Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study

Mine Filiz; Hakan Erdem; Handan Ankarali; Edmond Puca; Yvon Ruch; Lurdes Santos; Teresa Fasciana; Anna M. Giammanco; Nesrin Ghanem-Zoubi; Xavier Argemi; Yves Hansmann; Rahmet Guner; Gilda Tonziello; Jean Philippe Mazzucotelli; Najada Como; Sukran Kose; Ayse Batirel; Asuman Inan; Necla Tulek; Abdullah Umut Pekok; Ejaz Ahmed Khan; Atilla Iyisoy; Meliha Meric-Koc; Ayse Kaya-Kalem; Pedro Palma Martins; Imran Hasanoglu; André Silva-Pinto; Nefise Oztoprak; Raquel Duro; Fahad Almajid; Mustafa Dogan; Nicolas Dauby; Jesper Damsgaard Gunst; Recep Tekin; Deborah Konopnicki; Nicola Petrosillo; Ilkay Bozkurt; Jamal Wadi Al Ramahi; Corneliu Popescu; Ilker Inanc Balkan; Safak Ozer-Balin; Tatjana Lejko Zupanc; Antonio Cascio; Irina Magdalena Dumitru; Aysegul Erdem; Gulden Ersoz; Meltem Tasbakan; Oday Abu Ajamieh; Fatma Sirmatel; Simin Florescu; Serda Gulsun; Hacer Deniz Ozkaya; Sema Sari; Selma Tosun; Meltem Avci; Yasemin Cag; Guven Celebi; Ayse Sagmak-Tartar; Sumeyra Karakus; Alper Sener; Arjeta Dedej; Serkan Oncu; Rosa Fontana Del Vecchio; Derya Ozturk-Engin; Canan Agalar

doi:10.1016/j.nmni.2024.101453

Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study

Mine Filiz, Hakan Erdem, Handan Ankarali, Edmond Puca, Yvon Ruch, Lurdes Santos, Teresa Fasciana, Anna M. Giammanco, Nesrin Ghanem-Zoubi, Xavier Argemi, Yves Hansmann, Rahmet Guner, Gilda Tonziello, Jean Philippe Mazzucotelli, Najada Como, Sukran Kose, Ayse Batirel, Asuman Inan, Necla Tulek, Abdullah Umut PekokEjaz Ahmed Khan, Atilla Iyisoy, Meliha Meric-Koc, Ayse Kaya-Kalem, Pedro Palma Martins, Imran Hasanoglu, André Silva-Pinto, Nefise Oztoprak, Raquel Duro, Fahad Almajid, Mustafa Dogan, Nicolas Dauby, Jesper Damsgaard Gunst, Recep Tekin, Deborah Konopnicki, Nicola Petrosillo, Ilkay Bozkurt, Jamal Wadi Al Ramahi, Corneliu Popescu, Ilker Inanc Balkan, Safak Ozer-Balin, Tatjana Lejko Zupanc, Antonio Cascio, Irina Magdalena Dumitru, Aysegul Erdem, Gulden Ersoz, Meltem Tasbakan, Oday Abu Ajamieh, Fatma Sirmatel, Simin Florescu, Serda Gulsun, Hacer Deniz Ozkaya, Sema Sari, Selma Tosun, Meltem Avci, Yasemin Cag, Guven Celebi, Ayse Sagmak-Tartar, Sumeyra Karakus, Alper Sener, Arjeta Dedej, Serkan Oncu, Rosa Fontana Del Vecchio, Derya Ozturk-Engin, Canan Agalar

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. 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.

