Abstract
Enterococcal prosthetic valve infective endocarditis (PVE) is an incompletely understood disease. In the present study, patients with enterococcal PVE were compared to patients with enterococcal native valve endocarditis (NVE) and other types of PVE to determine differences in basic clinical characteristics and outcomes using a large multicenter, international database of patients with definite endocarditis. Forty-five of 159 (29%) cases of definite enterococcal endocarditis were PVE. Patients with enterococcal PVE were demographically similar to patients with enterococcal NVE but had more intracardiac abscesses (20% vs. 6%; p=0.009), fewer valve vegetations (51% vs. 79%; p<0.001), and fewer cases of new valvular regurgitation (12% vs. 45%; p=0.01). Patients with either enterococcal PVE or NVE were elderly (median age, 73 vs. 69; p=0.06). Rates of in-hospital mortality, surgical intervention, heart failure, peripheral embolization, and stroke were similar in both groups. Patients with enterococcal PVE were also demographically similar to patients with other types of PVE, but mortality may be lower (14% vs. 26%; p=0.08). Notably, 93% of patients with enterococcal PVE came from European centers, as compared with only 79% of patients with enterococcal NVE (p=0.03). Thus, patients with enterococcal PVE have higher rates of myocardial abscess formation and lower rates of new regurgitation compared to patients with enterococcal NVE, but there are no differences between the groups with regard to surgical or mortality rates. In contrast, though patients with enterococcal PVE and patients with other types of PVE share similar characteristics, mortality is higher in the latter group. Importantly, the prevalence of enterococcal PVE was higher in the European centers in this study.
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References
Shales DM, Levy J, Wolinsky E (1981) Enterococcal bacteremia without endocarditis. Arch Int Med 141:578–581
Herztein J, Ryan JL, Mangi RJ, Greco TP, Andriole VT (1984) Optimal therapy for enterococcal endocarditis. Am J Med 16:186–191
Malone DA, Wagner RA, Myers JP, Watanakunakorn C (1986) Enterococcal bacteremia in two large community teaching hospitals. Am J Med 81:601–606
Maki DG, Agger WA (1988) Enterococcal bacteremia: clinical features, the risk of endocarditis, and management. Medicine (Baltimore) 67:248–269
Anderson DJ, Murdoch DR, Sexton DJ, Reller LB, Stout JE, Cabell CH, Corey GR (2004) Risk factors for infective endocarditis in patients with enterococcal bacteremia: a case-control study. Infection 32:72–77
Jawetz E, Sonne M (1966) Penicillin–streptomycin treatment of enterococcal endocarditis. N Engl J Med 274:710–715
Lerner PI, Weinstein L (1966) Infective endocarditis in the antibiotic era. N Engl J Med 274:199–206 (259–266, 323–331, 388–393)
Pelletier LL, Petersdorf RG (1977) Infective endocarditis: a review of 125 cases from the University of Washington Hospital 1963–1972. Medicine (Baltimore) 56:287–313
Geraci JE, Martin WJ (1974) Antibiotic therapy of bacterial endocarditis: IV. Subacute enterococcal endocarditis. Circulation 10:173–194
Garvey GJ, Neu HC (1978) Infective endocarditis—an evolving disease: a review of endocarditis at the Columbia-Presbyterian Medical Center, 1968–1973. Medicine (Baltimore) 57:105–127
Cabell CH, Jollis JG, Peterson GE, Corey GR, Anderson DJ, Sexton DJ, Woods CW, Reller LB, Ryan T, Fowler VG Jr (2002) Changing patient characteristics and the effect on mortality in endocarditis. Arch Intern Med 162:90–94
Mandell GL, Kaye D, Levison ME, Hook EW (1970) Enterococcal endocarditis: an analysis of 38 patients observed at the New York Hospital–Cornell Medical Center. Arch Intern Med 125:258–264
Moellering RC, Watson BK, Kunz LJ (1974) Endocarditis due to group D streptococci: comparison of disease caused by Streptococcus bovis with that produced by the enterococci. Am J Med 57:239–250
Wilson WR, Wilkowske CJ, Wright AJ, Sande MA, Geraci JE (1984) Treatment of streptomycin-susceptible and streptomycin-resistant enterococcal endocarditis. Ann Intern Med 100:816–823
Rice LB, Calderwood SB, Eliopoulos GM, Farber BF, Karchmer AW (1991) Enterococcal endocarditis: a comparison of prosthetic and native valve disease. Rev Infect Dis 13:1–7
