Cited by 187Infective Endocarditis Diagnosis and ManagementCardiac Valve Diseases and TreatmentsStreptococcal Infections and Treatments

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Emergence of Coagulase-Negative Staphylococci as a Cause of Native Valve Endocarditis

Chu, V. H., Woods, C. W., Miro, J. M., Hoen, B., Cabell, C. H., Pappas, P. A., Federspiel, J., Athan, E., Stryjewski, M. E., Nacinovich, F., Marco, F., Levine, D. P., Elliott, T. S., Fortes, C. Q., Tornos, P., Gordon, D. L., Utili, R., Delahaye, F., Corey, G. R., Fowler, V. G., International Collaboration on Endocarditis-Prospective Cohort Study Group·2008·Clinical Infectious Diseases

DOI 10.1086/524666

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Abstract

BACKGROUND: Coagulase-negative staphylococci (CoNS) are an infrequent cause of native valve endocarditis (NVE), and our understanding of NVE caused by CoNS is incomplete. METHOD: The International Collaboration on Endocarditis-Prospective Cohort Study includes patients with endocarditis from 61 centers in 28 countries. Patients with definite cases of NVE caused by CoNS who were enrolled during the period June 2000-August 2006 were compared with patients with definite cases of NVE caused by Staphylococcus aureus and patients with NVE caused by viridans group streptococci. Multivariable logistic regression was used to determine factors associated with death in patients with NVE caused by CoNS. RESULTS: Of 1635 patients with definite NVE and no history of injection drug use, 128 (7.8%) had NVE due to CoNS. Health care-associated infection occurred in 63 patients (49%) with NVE caused by CoNS. Comorbidities, long-term intravascular catheter use, and history of recent invasive procedures were similar among patients with NVE caused by CoNS and among patients with NVE caused by S. aureus. Surgical treatment for endocarditis occurred more frequently in patients with NVE due to CoNS (76 patients [60%]) than in patients with NVE due to S. aureus (150 [33%]; P=.01) or in patients with NVE due to viridans group streptococci (149 [44%]; P=.01). Despite the high rate of surgical procedures among patients with NVE due to CoNS, the mortality rates among patients with NVE due to CoNS and among patients with NVE due to S. aureus were similar (32 patients [25%] and 124 patients [27%], respectively; P=.44); the mortality rate among patients with NVE due to CoNS was higher than that among patients with NVE due to viridans group streptococci (24 [7.0%]; P=.01). Persistent bacteremia (odds ratio, 2.65; 95% confidence interval, 1.08-6.51), congestive heart failure (odds ratio, 3.35; 95% confidence interval, 1.57-7.12), and chronic illness (odds ratio, 2.86; 95% confidence interval, 1.34-6.06) were independently associated with death in patients with NVE due to CoNS (c index, 0.73). CONCLUSIONS: CoNS have emerged as an important cause of NVE in both community and health care settings. Despite high rates of surgical therapy, NVE caused by CoNS is associated with poor outcomes.

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Authors: Chu, V. H., Woods, C. W., Miro, J. M., Hoen, B., Cabell, C. H., Pappas, P. A., Federspiel, J., Athan, E., Stryjewski, M. E., Nacinovich, F., Marco, F., Levine, D. P., Elliott, T. S., Fortes, C. Q., Tornos, P., Gordon, D. L., Utili, R., Delahaye, F., Corey, G. R., Fowler, V. G., & International Collaboration on Endocarditis-Prospective Cohort Study Group
Affiliations: Duke University (US)
Duke Medical Center (US)
Hôpital Saint-Jacques (FR)
Barwon Health (AU)
Instituto Cardiovascular de Buenos Aires (AR)
Universitat de Barcelona (ES)
Wayne State University (US)
Queen Elizabeth Hospital Birmingham (GB)
Hospital Universitário Clementino Fraga Filho (BR)
Vall d'Hebron Hospital Universitari (ES)
University of Campania "Luigi Vanvitelli" (IT)
Hôpital Louis Pradel (FR)
Corresponding author: Chu, V. H.
ORCID: Chu, V. H.
Woods, C. W.
Hoen, B.
Federspiel, J.
Athan, E.
Stryjewski, M. E.
Nacinovich, F.
Marco, F.
Levine, D. P.
Elliott, T. S.
Fortes, C. Q.
Tornos, P.
Gordon, D. L.
Fowler, V. G.
Venue: Clinical Infectious Diseases
Publisher: Oxford University Press (OUP)
Published: 2008-01-15
Volume: 46
Issue: 2
Pages: 232-242
ISSN: 1058-4838 (ISSN-L)
1537-6591
DOI: 10.1086/524666
OpenAlex: W2152846901
Semantic Scholar: 5890d85407bf1bd730d39e425dfc5fb5da14b1b0
Cited by: 187
References: 28
Citations by year: 2026: 2 · 2025: 4 · 2024: 6 · 2023: 12 · 2022: 10 · 2021: 12 · 2020: 13 · 2019: 8 · 2018: 8 · 2017: 11 · 2016: 8 · 2015: 13 · 2014: 6 · 2013: 11 · 2012: 9
FWCI: 8.75
Type: journal article
Language: en
Open access: closed
Locations: Clinical Infectious Diseases (publishedVersion)
PubMed (publishedVersion)
HAL (submittedVersion)
Deakin Research Online (Deakin University) (submittedVersion)
Funders: American Heart Association (0675027N)
Generalitat de Catalunya
National Institutes of Health
Instituto de Salud Carlos III (RD06/0008)
National Institute of Allergy and Infectious Diseases (R01AI068804)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
Keywords: coagulase-negative staphylococci, native valve endocarditis, Staphylococcus aureus, Streptococcus viridans, endocarditis mortality, persistent bacteremia, congestive heart failure, nosocomial infections, surgical treatment, mortality risk factors, invasive procedures
MeSH terms: Adult, Aged, Coagulase, Cross Infection, Endocarditis, Bacterial, Female, Heart Failure, Heart Valve Diseases, Humans, Male, Middle Aged, Pacemaker, Artificial, Prospective Studies, Staphylococcus, Methicillin Resistance, Community-Acquired Infections

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Emergence of Coagulase-Negative Staphylococci as a Cause of Native Valve Endocarditis

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