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. 2023 Aug 22;77(4):518-526.
doi: 10.1093/cid/ciad271.

The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: Updating the Modified Duke Criteria

Vance G Fowler  1   2 , David T Durack  1 , Christine Selton-Suty  3 , Eugene Athan  4 , Arnold S Bayer  5   6 , Anna Lisa Chamis  1 , Anders Dahl  7 , Louis DiBernardo  1 , Emanuele Durante-Mangoni  8 , Xavier Duval  9 , Claudio Querido Fortes  10 , Emil Fosbøl  11 , Margaret M Hannan  12 , Barbara Hasse  13 , Bruno Hoen  14 , Adolf W Karchmer  15 , Carlos A Mestres  16 , Cathy A Petti  1   17 , María Nazarena Pizzi  18 , Stephen D Preston  19 , Albert Roque  20 , Francois Vandenesch  21   22 , Jan T M van der Meer  23 , Thomas W van der Vaart  23 , Jose M Miro  24   25
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The 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for Infective Endocarditis: Updating the Modified Duke Criteria

Vance G Fowler et al. Clin Infect Dis. .

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Abstract

The microbiology, epidemiology, diagnostics, and treatment of infective endocarditis (IE) have changed significantly since the Duke Criteria were published in 1994 and modified in 2000. The International Society for Cardiovascular Infectious Diseases (ISCVID) convened a multidisciplinary Working Group to update the diagnostic criteria for IE. The resulting 2023 Duke-ISCVID IE Criteria propose significant changes, including new microbiology diagnostics (enzyme immunoassay for Bartonella species, polymerase chain reaction, amplicon/metagenomic sequencing, in situ hybridization), imaging (positron emission computed tomography with 18F-fluorodeoxyglucose, cardiac computed tomography), and inclusion of intraoperative inspection as a new Major Clinical Criterion. The list of "typical" microorganisms causing IE was expanded and includes pathogens to be considered as typical only in the presence of intracardiac prostheses. The requirements for timing and separate venipunctures for blood cultures were removed. Last, additional predisposing conditions (transcatheter valve implants, endovascular cardiac implantable electronic devices, prior IE) were clarified. These diagnostic criteria should be updated periodically by making the Duke-ISCVID Criteria available online as a "Living Document."

Keywords: Duke Criteria; ISCVID; PET/CT; echocardiography; endocarditis.

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Conflict of interest statement

Potential conflicts of interest. V. G. F. reports personal consulting fees from Novartis, Debiopharm, Genentech, Achaogen, Affinium, Medicines Co., MedImmune, Bayer, Basilea, Affinergy, Janssen, Contrafect, Regeneron, Destiny, Amphliphi Biosciences, Integrated Biotherapeutics; C3J, Armata, and Valanbio; Akagera, Aridis, Roche, and Pfizer (paid to author); grants from the National Institutes of Health, MedImmune, Allergan, Pfizer, Advanced Liquid Logics, Theravance, Novartis, and Merck, Medical Biosurfaces, Locus, Affinergy, Contrafect, Karius, Genentech, Regeneron, Deep Blue, Basilea, and Janssen; royalties from UpToDate; stock options from Valanbio and ArcBio; honoraria from the Infectious Diseases Society of America for his service as Associate Editor of Clinical Infectious Diseases; travel support from Contrafect to 2019 ECCMID; and a sepsis diagnostics patent pending. D. T. D. reports payment for expert testimony for 2 worker's compensation claims and 1 medico-legal claim (paid to author); membership on the ISCVID Council; stock in Becton Dickinson Company, Moderna, Merck, and Illumina; and stock options in Magnolia Medical, Inc. A. S. B. reports research grants from the National Institute of Allergy and Infectious Diseases, Akagera Medicines, ContraFect Corporation, and Riovant Pharmaceuticals; and payment for expert testimony from Hanson, Skemp & Sleik, La Crosse, Wisconsin. A. D. reports research grant support from the Lundbeck Foundation (unrelated to this work). L. D. reports payment for expert testimony in inferior vena cava filter litigation for Cordis, Braun, and Bard; and stock or stock options from Asensus Surgical (Transenterix). E. D. M. reports research funding for his institution from MSD, Pfizer, Angelini, Infectopharm, Advanz pharma, Menarini, and Shionogi; and personal consulting fees from Genentech, Roche, Angelini, Trx, Medtronic, and Abbvie; fees to participate in advisory boards for Pfizer; role as Secretary of the International Society for Cardiovascular Infectious Diseases; speaker's honoraria from Pfizer, Shionogi, and Advanz pharma; as well as personal fees from Bio-Merieux, Sanofi-Aventis, and DiaSorin. X. D. reports grants or contracts with Pfizer and Sanofi Pasteur (paid to institution). All other authors report no potential conflicts. E. F. reports independent research grants for valvular heart diseases from the Novo Nordisk Foundation. M. M. H. reports payment from Up To Date (paid to author) and participation on an Advisory Board for Takeda Island. A. W. K. reports a research grant from Karius; honoraria from Pfizer, Data Safety Monitoring Board; personal fees consulting from Debio Pharma; royalties from Up To Date; common stock in Pfizer, Abbvie, and Johnson and Johnson; and participation in Winter Course in Infectious Diseases. C. A. M. reports personal fees from Edwards Lifesciences (Clinical Events Committee) and Cytosorbents Corp. S. D. P. reports event payment from Agilent and Cariomyopathy UK (paid to institution); role as councilor for Association for European Cardiovascular Pathology (unpaid). F. V. reports research funding outside the scope of the present study by bioMérieux; 2 patents pending in antimicrobial resistance detection (PCT/EP2022/069857 July 2022; FR 2200268 Jan 2022); and shares in Weezion. J. M. M. reports consulting honoraria and/or research grants from Angelini, Contrafect, Cubist, Genentech, Gilead Sciences, Jansen, Lysovant, Medtronic, MSD, Novartis, Pfizer, and ViiV Healthcare, outside the submitted work. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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