P3665Prevalence of infective endocarditis in patients with positive blood cultures: a Danish nationwide study

Abstract

Abstract Background Increasing attention has been given to the risk of infective endocarditis (IE) in patients with certain blood stream infections (BSI). Previous studies have been conducted on selected patient cohorts, yet unselected data are sparse. Purpose To investigate the nationwide prevalence of diagnosed IE in BSIs with bacteria typically associated with IE. Methods By crosslinking nationwide registries from 2010–2016, we identified patients with BSIs typically associated with IE: Enterococcus faecalis, Staphylococcus, Streptococcus spp., and coagulase negative staphylococci (CoNS) and examined the concurrent IE prevalence. A trend test was used to examine temporal changes in the prevalence of IE. Results In total 60,119 BSIs, distributed with 15,407, 16,790, and 27,922 BSIs were identified in the periods of 2010–2011, 2012–2013, and 2014–2016, respectively. Patients with E. Faecalis had the highest prevalence of diagnosed IE (16.3%) followed by S. aureus (10.2%), Streptococcus spp. (7.3%), and CoNS (1.6%) (Figure). During the study period, the prevalence of IE among patients with E. faecalis increased significantly (p=0.003), Male patients had higher prevalence of IE for all microorganisms investigated compared with females. A significant increase in the prevalence of IE was seen for E. faecalis, Streptococcus spp., and CoNS with increasing age. Percent with endocarditis Conclusion For E. faecalis BSI, 1 in 6 had IE, for S. aureus BSI 1 in 10 had IE, and for Streptococcus spp. 1 in 14 had IE. Our results support screening for IE in patients with E. faecalis, S. aureus, or Streptococcus spp. BSI in order to offer appropriate therapy.