期刊
EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY
卷 12, 期 6, 页码 414-420出版社
OXFORD UNIV PRESS
DOI: 10.1093/ejechocard/jer023
关键词
Infective endocarditis; Echocardiography; Staphylococcus aureus; Screening
资金
- Danish Heart Foundation [08-10-R68-A2155-B778-22512]
- Augustinus Foundation
- Aase and Ejnar Danielsens Foundation
- NIH
- Astellas
- Cubist
- Merck
- Theravance
- Cerexa
- Pfizer
- Novartis
- Advanced Liquid Logic
Aims Staphylococcus aureus infective endocarditis (IE) is a critical medical condition associated with a high morbidity and mortality. In the present study, we prospectively evaluated the importance of screening with echocardiography in an unselected S. aureus bacteraemia (SAB) population. Methods and results From 1 January 2009 to 31 August 2010, a total of 244 patients with SAB at six Danish hospitals underwent screening echocardiography. The inclusion rate was 73% of all eligible patients (n = 336), and 53 of the 244 included patients (22%; 95% Cl: 17-27%) were diagnosed with definite IE. In patients with native heart valves the prevalence was 19% (95% Cl: 14-25%) compared with 38% (95% Cl: 20-55%) in patients with prosthetic heart valves and/or cardiac rhythm management devices (P = 0.02). No difference was found between Main Regional Hospitals and Tertiary Cardiac Hospitals, 20 vs. 23%, respectively (NS). The prevalence of IE in high-risk patients with one or more predisposing condition or clinical evidence of IE were significantly higher compared with low-risk patients with no additional risk factors (38 vs. 5%; P < 0.001). IE was associated with a higher 6 months mortality, 14(26%) vs. 28(15%) in SAB patients without IE, respectively (P < 0.05). Conclusion SAB patients carry a high risk for development of IE, which is associated with a worse prognosis compared with uncomplicated SAB. The presenting symptoms and clinical findings associated with IE are often non-specific and echocardiography should always be considered as part of the initial evaluation of SAB patients.
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