Blood Culture Negative Endocarditis; What Do Concurrent Cardiac Disorders Tell Us?
Makaleler > Tam Makale · 2024
Yazarlar: Mine Filiz, Hakan Erdem, Handan Ankaralı, Edmond Puca, Yvon Ruch, Lurdes Santos, Nesrin Ghanem‐Zoubi, Xavier Argemi, Yves Hansmann, Rahmet Güner, Gilda Tonziello, Jean‐Philippe Mazzucotelli, N. Çomo, Şükran Köse, Ayşe Batırel, Asuman İnan, Necla Tülek, Abdullah Umut Pekok, Ejaz Ahmed Khan, Atilla İyisoy, Meliha Meriç-Koç, Ayşe Kaya-Kalem, Pedro Palma, İmran Hasanoğlu, André Silva‐Pinto, Nefise Öztoprak, Raquel Duro, Fahad Almajid, Mustafa Doğan, Nicolás Dauby, Jesper Damsgaard Gunst, Recep Tekin, Déborah Konopnicki, Nicola Petrosillo, İlkay Bozkurt, Jamal Wadi Al Ramahi, Corneliu Petru Popescu, İ̇lker İnanç Balkan, Safak Ozer-Balin, Tatjana Lejko Zupanc, Antonio Cascio, Irina Magdalena Dumitru, Aysegul Erdem, Gülden Ersöz, Meltem TAŞBAKAN, Oday Abu Ajamieh, Fatma Sırmatel, Simin Aysel Florescu, Serda Gülsün, Hacer Deniz Özkaya, Sema Sarı, Selma Tosun, Meltem Avcı, Yasemin Çağ, Güven Çelebi, Ayşe Sağmak-Tartar, Sumeyra Karakus, Alper Şener, Arjeta Dedej, Serkan Öncü, Rosa Fontana Del Vecchio, Derya Öztürk-Engin, Canan Ağalar
Greater South Information System, Uluslararası, 2024
DOI: 10.60692/jr5ma-6qh48
Özet
Abstract Purpose: Blood culture negative endocarditis (BCNE) presents diagnostic challenges, necessitating precise identification of high-risk patient cohorts. Hence, our objective was to pinpoint high-risk cohorts for BCNE. Methods: The study included adult patients with definite endocarditis. Data was collected via the Infectious Diseases International Research Initiative (ID-IRI). The primary study analysing one of the largest case series ever reported and was published in the European Journal of Clinical Microbiology and Infectious Diseases in 2019, was conducted across 41 centres in 13 countries. We performed a re-analysis of the database to determine the predictors of BCNE. Results: 867 cases with definite endocarditis were included in the study. Blood cultures were negative in 101 (11.65%) patients. We disclosed that as patients age, the likelihood of a negative blood culture significantly decreases (OR 0.975, 95% CI 0.963-0.987, p<0.001). Additionally, factors such as rheumatic heart disease (OR 2.036, 95% CI 0.970-4.276, p=0.049), aortic stenosis (OR 3.066, 95% CI 1.564-6.010, p=0.001), mitral regurgitation (OR 1.693, 95% CI 1.012-2.833, p=0.045), and prosthetic valves (OR 2.539, 95% CI 1.599-4.031, p<0.001) are associated with higher likelihoods of negative blood cultures. Our model can predict whether a patient falls into the culture-negative or culture-positive groups with a threshold of 0.104 (AUC±SE=0.707±0.027). The final model demonstrates a sensitivity of 70.3% and a specificity of 57.0%. Conclusion: Our study reveals a high prevalence of negative blood cultures in patients with concurrent cardiac disorders, particularly in younger cases. Therefore, caution is indicated in diagnosing and treating endocarditis in these particular patient subgroups.