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Clinical utility of echocardiography for the diagnosis of native valve infective endocarditis in Staphylococcus aureus bacteremia.

Authors
  • Lau, Lawrence1
  • Wiens, Evan J1
  • Karlowsky, James A2
  • Keynan, Yoav2, 3
  • Jassal, Davinder S4, 5
  • 1 Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. , (Canada)
  • 2 Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. , (Canada)
  • 3 Section of Infectious Diseases, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. , (Canada)
  • 4 Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. , (Canada)
  • 5 Department of Radiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. , (Canada)
Type
Published Article
Journal
Echocardiography (Mount Kisco, N.Y.)
Publication Date
Oct 01, 2019
Volume
36
Issue
10
Pages
1852–1858
Identifiers
DOI: 10.1111/echo.14480
PMID: 31536152
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The incidence of Staphylococcus aureus infective endocarditis (IE) is steadily rising due to advances in health care delivery. Routine echocardiography is essential in the management of Staphylococcus aureus bacteremia (SAB). The aim of this retrospective cohort study was to characterize the real-world use of echocardiography in adult patients with SAB and native valve S aureus IE. Using an academic hospital microbiological database, all cases of SAB in adults between 2010 and 2016 were identified. Demographic, echocardiographic, and clinical features were recorded. A total of 738 episodes of SAB were identified, of which 504 (68%) patients underwent transthoracic echocardiography (TTE) within 30 days. Of 73 patients with definite IE, 46 (63%) patients had definite IE diagnosed on the initial TTE. An additional 14 (19%) patients had definite IE diagnosed on repeat TTE, 6 (8%) on transesophageal echocardiography (TEE), and 7 (10%) were diagnosed without fulfilling Duke echocardiographic criteria. The yield of repeat TTE was comparable to that of TEE for identifying new vegetations not identified on the initial TTE (17% vs 21%, P = .78). Most cases of IE in SAB were identified using TTE alone, with repeat TTE improving the diagnostic yield in the setting of clinical decompensation. © 2019 Wiley Periodicals, Inc.

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