Clinical features and prognostic factors of positive blood culture infective endocarditis
Wang Shan
Zhu Guangfa
Abstract：Objective To investigate clinical features and prognostic factors of positive blood culture infective endocarditis.Methods Clinical data of 244 cases of infective endocarditis admitted in Beijing Anzhen Hospital,Capital Medical University from July 2013 to November 2015 were retrospectively analyzed,and the patients were divided into positive blood culture group(86 cases) and negative blood culture group(158 cases).Clinical features,pathogenic distribution,drug resistance,and influence factors of prognosis were analyzed.Results Congenital heart disease was the main basic disease in both groups;ventricular septal defect [50.0％ (43/86)] was the main basic disease in positive blood culture group and bicuspid aortic valve [54.4％ (86/158)]was the main basic disease in negative blood culture group.Fever and cardiac murmur were the most common clinical presentations;incidence of fever showed a significant difference between positive blood culture group and negative blood culture group [94.2％ (81/86) vs 77.8％ (123/158)] (P ＜ 0.05).Cerebral infarction was the most common presentation of thromboembolism in major organs;incidence of cerebral infarction was 7.6％ (12/158) in positive blood culture group and 14.0％ (12/86) in negative blood culture group.Erythrocyte sedimentation rate and C-reactive protein elevation in blood culture positive group were significantly higher than those in negative blood culture group(P ＜ 0.05).Streptococcus and staphylococcus were the major pathogens in positive blood culture group,accounting for 57.0％ (49/86) and 20.9％ (18/86) respectively.Streptococcus,staphylococcus and enterococcus were highly resistant to erythromycin and clindamycin;staphylococcus was highly resistant to penicillin;all pathogens were sensitive to vancomycin and linezolid.There were 4 deaths in 86 patients;history of cardiac surgery,heart failure(New York Heart Association class Ⅲ-Ⅳ) and vegetation(≥ 15 mm) were risk factors of death(P ＜0.05).Conclusion Due to lack of specific clinical manifestations of positive blood culture infective endocarditis,laboratory indicators may help to determine the cause of disease,and characteristics of infective endocarditis may roughly determine the prognosis.
Keywords：Infective endocarditisBlood culture
Publication Date：2018-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 182-185 )