Infective Endocarditis Prevalence 26 Percent in Patients With E. faecalis

The prevalence of infective endocarditis (IE) is about 26 percent among patients with Enterococcus faecalis bacteremia, according to a study published in the issue of the Journal of the American College of Cardiology.

Anders Dahl, M.D., Ph.D., from Herlev Gentofte University Hospital in Copenhagen, Denmark, and colleagues examined the prevalence of IE in patients with E. faecalis bacteremia in a prospective multicenter study conducted in consecutive patients from Jan. 1, 2014, to Dec. 31, 2016. Data were included for 344 patients with E. faecalis bacteremia who were examined using echocardiography; 74 percent of the cases had transesophageal echocardiography (TEE).

The researchers found that definite endocarditis was diagnosed in 90 patients, yielding a prevalence of 26.1 ± 4.6 percent. Prosthetic heart valve, community acquisition, three or more positive blood culture bottles, unknown portal of entry, monomicrobial bacteremia, and immunosuppression were risk factors for IE (odds ratios, 3.93, 3.35, 3.69, 2.36, 2.73, and 2.82, respectively). "

On the basis of our findings, we recommend increasing the use of echocardiography in E. faecalis bacteremia," the authors write. "We find an endocarditis prevalence of 26 percent and propose that TEE should be considered in all patients with E. faecalis bacteremia, especially those with relevant risk factors."

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