Comparison of the 2023 ISCVID and ESC Duke clinical criteria for the diagnosis of infective endocarditis among patients with positive blood cultures for new typical microorganisms.

IF 3.6 2区医学 Q1 INFECTIOUS DISEASES Infection Pub Date : 2025-08-01 Epub Date: 2025-01-02 DOI:10.1007/s15010-024-02460-1

Nicolas Fourré, Virgile Zimmermann, Laurence Senn, Pierre Monney, Georgios Tzimas, Florian Tagini, Piergiorgio Tozzi, Matthias Kirsch, Benoit Guery, Matthaios Papadimitriou-Olivgeris

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Abstract

Purpose: To evaluate the performance of the Duke clinical criteria of the European Society of Cardiology (ESC; 2015 and 2023 versions) and the 2023 International Society for Cardiovascular Infectious Diseases (ISCVID) in diagnosing infective endocarditis (IE) among patients with bacteraemia/candidaemia by pathogens introduced for the first time as typical microorganisms by ISCVID.

Methods: Retrospective study.

Setting: This study included adult patients with bacteraemia/candidaemia by such pathogens (coagulase negative staphylococci, Abiotrophia spp., Gemella spp., and Granulicatella spp., Cutibacterium. acnes, Corynebacterium striatum, C. jeikeium, Pseudomonas aeruginosa, Serratia marcescens, non-tuberculous mycobacteria, and Candida spp.) hospitalized at Lausanne University Hospital. Episodes were classified as IE by two expert clinicians.

Results: Among 463 episodes with bacteraemia/candidaemia by such pathogens, IE was diagnosed in 63 episodes (14%). IE prevalence was 17% among episodes with bacteraemia by Staphylococcus lugdunensis or Abiotrophia spp. No case of IE was identified among Granulicatella spp. and Gemella spp. bacteraemias. Among 113 episodes with intracardiac prosthetic material, IE prevalence was 51% in episodes with bacteraemia by S. epidermidis. Sensitivity for the 2015 Duke-ESC, 2023 Duke-ISCVID, and the 2023 Duke-ESC clinical criteria was calculated at 5%, 57%, and 8%, respectively. More episodes were classified as possible IE by the 2023 Duke-ISCVID (30%) compared to 2015 Duke-ESC (13%) and 2023 Duke-ESC (16%) clinical criteria.

Conclusion: The 2023 ISCVID version demonstrated superior sensitivity compared to both 2015 and 2023 Duke-ESC in diagnosing IE caused by new typical microorganisms, compared to the other criteria, albeit an increase in cases being classified as possible IE.

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2023 ISCVID和ESC Duke诊断新型典型微生物血培养阳性患者感染性心内膜炎临床标准的比较

目的：评价欧洲心脏病学会（ESC）杜克临床标准的表现；2015年和2023年版本)和2023年国际心血管传染病学会（ISCVID）在诊断细菌血症/念珠菌血症患者中的感染性心内膜炎（IE）时，首次引入的病原体作为ISCVID的典型微生物。方法：回顾性研究。环境：本研究包括由以下病原体（凝固酶阴性葡萄球菌、无营养菌、Gemella、Granulicatella spp、Cutibacterium）引起的菌血症/念珠菌血症的成年患者。痤疮、纹状棒状杆菌、耶氏假单胞菌、铜绿假单胞菌、粘质沙雷氏菌、非结核分枝杆菌和念珠菌)在洛桑大学医院住院。两名专家临床医生将发作分类为IE。结果：在463例由此类病原体引起的菌血症/念珠菌血症中，63例（14%）被诊断为IE。lugdunensis葡萄球菌和无营养菌属菌血症患者中IE患病率为17%，Granulicatella和Gemella菌血症患者中未发现IE病例。在113例使用心内假体的患者中，表皮葡萄球菌引起的菌血症患者的IE患病率为51%。2015年Duke-ESC、2023年Duke-ISCVID和2023年Duke-ESC临床标准的敏感性分别为5%、57%和8%。与2015年杜克- esc（13%）和2023年杜克- esc（16%）临床标准相比，2023年杜克- iscvid（30%）将更多的事件归类为可能的IE。结论：与其他标准相比，2023 ISCVID版本在诊断新型典型微生物引起的IE方面表现出更高的敏感性，尽管被归类为可能IE的病例有所增加。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.