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. 2024 Nov 1;6(6):dlae167.
doi: 10.1093/jacamr/dlae167. eCollection 2024 Dec.

Outcomes of Enterococcus faecalis infective endocarditis according to MIC of amoxicillin: a multicentric study

Hermann Do Rego  1 , Yousra Kherabi  1 , Stephane Corvec  2 , Chloé Plouzeau-Jayle  3 , Coralie Bouchiat  4 , Gabriel Macheda  5 , Sylvain Meyer  6 , Vincent Cattoir  7   8 , Caroline Piau  7 , Thomas Guillard  9 , Jean-Ralph Zahar  10 , Eric Farfour  11 , Raphaël Lecomte  12 , Marlène Amara  13 , Christophe Isnard  14 , Alban Le Monnier  15 , Benoit Pilmis  1
Affiliations

Outcomes of Enterococcus faecalis infective endocarditis according to MIC of amoxicillin: a multicentric study

Hermann Do Rego et al. JAC Antimicrob Resist. .

Abstract

Background: The incidence of Enterococcus faecalis infective endocarditis is increasing over time. Data on the impact of minimum inhibitory concentration (MIC) of amoxicillin on treatment outcomes are scarce. The objective of this study was to describe the epidemiology of E. faecalis infective endocarditis and to evaluate whether the MIC of amoxicillin might influence mortality.

Materials: We retrospectively included all consecutive patients diagnosed with definite E. faecalis infective endocarditis between 2013 and 2020 in 11 French hospitals. We extracted data from the local diagnosis-related group (DRG) database and matched these data with microbiological results. Amoxicillin MIC was determined by Etest strip. The primary endpoints were endocarditis-related mortality and risk factors for endocarditis-related mortality including amoxicillin MIC.

Results: A total of 403 patients with definite E. faecalis infective endocarditis were included. Patients were predominantly male (76.4%) with a median age of 74 years (67-82). Embolic complications occurred in 170 (42.1%) patients. Cardiac surgery was performed in 158 (61.5%) patients. The endocarditis-related mortality rate was 28.3% and the median delay between mortality and onset of hospitalization was 24 (9; 41) days. E. faecalis MIC of amoxicillin was available for 246 (61%) patients. The median MIC was 0.5 mg/L (0.4-0.7). Amoxicillin MIC was not found to be associated with in-hospital mortality. None of the variables included in the multivariate model were identified as a risk factor for mortality and there was no correlation between mortality and the duration of treatment for 4 weeks versus 6 weeks.

Conclusions: Higher amoxicillin MIC was not a risk factor leading to endocarditis-related mortality in definite E. faecalis infective endocarditis. However, further studies are needed to assess the effect of amoxicillin MIC on relapse.

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Figures

Figure 1.
Figure 1.
Distribution of E. faecalis MICs of amoxicillin in 246 patients affected by E. faecalis IE, France, 2013–2020.
Figure 2.
Figure 2.
ROC curve for endocarditis-related mortality according to MIC.
See this image and copyright information in PMC

References

    1. Habib G, Erba PA, Iung B et al. Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European Infective Endocarditis) Registry: a prospective cohort study. Eur Heart J 2019; 40: 3222–32. 10.1093/eurheartj/ehz620 - DOI - PubMed
    1. Østergaard L, Voldstedlund M, Bruun NE et al. Temporal changes, patient characteristics, and mortality, according to microbiological cause of infective endocarditis: a nationwide study. J Am Heart Assoc 2022; 11: e025801. 10.1161/JAHA.122.025801 - DOI - PMC - PubMed
    1. Pericàs JM, Llopis J, Muñoz P et al. A contemporary picture of enterococcal endocarditis. J Am Coll Cardiol 2020; 75: 482–94. 10.1016/j.jacc.2019.11.047 - DOI - PubMed
    1. Delahaye F, M’Hammedi A, Guerpillon B et al. Systematic search for present and potential portals of entry for infective endocarditis. J Am Coll Cardiol 2016; 67: 151–8. 10.1016/j.jacc.2015.10.065 - DOI - PubMed
    1. Herrera-Hidalgo L, Fernández-Rubio B, Luque-Márquez R et al. Treatment of Enterococcus faecalis infective endocarditis: a continuing challenge. Antibiotics 2023; 12: 704. 10.3390/antibiotics12040704 - DOI - PMC - PubMed

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