureus bacteremia. We analyze factors influencing TTP in bacteremia with Enterococcus faecalis. This retrospective observational study of medical records included adults diagnosed with monomicrobial E. faecalis bacteremia between 2015 and 2018 in the Skåne region (Sweden). For each episode, the shortest TTP was recorded. Median TTP was compared between patients grouped based on age, sex, comorbidity, site of acquisition, and focus of infection. Using a dichotomized TTP (shorter or longer than 12 h), a multivariable logistic regression for factors associated to TTP was performed. The association between TTP and IE or mortality was evaluated. Three hundred sixty-seven episodes with monomicrobial E. faecalis bacteremia with the corresponding TTP were identified. Median TTP for the entire cohort was 11.6 (IQR 9.9–14.1) h and a significantly shorter TTP was noted for episodes which represented IE (n = 55, 9.4 (IQR 6.4–10.6) h). Only IE remained associated with a short TTP (≤ 12 h) in binary logistic regression analysis. Factors associated with IE were investigated and TTP was associated with IE also when adjusted for age, gender, comorbidity, and nosocomial acquisition. There was no association between TTP and mortality. A low TTP is associated with IE in E. faecalis bacteremia and could be used as a help in determining the need for echocardiography in patients with this condition.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bacteremia, Enterococcus faecalis, Infective endocarditis, Time to positivity
in
European Journal of Clinical Microbiology and Infectious Diseases
volume
40
pages
1657 - 1664
publisher
Springer
external identifiers
  • scopus:85102343474
  • pmid:33687580
ISSN
0934-9723
DOI
10.1007/s10096-021-04210-9
language
English
LU publication?
yes
id
3da431b6-f839-47c0-b9fa-c237f33e0c1d
date added to LUP
2021-03-26 12:51:03
date last changed
2024-06-29 09:43:47
@article{3da431b6-f839-47c0-b9fa-c237f33e0c1d,
  abstract     = {{<p>Time to blood culture positivity (TTP) is an indirect measure of bacterial concentration in blood. A short TTP has been linked to the presence of infective endocarditis (IE) and to poor prognosis in Staphylococcus aureus bacteremia. We analyze factors influencing TTP in bacteremia with Enterococcus faecalis. This retrospective observational study of medical records included adults diagnosed with monomicrobial E. faecalis bacteremia between 2015 and 2018 in the Skåne region (Sweden). For each episode, the shortest TTP was recorded. Median TTP was compared between patients grouped based on age, sex, comorbidity, site of acquisition, and focus of infection. Using a dichotomized TTP (shorter or longer than 12 h), a multivariable logistic regression for factors associated to TTP was performed. The association between TTP and IE or mortality was evaluated. Three hundred sixty-seven episodes with monomicrobial E. faecalis bacteremia with the corresponding TTP were identified. Median TTP for the entire cohort was 11.6 (IQR 9.9–14.1) h and a significantly shorter TTP was noted for episodes which represented IE (n = 55, 9.4 (IQR 6.4–10.6) h). Only IE remained associated with a short TTP (≤ 12 h) in binary logistic regression analysis. Factors associated with IE were investigated and TTP was associated with IE also when adjusted for age, gender, comorbidity, and nosocomial acquisition. There was no association between TTP and mortality. A low TTP is associated with IE in E. faecalis bacteremia and could be used as a help in determining the need for echocardiography in patients with this condition.</p>}},
  author       = {{Oldberg, Karl and Thorén, Rebecca and Nilson, Bo and Gilje, Patrik and Inghammar, Malin and Rasmussen, Magnus}},
  issn         = {{0934-9723}},
  keywords     = {{Bacteremia; Enterococcus faecalis; Infective endocarditis; Time to positivity}},
  language     = {{eng}},
  pages        = {{1657--1664}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Microbiology and Infectious Diseases}},
  title        = {{Short time to blood culture positivity in Enterococcus faecalis infective endocarditis}},
  url          = {{http://dx.doi.org/10.1007/s10096-021-04210-9}},
  doi          = {{10.1007/s10096-021-04210-9}},
  volume       = {{40}},
  year         = {{2021}},
}