Fang G, Keys TF, Gentry LO, Harris AA, Rivera N, Getz K, Fuchs PC, Gustafson M, Wong ES, Goetz A, Wagener MM, Yu VL (1993) Prosthetic valve endocarditis resulting from nosocomial bacteremia: a prospective, multicenter study. Ann Intern Med 119:560–567
Patterson JE, Sweeney AH, Simms M, Carley N, Mangi R, Sabetta J, Lyons RW (1995) An analysis of 110 serious enterococcal infections: epidemiology, antibiotic susceptibility, and outcome. Medicine 74:191–200
Fernandez-Guerrero ML, Herrero L, Bellver M, Gadea I, Roblas RF, De Gorgolas M (2002) Nosocomial enterococcal endocarditis: a serious hazard for hospitalized patients with enterococcal bacteremia. J Intern Med 252:510–515
Almirante B, Tornos MP, Gurgui M, Pujol M, Miró JM and the Cooperative Group for the Study of Enterococcal Endocarditis (1991) Prognosis of enterococcal endocarditis. Rev Infect Dis 13:1248–1249
Olaison L, Schadewitz K (2002) Enterococcal endocarditis in Sweden, 1995–1999: can shorter therapy with aminoglycosides be used? Clin Inf Dis 34:159–166
Cabell CH, Abrutyn E (2002) Progress toward a global understanding of infective endocarditis. Early lessons from the International Collaboration on Endocarditis investigation. Infect Dis Clin North Am 16:255–272
Durack DT, Lukes AS, Bright DK, Duke Endocarditis Service (1994) New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findings. Am J Med 96:200–209
Friedman ND, Kaye KS, Jason E, Stout, McGarry SA, Trivette SL, Briggs JP, Lamm W, Clark C, MacFarquhar J, Walton AL, Reller LB, Sexton DJ (2002) Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. Ann Intern Med 137:791–797
Rich RL, Kreikemeyer B, Owens RT, LaBrenz S, Narayana SV, Weinstock GM, Murray BE, Hook H (1999) Ace is a collagen-binding MSCRAMM from Enterococcus faecalis. J Biol Chem 274(38):26939–26945
Nallapareddy SR, Weinstock GM, Murray BE (2003) Clinical isolates of Enterococcus faecium exhibit strain-specific collagen binding mediated by Acm, a new member of the MSCRAMM family. Molecular Microbiol 47:1733–1747
Xiao J, Hook M, Weinstock GM, Murray BE (1998) Conditional adherence of Enterococcus faecalis to extracellular matrix proteins. FEMS Immunol Med Microbiol 21:287–295
Chirouze C, Cabell CH, Fowler VG, Khayat N, Olaison L, Miro JM, Habib G, Abrutyn E, Eykyn S, Corey GR, Selton-Suty C, Hoen B, ICE Study Group (2004) Prognostic factors in 61 cases of Staphylococcus aureus prosthetic valve infective endocarditis (SA-PVIE) from the International Collaboration on Endocarditis (ICE) Merged Database. Clin Infect Dis 38:1323–1327
Hoen B, Chirouze C, Cabell CH, Selton-Suty C, Duchene F, Olaison L, Miro JM, Habib G, Abrutyn E, Eykyn S, Bernard Y, Marco F, Corey GR (2005) Emergence of endocarditis due to group D streptococci: findings derived from the merged database of the International Collaboration on Endocarditis. Eur J Clin Infect Dis 24:12–16
Acknowledgements
The following investigators were members of the International Collaboration on Endocarditis Study Group and were involved in implementing and updating the endocarditis databases: Miró JM, del Río A, Benito N, Claramonte X, Díaz ME, Baraldes A, Jiménez-Expósito MJ, Moreno A, Gatell JM, Marco F, García de la María C, Armero Y, Almela M, Jiménez de Anta MT, Paré JC, Azqueta M, Mestres CA, Cartaña R, Pomar JL, Perez N, Ramírez J, and Ribalta T (Barcelona); Stolley P (Baltimore); Hoen B, Selton-Suty C, Doco-Lecompte T, Duchêne F, Khayat N, Bernard Y, Chirouze C, Carteaux JP, Chocron S, Weber M, and Plésiat P (Besançon/Nancy, France); Corey GR, Sexton DJ, Fowler VG Jr, Woods CW, Wang A, Peterson GE, Jollis JG, Anderson DJ, Singh R, Cabell CH, Glower D, Chen A, and Stafford J (Durham, North Carolina, USA); Olaison L, Thalme A, and the Swedish Society of Infectious Diseases Quality Assurance Study Group for Endocarditis (Gothenburg, Sweden); Eykyn S (London); Raoult D, Habib G, Casalta JP, Barrau K, and Fournier PE (Marseille, France); and Abrutyn E, Strom BL, Berlin JA, Kinman JL, Feldman RS, Stolley PD, Levison ME, Korzeniowski OM, and Kaye E (Philadelphia, PA, USA).
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Anderson, D.J., Olaison, L., McDonald, J.R. et al. Enterococcal prosthetic valve infective endocarditis: report of 45 episodes from the International Collaboration on Endocarditis-merged database. Eur J Clin Microbiol Infect Dis 24, 665–670 (2005). https://doi.org/10.1007/s10096-005-0007-9
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DOI: https://doi.org/10.1007/s10096-005-0007-9