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S taphylococcus aureus bacteraemia, cardiac implantable electronic device, and the risk of endocarditis : a retrospective population–based cohort study

Berge, Andreas ; Carlsén, Casper ; Petropoulos, Alexandros ; Gadler, Fredrik and Rasmussen, Magnus LU (2023) In European Journal of Clinical Microbiology and Infectious Diseases 42(5). p.583-591
Abstract

Patients with cardiac implantable electronic device (CIED) and Staphylococcus aureus bacteraemia (SAB) are at risk of having infective endocarditis (IE). The objectives were to describe a Swedish population-based cohort of patients with CIED and SAB, to identify risk factors, and to construct a predictive score for IE. Patients over 18 years old in the Stockholm Region identified to have SAB in the Karolinska Laboratory database from January 2015 through December 2019 were matched to the Swedish Pacemaker and Implantable Cardioverter-Defibrillator ICD Registry to identify the study cohort. Data were collected from study of medical records. A cohort of 274 patients with CIED and SAB was identified and in 38 episodes (14%) IE were... (More)

Patients with cardiac implantable electronic device (CIED) and Staphylococcus aureus bacteraemia (SAB) are at risk of having infective endocarditis (IE). The objectives were to describe a Swedish population-based cohort of patients with CIED and SAB, to identify risk factors, and to construct a predictive score for IE. Patients over 18 years old in the Stockholm Region identified to have SAB in the Karolinska Laboratory database from January 2015 through December 2019 were matched to the Swedish Pacemaker and Implantable Cardioverter-Defibrillator ICD Registry to identify the study cohort. Data were collected from study of medical records. A cohort of 274 patients with CIED and SAB was identified and in 38 episodes (14%) IE were diagnosed, 19 with changes on the CIED, and 35 with changes on the left side of the heart. The risk factors predisposition for IE, community acquisition, embolization, time to positivity of blood cultures, and growth in blood culture after start of therapy in blood cultures were independently associated to IE. A score to identify patients with IE was constructed, the CTEPP score, and the chosen cut-off generated a sensitivity of 97%, specificity of 25%, and a negative predictive value of 98%. The score was externally validated in a population-based cohort of patients with CIED and SAB from another Swedish region. We found that 14% of patients with CIED and SAB had definite IE diagnosed. The CTEPP-score can be used to predict the risk of IE and, when negative, the risk is negligible.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bacteraemia, CIED, Endocarditis, Management score, Staphylococcus aureus
in
European Journal of Clinical Microbiology and Infectious Diseases
volume
42
issue
5
pages
583 - 591
publisher
Springer
external identifiers
  • pmid:36920628
  • scopus:85150074437
ISSN
0934-9723
DOI
10.1007/s10096-023-04585-x
language
English
LU publication?
yes
id
83cfe128-c835-4b3e-8271-3e0753807dd4
date added to LUP
2023-04-04 14:46:30
date last changed
2024-06-28 19:49:20
@article{83cfe128-c835-4b3e-8271-3e0753807dd4,
  abstract     = {{<p>Patients with cardiac implantable electronic device (CIED) and Staphylococcus aureus bacteraemia (SAB) are at risk of having infective endocarditis (IE). The objectives were to describe a Swedish population-based cohort of patients with CIED and SAB, to identify risk factors, and to construct a predictive score for IE. Patients over 18 years old in the Stockholm Region identified to have SAB in the Karolinska Laboratory database from January 2015 through December 2019 were matched to the Swedish Pacemaker and Implantable Cardioverter-Defibrillator ICD Registry to identify the study cohort. Data were collected from study of medical records. A cohort of 274 patients with CIED and SAB was identified and in 38 episodes (14%) IE were diagnosed, 19 with changes on the CIED, and 35 with changes on the left side of the heart. The risk factors predisposition for IE, community acquisition, embolization, time to positivity of blood cultures, and growth in blood culture after start of therapy in blood cultures were independently associated to IE. A score to identify patients with IE was constructed, the CTEPP score, and the chosen cut-off generated a sensitivity of 97%, specificity of 25%, and a negative predictive value of 98%. The score was externally validated in a population-based cohort of patients with CIED and SAB from another Swedish region. We found that 14% of patients with CIED and SAB had definite IE diagnosed. The CTEPP-score can be used to predict the risk of IE and, when negative, the risk is negligible.</p>}},
  author       = {{Berge, Andreas and Carlsén, Casper and Petropoulos, Alexandros and Gadler, Fredrik and Rasmussen, Magnus}},
  issn         = {{0934-9723}},
  keywords     = {{Bacteraemia; CIED; Endocarditis; Management score; Staphylococcus aureus}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{583--591}},
  publisher    = {{Springer}},
  series       = {{European Journal of Clinical Microbiology and Infectious Diseases}},
  title        = {{S taphylococcus aureus bacteraemia, cardiac implantable electronic device, and the risk of endocarditis : a retrospective population–based cohort study}},
  url          = {{http://dx.doi.org/10.1007/s10096-023-04585-x}},
  doi          = {{10.1007/s10096-023-04585-x}},
  volume       = {{42}},
  year         = {{2023}},
}