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Community-acquired culture-negative endocarditis: clinical characteristics and risk factors for mortality
Journal article   Open access   Peer reviewed

Community-acquired culture-negative endocarditis: clinical characteristics and risk factors for mortality

Rinaldo Focaccia Siciliano, Alfredo Jose Mansur, Jussara Bianchi Castelli, Vanessa Arias, Max Grinberg, Matthew E. Levison and Tania Mara Varejao Strabelli
International journal of infectious diseases, v 25
01 Aug 2014
DOI: https://doi.org/10.1016/j.ijid.2014.05.005
PMID: 24971520
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.ijid.2014.05.005View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Infectious Diseases Life Sciences & Biomedicine Science & Technology
Objectives: We studied the clinical characteristics, in-hospital mortality, and long-term prognosis of patients with culture-negative endocarditis. Methods: In total, 221 episodes of definite endocarditis were studied (2004-2009). We compared the clinical, laboratory, and echocardiography characteristics and the survival rates of patients with culture-negative and culture-positive endocarditis. Survival after hospital discharge was evaluated using the Kaplan-Meier method and coefficient of mortality comparisons. Results: Culture-negative endocarditis occurred in 51/221 (23.1%) episodes. Compared with the culture-positive endocarditis patients, the time elapsed between admission and initiation of antibiotic therapy was longer in patients with culture-negative endocarditis (p < 0.001), and these patients also had lower C-reactive protein levels at admission (p < 0.001). In-hospital mortality rates were not different between culture-negative and culture-positive patients. After hospital discharge, there was also no significant difference between groups in survival curves (p = 0.471). Severe sepsis (adjusted prevalence ratio 3.32, p = 0.010) and diabetes mellitus (adjusted prevalence ratio 2.32, p = 0.009) were independently associated with in-hospital death in culture-negative patients. Conclusions: Culture-negative endocarditis patients presented with lower levels of C-reactive protein at admission and required more time for initiation of antibiotic therapy, although there was no difference in in-hospital mortality or long-term survival between culture-negative and culture-positive endocarditis patients. Diabetes mellitus and severe sepsis were associated with in-hospital death in patients with culture-negative endocarditis. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

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Infectious Diseases
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