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. 2022 Aug 1;43(29):2770-2780.
doi: 10.1093/eurheartj/ehac307.

Outcomes of culture-negative vs. culture-positive infective endocarditis: the ESC-EORP EURO-ENDO registry

William K F Kong  1   2 , Antonio Salsano  3   4 , Daniele Roberto Giacobbe  5   6 , Bogdan A Popescu  7 , Cécile Laroche  8 , Xavier Duval  9   10 , Robert Schueler  11 , Antonella Moreo  12 , Paolo Colonna  13 , Cornelia Piper  14 , Francisco Calvo-Iglesias  15 , Luigi P Badano  16   17 , Ilija Srdanovic  18   19 , David Boutoille  20 , Olivier Huttin  21   22   23 , Elisabeth Stöhr  11 , Ana Teresa Timóteo  24   25   26 , Jolanta Justina Vaskelyte  27 , Anita Sadeghpour  28   29 , Pilar Tornos  30 , Leila Abid  31 , Kian Keong Poh  1   2 , Gilbert Habib  32   33 , Patrizio Lancellotti  28 ; The EURO-ENDO Investigators
Collaborators, Affiliations

Outcomes of culture-negative vs. culture-positive infective endocarditis: the ESC-EORP EURO-ENDO registry

William K F Kong et al. Eur Heart J. .

Erratum in

Abstract

Aim: Fatality of infective endocarditis (IE) is high worldwide, and its diagnosis remains a challenge. The objective of the present study was to compare the clinical characteristics and outcomes of patients with culture-positive (CPIE) vs. culture-negative IE (CNIE).

Methods and results: This was an ancillary analysis of the ESC-EORP EURO-ENDO registry. Overall, 3113 patients who were diagnosed with IE during the study period were included in the present study. Of these, 2590 (83.2%) had CPIE, whereas 523 (16.8%) had CNIE. As many as 1488 (48.1%) patients underwent cardiac surgery during the index hospitalization, 1259 (48.8%) with CPIE and 229 (44.5%) with CNIE. The CNIE was a predictor of 1-year mortality [hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.04-1.56], whereas surgery was significantly associated with survival (HR 0.49, 95% CI 0.41-0.58). The 1-year mortality was significantly higher in CNIE than CPIE patients in the medical subgroup, but it was not significantly different in CNIE vs. CPIE patients who underwent surgery.

Conclusion: The present analysis of the EURO-ENDO registry confirms a higher long-term mortality in patients with CNIE compared with patients with CPIE. This difference was present in patients receiving medical therapy alone and not in those who underwent surgery, with surgery being associated with reduced mortality. Additional efforts are required both to improve the aetiological diagnosis of IE and identify CNIE cases early before progressive disease potentially contraindicates surgery.

Keywords: Blood culture-negative endocarditis; Diagnosis; Endocarditis; Heart valves; Infective endocarditis; Surgery.

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Figures

Structured Graphical Abstract
Structured Graphical Abstract
CPIE, culture-positive infective endocarditis; CNIE, culture-negative infective endocarditis; ESC-EORP EURO-ENDO, European Infective Endocarditis.
Figure 1
Figure 1
Kaplan–Meier curves demonstrating freedom from mortality during follow-up in patients with culture-positive and culture-negative endocarditis. Graphs have been plotted by EORP.
Figure 2
Figure 2
Kaplan–Meier curves demonstrating freedom from mortality during follow-up in patients with culture-positive and culture-negative endocarditis treated with (A) medical therapy alone and (B) cardiac surgery during index hospitalization.
See this image and copyright information in PMC

Comment in

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