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Non-betahemolytic streptococcal bacteremia, cardiac implantable electronic device, endocarditis, extraction, and outcome; a population-based retrospective cohort study

Berge, Andreas LU ; Lundin, Johannes ; Bläckberg, Anna LU ; Sunnerhagen, Torgny LU orcid and Rasmussen, Magnus LU (2024) In Infection
Abstract
Purpose
Patients with non-beta-hemolytic streptococcal bacteremia (NBHSB) are at risk of infective endocarditis (IE). Patients with cardiac implantable electronic device (CIED) have been described to have an increased risk of IE. The aim of the study was to describe a population-based cohort of patients with NBHSB and CIED and variables associated with IE and recurrent NBHSB.

Methods
All episodes with NBHSB in blood culture from 2015 to 2018 in a population of 1.3 million inhabitants were collected from the Clinical Microbiology Laboratory, Lund, Sweden. Through medical records, patients with CIED during NBHSB were identified and clinical data were collected. Patients were followed 365 days after... (More)
Purpose
Patients with non-beta-hemolytic streptococcal bacteremia (NBHSB) are at risk of infective endocarditis (IE). Patients with cardiac implantable electronic device (CIED) have been described to have an increased risk of IE. The aim of the study was to describe a population-based cohort of patients with NBHSB and CIED and variables associated with IE and recurrent NBHSB.

Methods
All episodes with NBHSB in blood culture from 2015 to 2018 in a population of 1.3 million inhabitants were collected from the Clinical Microbiology Laboratory, Lund, Sweden. Through medical records, patients with CIED during NBHSB were identified and clinical data were collected. Patients were followed 365 days after NBHSB.

Results
Eighty-five episodes in 79 patients with CIED and NBHSB constituted the cohort. Eight patients (10%) were diagnosed with definite IE during the first episode, five of whom also had heart valve prosthesis (HVP). In 39 patients (49%) transesophageal echocardiography (TEE) was performed of which six indicated IE. Four patients had the CIED extracted. Twenty-four patients did not survive (30%) the study period. Four patients had a recurrent infection with NBHSB with the same species, three of whom had HVP and had been evaluated with TEE with a negative result during the first episode and diagnosed with IE during the recurrency.

Conclusion
The study did not find a high risk of IE in patients with NBHSB and CIED. Most cases of IE were in conjunction with a simultaneous HVP. A management algorithm is suggested. (Less)
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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Infection
publisher
Springer
external identifiers
  • pmid:38634990
  • scopus:85190652150
ISSN
0300-8126
DOI
10.1007/s15010-024-02221-0
language
English
LU publication?
yes
id
550f986c-5eaf-40d9-baca-5ade3d1b8e40
date added to LUP
2024-04-19 07:20:21
date last changed
2024-04-30 10:21:48
@article{550f986c-5eaf-40d9-baca-5ade3d1b8e40,
  abstract     = {{Purpose<br/>Patients with non-beta-hemolytic streptococcal bacteremia (NBHSB) are at risk of infective endocarditis (IE). Patients with cardiac implantable electronic device (CIED) have been described to have an increased risk of IE. The aim of the study was to describe a population-based cohort of patients with NBHSB and CIED and variables associated with IE and recurrent NBHSB.<br/><br/>Methods<br/>All episodes with NBHSB in blood culture from 2015 to 2018 in a population of 1.3 million inhabitants were collected from the Clinical Microbiology Laboratory, Lund, Sweden. Through medical records, patients with CIED during NBHSB were identified and clinical data were collected. Patients were followed 365 days after NBHSB.<br/><br/>Results<br/>Eighty-five episodes in 79 patients with CIED and NBHSB constituted the cohort. Eight patients (10%) were diagnosed with definite IE during the first episode, five of whom also had heart valve prosthesis (HVP). In 39 patients (49%) transesophageal echocardiography (TEE) was performed of which six indicated IE. Four patients had the CIED extracted. Twenty-four patients did not survive (30%) the study period. Four patients had a recurrent infection with NBHSB with the same species, three of whom had HVP and had been evaluated with TEE with a negative result during the first episode and diagnosed with IE during the recurrency.<br/><br/>Conclusion<br/>The study did not find a high risk of IE in patients with NBHSB and CIED. Most cases of IE were in conjunction with a simultaneous HVP. A management algorithm is suggested.}},
  author       = {{Berge, Andreas and Lundin, Johannes and Bläckberg, Anna and Sunnerhagen, Torgny and Rasmussen, Magnus}},
  issn         = {{0300-8126}},
  language     = {{eng}},
  month        = {{04}},
  publisher    = {{Springer}},
  series       = {{Infection}},
  title        = {{Non-betahemolytic streptococcal bacteremia, cardiac implantable electronic device, endocarditis, extraction, and outcome; a population-based retrospective cohort study}},
  url          = {{https://lup.lub.lu.se/search/files/181105192/s15010-024-02221-0.pdf}},
  doi          = {{10.1007/s15010-024-02221-0}},
  year         = {{2024}},
}