Original language	English
Article number	101453
Journal	New Microbes and New Infections
Volume	60-61
DOIs	https://doi.org/10.1016/j.nmni.2024.101453
Publication status	Published - 1 Aug 2024
Externally published	Yes

Keywords

Blood culture negative endocarditis
Cardiac disorders
Infective endocarditis
Prosthetic valves
Rheumatic heart disease

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.nmni.2024.101453Licence: CC BY-NC-ND

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Filiz, M., Erdem, H., Ankarali, H., Puca, E., Ruch, Y., Santos, L., Fasciana, T., Giammanco, A. M., Ghanem-Zoubi, N., Argemi, X., Hansmann, Y., Guner, R., Tonziello, G., Mazzucotelli, J. P., Como, N., Kose, S., Batirel, A., Inan, A., Tulek, N., ... Agalar, C. (2024). Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study. New Microbes and New Infections, 60-61, Article 101453. https://doi.org/10.1016/j.nmni.2024.101453

@article{6047d9e113b54fa180c8b9b4ea8a32a3,

title = "Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study",

abstract = "Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. 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.",

keywords = "Blood culture negative endocarditis, Cardiac disorders, Infective endocarditis, Prosthetic valves, Rheumatic heart disease",

author = "Mine Filiz and Hakan Erdem and Handan Ankarali and Edmond Puca and Yvon Ruch and Lurdes Santos and Teresa Fasciana and Giammanco, \{Anna M.\} and Nesrin Ghanem-Zoubi and Xavier Argemi and Yves Hansmann and Rahmet Guner and Gilda Tonziello and Mazzucotelli, \{Jean Philippe\} and Najada Como and Sukran Kose and Ayse Batirel and Asuman Inan and Necla Tulek and Pekok, \{Abdullah Umut\} and Khan, \{Ejaz Ahmed\} and Atilla Iyisoy and Meliha Meric-Koc and Ayse Kaya-Kalem and Martins, \{Pedro Palma\} and Imran Hasanoglu and Andr{\'e} Silva-Pinto and Nefise Oztoprak and Raquel Duro and Fahad Almajid and Mustafa Dogan and Nicolas Dauby and Gunst, \{Jesper Damsgaard\} and Recep Tekin and Deborah Konopnicki and Nicola Petrosillo and Ilkay Bozkurt and \{Al Ramahi\}, \{Jamal Wadi\} and Corneliu Popescu and Balkan, \{Ilker Inanc\} and Safak Ozer-Balin and Zupanc, \{Tatjana Lejko\} and Antonio Cascio and Dumitru, \{Irina Magdalena\} and Aysegul Erdem and Gulden Ersoz and Meltem Tasbakan and Ajamieh, \{Oday Abu\} and Fatma Sirmatel and Simin Florescu and Serda Gulsun and Ozkaya, \{Hacer Deniz\} and Sema Sari and Selma Tosun and Meltem Avci and Yasemin Cag and Guven Celebi and Ayse Sagmak-Tartar and Sumeyra Karakus and Alper Sener and Arjeta Dedej and Serkan Oncu and \{Del Vecchio\}, \{Rosa Fontana\} and Derya Ozturk-Engin and Canan Agalar",

year = "2024",

month = aug,

day = "1",

doi = "10.1016/j.nmni.2024.101453",

language = "English",

volume = "60-61",

journal = "New Microbes and New Infections",

issn = "2052-2975",

publisher = "Elsevier Ltd",

}

Filiz, M, Erdem, H, Ankarali, H, Puca, E, Ruch, Y, Santos, L, Fasciana, T, Giammanco, AM, Ghanem-Zoubi, N, Argemi, X, Hansmann, Y, Guner, R, Tonziello, G, Mazzucotelli, JP, Como, N, Kose, S, Batirel, A, Inan, A, Tulek, N, Pekok, AU, Khan, EA, Iyisoy, A, Meric-Koc, M, Kaya-Kalem, A, Martins, PP, Hasanoglu, I, Silva-Pinto, A, Oztoprak, N, Duro, R, Almajid, F, Dogan, M, Dauby, N, Gunst, JD, Tekin, R, Konopnicki, D, Petrosillo, N, Bozkurt, I, Al Ramahi, JW, Popescu, C, Balkan, II, Ozer-Balin, S, Zupanc, TL, Cascio, A, Dumitru, IM, Erdem, A, Ersoz, G, Tasbakan, M, Ajamieh, OA, Sirmatel, F, Florescu, S, Gulsun, S, Ozkaya, HD, Sari, S, Tosun, S, Avci, M, Cag, Y, Celebi, G, Sagmak-Tartar, A, Karakus, S, Sener, A, Dedej, A, Oncu, S, Del Vecchio, RF, Ozturk-Engin, D & Agalar, C 2024, 'Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study', New Microbes and New Infections, vol. 60-61, 101453. https://doi.org/10.1016/j.nmni.2024.101453

