Review
Version 1
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Is It Useful to Repeat Blood Cultures in Endocarditis Patients? A Critical Appraisal
Version 1
: Received: 13 June 2024 / Approved: 14 June 2024 / Online: 14 June 2024 (17:43:32 CEST)
A peer-reviewed article of this Preprint also exists.
Kok, W. Is It Useful to Repeat Blood Cultures in Endocarditis Patients? A Critical Appraisal. Diagnostics 2024, 14, 1578. Kok, W. Is It Useful to Repeat Blood Cultures in Endocarditis Patients? A Critical Appraisal. Diagnostics 2024, 14, 1578.
Abstract
Background: for patients with endocarditis, guidelines recommend repeating blood cultures until they become negative, but with very limited evidence. Methods: a literature review was done on the incidence and duration of persistent bacteremia and persistent fever in endocarditis patients, compared to their associations with persistent infection at day 7. Results: persistent bacteremia and persistent fever are common in the first few days after starting antibiotic therapy, a normal duration for either at or around < 3-7 days. Persistent bacteremia is more prevalent and longer lasting in Staphylococcus (especially MRSA) and Enterococcus species than in Streptococcus species. In one study the risk for persistent infection at day 7 was 50% in those with positive blood cultures at 48-72 hours while it was 32% in those with negativization of blood cultures. Both persistent bacteremia at 48-72 hours and persistent infection at day 7 are predictive of in-hospital mortality. Conclusion: persistent bacteremia after treatment for endocarditis is common and often accompanied by persistent fever. Persistent infection at 7 days (as indication for urgent surgery) cannot be reliably predicted by positive or negative blood cultures at 48-72 hours. The recommendation of performing survey blood cultures in all patients therefore needs to be reconsidered.
Keywords
endocarditis; blood cultures; bacteremia; persistent infection
Subject
Medicine and Pharmacology, Cardiac and Cardiovascular Systems
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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