Risk for Endocarditis in Bacteremia with Streptococcus-Like Bacteria : A Retrospective Population-Based Cohort Study
Berge, Andreas LU ; Kronberg, Karin ; Sunnerhagen, Torgny LU
; Nilson, Bo H.K.
LU
; Giske, Christian G.
and Rasmussen, Magnus
LU
(2019)
In Open Forum Infectious Diseases
6(10).
- Abstract
Background: Many genera and species of Streptococcus-like bacteria (SLB) can cause infective endocarditis (IE), but little is known about the epidemiology of and the risk factors for IE in SLB-bacteremia. The aim of the study was to analyze this in a cohort of patients with SLB-bacteremia, focusing on Abiotrophia, Aerococcus, Gemella, and Granulicatella. We also evaluated whether published scoring systems generated for other Gram-positive bacteria known to cause IE (HANDOC for streptococci and NOVA and DENOVA for enterococci) could be used in SLB bacteremia to decide whether transesophageal echocardiography (TEE) could be omitted. Methods: Positive blood cultures with SLB were retrieved from population-based registries in Sweden (3.2... (More)
Background: Many genera and species of Streptococcus-like bacteria (SLB) can cause infective endocarditis (IE), but little is known about the epidemiology of and the risk factors for IE in SLB-bacteremia. The aim of the study was to analyze this in a cohort of patients with SLB-bacteremia, focusing on Abiotrophia, Aerococcus, Gemella, and Granulicatella. We also evaluated whether published scoring systems generated for other Gram-positive bacteria known to cause IE (HANDOC for streptococci and NOVA and DENOVA for enterococci) could be used in SLB bacteremia to decide whether transesophageal echocardiography (TEE) could be omitted. Methods: Positive blood cultures with SLB were retrieved from population-based registries in Sweden (3.2 million inhabitants), from January 2012 to December 2017. Clinical data were collected from medical records. Risk factors for IE were analyzed and the performances of the scoring systems were calculated. Results: The incidence of bacteremia with the 4 SLB genera was 30 episodes/1 000 000 population per year, of which Aerococcus contributed with 18. Among 568 episodes of bacteremia, 32 cases of IE were identified (5.6%). Infective endocarditis was most common in bacteremia with Abiotrophia (4 of 19) followed by Granulicatella (9 of 124), Gemella (6 of 87), and Aerococcus (13 of 338). NOVA had 100% sensitivity to identify IE but a low specificity (15%). For HANDOC and DENOVA, the sensitivities were 97% and 91%, respectively, whereas specificities were 85% and 90%, respectively, and numbers needed to screen were 3.6 and 2.8, respectively. Conclusions: Bacteremia with these SLB is relatively rare, and the decision whether TEE should be performed or not could be based on either HANDOC or DENOVA.
(Less)
- author
- Berge, Andreas
LU
; Kronberg, Karin
; Sunnerhagen, Torgny
LU
; Nilson, Bo H.K.
LU
; Giske, Christian G.
and Rasmussen, Magnus
LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- bacteremia, echocardiography, endocarditis, management score
- in
- Open Forum Infectious Diseases
- volume
- 6
- issue
- 10
- article number
- ofz437
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85084306131
- pmid:31667201
- ISSN
- 2328-8957
- DOI
- 10.1093/ofid/ofz437
- project
- Infections caused by Aerococcus and other endocarditis-causing pathogens
- language
- English
- LU publication?
- yes
- id
- f926a60a-4d2c-4d3a-aad0-2cc864aafa85
- date added to LUP
- 2020-05-26 12:06:25
- date last changed
- 2024-05-02 10:07:16
@article{f926a60a-4d2c-4d3a-aad0-2cc864aafa85,
abstract = {{<p>Background: Many genera and species of Streptococcus-like bacteria (SLB) can cause infective endocarditis (IE), but little is known about the epidemiology of and the risk factors for IE in SLB-bacteremia. The aim of the study was to analyze this in a cohort of patients with SLB-bacteremia, focusing on Abiotrophia, Aerococcus, Gemella, and Granulicatella. We also evaluated whether published scoring systems generated for other Gram-positive bacteria known to cause IE (HANDOC for streptococci and NOVA and DENOVA for enterococci) could be used in SLB bacteremia to decide whether transesophageal echocardiography (TEE) could be omitted. Methods: Positive blood cultures with SLB were retrieved from population-based registries in Sweden (3.2 million inhabitants), from January 2012 to December 2017. Clinical data were collected from medical records. Risk factors for IE were analyzed and the performances of the scoring systems were calculated. Results: The incidence of bacteremia with the 4 SLB genera was 30 episodes/1 000 000 population per year, of which Aerococcus contributed with 18. Among 568 episodes of bacteremia, 32 cases of IE were identified (5.6%). Infective endocarditis was most common in bacteremia with Abiotrophia (4 of 19) followed by Granulicatella (9 of 124), Gemella (6 of 87), and Aerococcus (13 of 338). NOVA had 100% sensitivity to identify IE but a low specificity (15%). For HANDOC and DENOVA, the sensitivities were 97% and 91%, respectively, whereas specificities were 85% and 90%, respectively, and numbers needed to screen were 3.6 and 2.8, respectively. Conclusions: Bacteremia with these SLB is relatively rare, and the decision whether TEE should be performed or not could be based on either HANDOC or DENOVA.</p>}},
author = {{Berge, Andreas and Kronberg, Karin and Sunnerhagen, Torgny and Nilson, Bo H.K. and Giske, Christian G. and Rasmussen, Magnus}},
issn = {{2328-8957}},
keywords = {{bacteremia; echocardiography; endocarditis; management score}},
language = {{eng}},
number = {{10}},
publisher = {{Oxford University Press}},
series = {{Open Forum Infectious Diseases}},
title = {{Risk for Endocarditis in Bacteremia with Streptococcus-Like Bacteria : A Retrospective Population-Based Cohort Study}},
url = {{https://lup.lub.lu.se/search/files/119180540/Risk_for_Endocarditis_in_Bacteremia_With_Streptococcus_Like_Bacteria.pdf}},
doi = {{10.1093/ofid/ofz437}},
volume = {{6}},
year = {{2019}},
}