TY - JOUR

T1 - Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study

AU - Filiz, Mine

AU - Erdem, Hakan

AU - Ankarali, Handan

AU - Puca, Edmond

AU - Ruch, Yvon

AU - Santos, Lurdes

AU - Fasciana, Teresa

AU - Giammanco, Anna M.

AU - Ghanem-Zoubi, Nesrin

AU - Argemi, Xavier

AU - Hansmann, Yves

AU - Guner, Rahmet

AU - Tonziello, Gilda

AU - Mazzucotelli, Jean Philippe

AU - Como, Najada

AU - Kose, Sukran

AU - Batirel, Ayse

AU - Inan, Asuman

AU - Tulek, Necla

AU - Pekok, Abdullah Umut

AU - Khan, Ejaz Ahmed

AU - Iyisoy, Atilla

AU - Meric-Koc, Meliha

AU - Kaya-Kalem, Ayse

AU - Martins, Pedro Palma

AU - Hasanoglu, Imran

AU - Silva-Pinto, André

AU - Oztoprak, Nefise

AU - Duro, Raquel

AU - Almajid, Fahad

AU - Dogan, Mustafa

AU - Dauby, Nicolas

AU - Gunst, Jesper Damsgaard

AU - Tekin, Recep

AU - Konopnicki, Deborah

AU - Petrosillo, Nicola

AU - Bozkurt, Ilkay

AU - Al Ramahi, Jamal Wadi

AU - Popescu, Corneliu

AU - Balkan, Ilker Inanc

AU - Ozer-Balin, Safak

AU - Zupanc, Tatjana Lejko

AU - Cascio, Antonio

AU - Dumitru, Irina Magdalena

AU - Erdem, Aysegul

AU - Ersoz, Gulden

AU - Tasbakan, Meltem

AU - Ajamieh, Oday Abu

AU - Sirmatel, Fatma

AU - Florescu, Simin

AU - Gulsun, Serda

AU - Ozkaya, Hacer Deniz

AU - Sari, Sema

AU - Tosun, Selma

AU - Avci, Meltem

AU - Cag, Yasemin

AU - Celebi, Guven

AU - Sagmak-Tartar, Ayse

AU - Karakus, Sumeyra

AU - Sener, Alper

AU - Dedej, Arjeta

AU - Oncu, Serkan

AU - Del Vecchio, Rosa Fontana

AU - Ozturk-Engin, Derya

AU - Agalar, Canan

PY - 2024/8/1

Y1 - 2024/8/1

N2 - Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. 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.

AB - Background: Blood culture-negative endocarditis (BCNE) is a diagnostic challenge, therefore our objective was to pinpoint high-risk cohorts for BCNE. 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.

KW - Blood culture negative endocarditis

KW - Cardiac disorders

KW - Infective endocarditis

KW - Prosthetic valves

KW - Rheumatic heart disease

U2 - 10.1016/j.nmni.2024.101453

DO - 10.1016/j.nmni.2024.101453

M3 - Article

SN - 2052-2975

VL - 60-61

JO - New Microbes and New Infections

JF - New Microbes and New Infections

M1 - 101453

ER -

Identifying risk factors for blood culture negative infective endocarditis: An international ID-IRI study: An international ID-IRI study

Abstract

Keywords

UN SDGs

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