Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study.
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Filiz Mine, Erdem Hakan, Ankarali Handan, Puca Edmond, Ruch Yvon, Santos Lurdes, Fasciana Teresa, Giammanco Anna M, Ghanem-Zoubi Nesrin, Argemi Xavier, Hansmann Yves, Guner Rahmet, Tonziello Gilda, Mazzucotelli Jean-Philippe, Como Najada, Kose Sukran, Batirel Ayse, Inan Asuman, Tulek Necla, Pekok Abdullah Umut, Khan Ejaz Ahmed, Iyisoy Atilla, Meric-Koc Meliha, Kaya-Kalem Ayse, Martins Pedro Palma, Hasanoglu Imran, Silva-Pinto André, Oztoprak Nefise, Duro Raquel, Almajid Fahad, Dogan Mustafa, Dauby Nicolas, Gunst Jesper Damsgaard, Tekin Recep, Konopnicki Deborah, Petrosillo Nicola, Bozkurt Ilkay, Al Ramahi Jamal Wadi, Popescu Corneliu, Balkan Ilker Inanc, Ozer-Balin Safak, Zupanc Tatjana Lejko, Cascio Antonio, Dumitru Irina Magdalena, Erdem Aysegul, Ersoz Gulden, Tasbakan Meltem, Ajamieh Oday Abu, Sirmatel Fatma, Florescu Simin, Gulsun Serda, Ozkaya Hacer Deniz, Sari Sema, Tosun Selma, Avci Meltem, Cag Yasemin, Celebi Guven, Sagmak-Tartar Ayse, Karakus Sumeyra, Sener Alper, Dedej Arjeta, Oncu Serkan, Del Vecchio Rosa Fontana, Ozturk-Engin Derya, Agalar Canan
Аннотация
METHODS: The study included adult patients with definite endocarditis. Data were collected via the Infectious Diseases International Research Initiative (ID-IRI). The study analysing one of the largest case series ever reported was conducted across 41 centers in 13 countries. We analysed the database to determine the predictors of BCNE using univariate and logistic regression analyses.
RESULTS: Blood cultures were negative in 101 (11.65 %) of 867 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: Caution should be exercised when diagnosing endocarditis in patients with concurrent cardiac disorders, particularly in younger cases.