Blood Culture Negative Endocarditis; What Do Concurrent Cardiac Disorders Tell Us?
Diğer yayınlar > Diğer · 2024
Yazarlar: Mine Filiz, Hakan Erdem, Handan Ankarali, Edmond Puca, Yvon Ruch, Lurdes Santos, Nesrin Ghanem-Zoubi, Xavier Argemi, Yves Hansmann, Rahmet Guner, Gilda Tonziello, Jean-Philippe Mazzucotelli, Najada Como, Sukran Kose, Ayse Batirel, Asuman Inan, Necla Tulek, Abdullah Umut Pekok, Ejaz Ahmed Khan, Atilla Iyisoy, Meliha Meric-Koc, Ayse Kaya-Kalem, Pedro Palma Martins, Imran Hasanoglu, André Silva-Pinto, Nefise Oztoprak, Raquel Duro, Fahad Almajid, Mustafa Dogan, Nicolas Dauby, Jesper Damsgaard Gunst, Recep Tekin, Deborah Konopnicki, Nicola Petrosillo, Ilkay Bozkurt, Jamal Wadi Al Ramahi, Corneliu Popescu, Ilker Inanc Balkan, Safak Ozer-Balin, Tatjana Lejko Zupanc, Antonio Cascio, Irina Magdalena Dumitru, Aysegul Erdem, Gulden Ersoz, Meltem TAŞBAKAN, Oday Abu Ajamieh, Fatma Sirmatel, Simin Florescu, Serda Gulsun, Hacer Deniz Ozkaya, Sema Sari, Selma Tosun, Meltem Avci, Yasemin Cag, Guven Celebi, Ayse Sagmak-Tartar, Sumeyra Karakus, Alper Sener, Arjeta Dedej, Serkan Oncu, Rosa Fontana Del Vecchio, Derya Ozturk-Engin, Canan Agalar
Diğer, Uluslararası, 2024,
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.