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Cited by 196Infective Endocarditis Diagnosis and ManagementAntimicrobial Resistance in StaphylococcusCardiac Valve Diseases and Treatments

Infective Endocarditis Due to Staphylococcus aureus: 59 Prospectively Identified Cases with Follow‐up

Fowler, Jr., Vance G., Sanders, Linda L., Kong, Li Kuo, McClelland, R. Scott, Gottlieb, Geoffrey S., Li, Jennifer, Ryan, Thomas, Sexton, Daniel J. +3 more·1999·Clinical Infectious Diseases
DOI 10.1086/515076
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Abstract

Fifty-nine consecutive patients with definite Staphylococcus aureus infective endocarditis (IE) by the Duke criteria were prospectively identified at our hospital over a 3-year period. Twenty-seven (45.8%) of the 59 patients had hospital-acquired S. aureus bacteremia. The presumed source of infection was an intravascular device in 50.8% of patients. Transthoracic echocardiography (TTE) revealed evidence of IE in 20 patients (33.9%), whereas transesophageal echocardiography (TEE) revealed evidence of IE in 48 patients (81.4%). The outcome for patients was strongly associated with echocardiographic findings: 13 (68.4%) of 19 patients with vegetations visualized by TTE had an embolic event or died of their infection vs. five (16.7%) of 30 patients whose vegetations were visualized only by TEE (P < .01). Most patients with S. aureus IE developed their infection as a consequence of a nosocomial or intravascular device-related infection. TEE established the diagnosis of S. aureus IE in many instances when TTE was nondiagnostic. Visualization of vegetations by TTE may provide prognostic information for patients with S. aureus IE.

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  • A retrospective study of 410 patients showed good agreement (72%-90%) between the Duke criteria and clinical assessment by infectious disease experts blinded to underlying infective endocarditis risk factors.

    “a retrospective study of 410 patients showed good agreement (72%-90%) between the Duke criteria and clinical assessment by infectious disease experts blinded to underlying IE risk factors.39”

    From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [39]

    The Abstract describes a prospective study of 59 patients with definite infective endocarditis, not a retrospective study of 410 patients. The Definition of IE says the authors used the Duke criteria, but our copy does not report the claimed 72%–90% agreement with blinded infectious disease experts. (LLM, conf=0.88)

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  • Of 59 consecutive patients with Staphylococcus aureus infective endocarditis, 45.8% had nosocomial infections, and 50.8% had a removable focus of infection.

    “of 59 consecutive patients with S aureus IE, 45.8% had nosocomial infections, and 50.8% had a removable focus of infection.39”

    From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [39]

    Table 2 reports 27 hospital-acquired cases among 59 patients (45.8%). The Sources of Infection section reports that an intravascular device was the presumed source in 30 patients (50.8%), but it does not establish that all 30 had a removable focus of infection. (LLM, conf=0.88)

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Research works printed but not linked: 6

  1. [2]2. Finally, the observational nature of this study limited our 12. Daniel WG, Mugge A. Transesophageal echocardiography. N Engl J Med ability to study the impact of different diagnostic and therapeu- 1995; 332:1268 -79.
  2. [7]7. Frimodt-Moller N, Esperson F, Skinhoj P, Rosdahl VT. Changing epidemi- early and accurate identification of S. aureus IE and therefore ology of Staphylococcus aureus bacteremia during 1960 -1990 in Den- improve survival. mark [abstract no 1441]. In: Program and abstracts of the 33rd Intersci- ence Conference on Antimicrobial Agents and Chemotherapy (New Orleans). Washington, DC: American Society for Microbiology, 1993: Acknowledgment 383.
  3. [9]9. Saiman L, Prince A, Gersony WM. Pediatric infective endocarditis in the modern era. J Pediatr 1993; 122:847 -53. References
  4. [25]25. Harbarth S, Rutschmann O, Sudre P, Pittet D. Impact of methicillin resis- 34. Mugge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infec- tive endocarditis: reassessment of the prognostic implications of vegeta- tance on the outcome of patients with bacteremia caused by Staphylo- coccus aureus. Arch Intern Med 1998; 158:182 -9.
  5. [26]26. tion size determined by the transthoracic and transesophageal approach. J Am Coll Cardiol 1989; 14:631 -8.
  6. [30]30. tions. J Am Coll Cardiol 1991; 18:1191 -9.

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Authors
Fowler, Jr., Sanders, L. L., Kong, L. K., McClelland, R. S., Gottlieb, G. S., Li, J., Ryan, T., Sexton, D. J., Roussakis, G., Harrell, L. J., & Corey, G. R.
Affiliations
Duke University (US)
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1999-01
Volume
28
Issue
1
Pages
106-114
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/515076
OpenAlex
W2030680958
Semantic Scholar
6ac0df0d9aa80d4116ce8b53b43f45d594564cc6
Cited by
196
References
41
Citations by year
2025: 1 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 7 · 2019: 2 · 2018: 4 · 2017: 3 · 2016: 5 · 2015: 7 · 2014: 16 · 2013: 3 · 2012: 4
FWCI
8.23
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
  • Health Sciences › Medicine › Infectious Diseases › Antimicrobial Resistance in Staphylococcus
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Keywords
Staphylococcus aureus, infective endocarditis, hospital-acquired bacteremia, intravascular devices, transesophageal echocardiography, transthoracic echocardiography, vegetation, embolic events, prognosis, nosocomial infections, Duke criteria
MeSH terms
Adult, Aged, Anti-Bacterial Agents, Catheters, Indwelling, Cross Infection, Endocarditis, Bacterial, Follow-Up Studies, Humans, Lactams, Male, Middle Aged, Prospective Studies, Staphylococcal Infections, Staphylococcus aureus, Vancomycin, Bacteremia, Treatment Outcome, Echocardiography, Transesophageal, Community-Acquired Infections

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