Clinicomicrobiological risk factors for infective endocarditis in viridans group streptococci bacteraemia (2024)

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Jiyeon Bae

Department of Internal Medicine, Seoul National University College of Medicine

,

Seoul

,

Republic of Korea

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Jae Hyeon Park

Department of Laboratory Medicine, Seoul National University Hospital

,

Seoul

,

Republic of Korea

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Minkyeong Lee

Department of Internal Medicine, Seoul National University College of Medicine

,

Seoul

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Republic of Korea

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Hyeon Jae Jo

Department of Internal Medicine, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Chan Mi Lee

Department of Internal Medicine, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Chang Kyung Kang

Department of Internal Medicine, Seoul National University College of Medicine

,

Seoul

,

Republic of Korea

Corresponding author. E-mail: voyager0@snu.ac.kr

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Pyoeng Gyun Choe

Department of Internal Medicine, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Wan Beom Park

Department of Internal Medicine, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Nam Joong Kim

Department of Internal Medicine, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Inho Kim

Department of Internal Medicine, Seoul National University Hospital, Cancer Research Institute, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Myoung-don Oh

Department of Internal Medicine, Seoul National University College of Medicine

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Seoul

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Republic of Korea

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Journal of Antimicrobial Chemotherapy, dkae231, https://doi.org/10.1093/jac/dkae231

Published:

08 July 2024

Article history

Received:

05 May 2024

Accepted:

21 June 2024

Published:

08 July 2024

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    Jiyeon Bae, Jae Hyeon Park, Minkyeong Lee, Hyeon Jae Jo, Chan Mi Lee, Chang Kyung Kang, Pyoeng Gyun Choe, Wan Beom Park, Nam Joong Kim, Inho Kim, Myoung-don Oh, Clinicomicrobiological risk factors for infective endocarditis in viridans group streptococci bacteraemia, Journal of Antimicrobial Chemotherapy, 2024;, dkae231, https://doi.org/10.1093/jac/dkae231

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Abstract

Background

When to perform echocardiography to rule out infective endocarditis (IE) in patients with viridans group streptococci (VGS) bloodstream infections (BSIs) is unclear.

Objectives

We aimed to identify independent risk factors for IE in patients with VGS BSI.

Methods

This retrospective study conducted at Seoul National University Hospital from January 2013 to December 2022 involved patients with VGS and nutritionally variant streptococcal BSI, excluding single positive blood cultures and polymicrobial BSI cases. Independent risk factors were identified by multivariate logistic regression and sensitivity analyses according to echocardiography results, VGS species or the inclusion of possible IE cases.

Results

Of 845 VGS BSI cases, 349 were analysed and 86 IE cases were identified (24.6%). In the multivariate analysis, heart valve disease [adjusted odds ratio (aOR), 14.14, 95% CI, 6.14–32.58; P < 0.001], persistent bacteraemia (aOR, 5.12, 95% CI, 2.03–12.94; P = 0.001), age (per year, aOR, 0.98; 95% CI, 0.96–1.00; P = 0.015), solid cancer (aOR, 0.26; 95% CI, 0.13–0.53; P < 0.001) and haematologic malignancy (aOR, 0.04; 95% CI, 0.01–0.41; P = 0.006) were independently associated with IE. Sensitivity analyses yielded consistent results; also, infection by a member of the mitis group was independent risk factor for IE (aOR, 6.50; 95% CI, 2.87–14.68; P < 0.001).

Conclusions

Younger age, heart valve disease, persistent bacteraemia, absence of underlying malignancy and BSI by a member of the mitis group were independent risk factors for IE in patients with VGS BSI. Echocardiographic evaluation could be prudently considered based on these clinicomicrobiological risk factors.

© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

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