Short time to blood culture positivity in Enterococcus faecalis infective endocarditis

Abstract

Time to blood culture positivity (TTP) is an indirect measure of bacterial concentration in blood. A short TTP has been linked to the presence of infective endocarditis (IE) and to poor prognosis in Staphylococcus aureus bacteremia. We analyze factors influencing TTP in bacteremia with Enterococcus faecalis. This retrospective observational study of medical records included adults diagnosed with monomicrobial E. faecalis bacteremia between 2015 and 2018 in the Skåne region (Sweden). For each episode, the shortest TTP was recorded. Median TTP was compared between patients grouped based on age, sex, comorbidity, site of acquisition, and focus of infection. Using a dichotomized TTP (shorter or longer than 12 h), a multivariable logistic regression for factors associated to TTP was performed. The association between TTP and IE or mortality was evaluated. Three hundred sixty-seven episodes with monomicrobial E. faecalis bacteremia with the corresponding TTP were identified. Median TTP for the entire cohort was 11.6 (IQR 9.9–14.1) h and a significantly shorter TTP was noted for episodes which represented IE (n = 55, 9.4 (IQR 6.4–10.6) h). Only IE remained associated with a short TTP (≤ 12 h) in binary logistic regression analysis. Factors associated with IE were investigated and TTP was associated with IE also when adjusted for age, gender, comorbidity, and nosocomial acquisition. There was no association between TTP and mortality. A low TTP is associated with IE in E. faecalis bacteremia and could be used as a help in determining the need for echocardiography in patients with this condition.

Blood culture time to positivity in non-β-hemolytic streptococcal bacteremia as a predictor of infective endocarditis—a retrospective cohort study

“…We and others have observed a strong association between a short TTP and IE in S. aureus [6] [4] [5] and E. faecalis bacteremia [8], indicating that if present, such differences would be feasible to identify also for NHBS. NBHS are, in contrast to S. aureus and E. faecalis, a heterogenous entity comprised of many different species with different properties and propensities to cause IE [1,3].…”

True infection or contamination in patients with positive Cutibacterium blood cultures—a retrospective cohort study

“…In patients with multiple positive blood cultures, a separate episode of positive Cutibacterium blood culture was considered to have happened in cases of a new positive blood culture if at least 7 days of antibiotic treatment had been given, or if at least 30 days had passed between positive cultures. This was based on the protocol used in previous studies on Enterococcus [ 33 ]. A new episode within 6 months in the patient with the same Cutibacterium species was considered a relapse.…”

Enterococcus faecalis OG1RF induces apoptosis in MG63 cells via caspase‐3/‐8/‐9 without activation of caspase‐1/GSDMD

“…Bacterial infection, such as Staphylococcus aureus in osteomyelitis and Porphyromonas gingivalis in chronic periodontitis, is considered an important factor for osteoblast apoptosis (Alexander et al, 2003; Zhang et al, 2017). Enterococcus faecalis is a Gram‐positive, facultatively anaerobic coccus commonly found in human genitourinary and gastrointestinal tracts and may cause infections such as urinary tract infection, infective endocarditis and bacteraemia (Brown et al, 2021; Ma et al, 2021; Oldberg et al, 2021). It is also one of the most frequently detected bacterial species in PAP lesions (Barbosa‐Ribeiro et al, 2020).…”

“…Enterococcus faecalis is a Gram-positive, facultatively anaerobic coccus commonly found in human genitourinary and gastrointestinal tracts and may cause infections such as urinary tract infection, infective endocarditis and bacteraemia (Brown et al, 2021;Ma et al, 2021;Oldberg et al, 2021). It is also one of the most frequently detected bacterial species in PAP lesions (Barbosa-Ribeiro et al, 2020).…”