Clinical characteristics, management and outcomes of enterococcal infective endocarditis: an ancillary study from the ESC-EORP EURO-ENDO registry
European Heart Journal - Quality of Care and Clinical Outcomes

Abstract
Enterococcal infective endocarditis (EIE) represents a growing proportion of infective endocarditis (IE) cases, particularly among elderly and comorbid patients. EIE poses diagnostic and therapeutic challenges, notably regarding optimal antimicrobial therapy and surgical decision-making. We aimed to compare the clinical characteristics, management, and outcomes of EIE vs. non-enterococcal IE (NEIE) in the ESC-EORP EURO-ENDO registry.
This ancillary analysis of the prospective EURO-ENDO registry included adult patients with definite or possible IE enrolled between January 2016 and March 2018. Patients with monomicrobial EIE were compared with those with NEIE. Clinical, microbiological, imaging, and therapeutic data were analysed. Multivariable logistic regression including EuroSCORE II and valve status identified independent predictors of in-hospital mortality. Among 3083 patients, 365 (12%) had monomicrobial EIE. Compared with NEIE, EIE patients were older (mean 68 vs. 58 years), had more comorbidities, and more frequent prosthetic valve involvement (41% vs. 26%). Aortic valve localization and colonic uptake on PET/CT were also more common. In-hospital mortality was similar (16% vs. 17%). After adjustment for EuroSCORE II and valve status, EIE was not independently associated with higher in-hospital mortality (adjusted OR 0.67 [95% confidence interval 0.42–1.04];
EIE affects older, high-risk patients. After adjustment for operative risk, mortality was comparable to other aetiologies, highlighting the need for tailored diagnostic and therapeutic strategies.
Contributors

Erick Calderon Aranda
Author

Nuno Miguel Cardim
Author

P Tornos
Author

Kwan-Leung Chan
Author

Bernard Cosyns
Author

A Bayes-Genis
Author

Ines Cruz
Author

L Pedro Botet
Author

N Vallejo
Author

E Berastegui
Author

Thor Edvardsen
Author

Georg Goliasch
Author

C Llibre
Author

L Mateu
Author

R Nunez
Author

D Quesada
Author

Robinson Gravier Dumonceau
Author

D Bosch Portell
Author

Gilbert Habib
Author

Rodolfo Citro
Author

Bernard Cosyns
Author

J Aboal Vinas
Author

Erwan Donal
Author

Paola Anna Erba
Author

X Albert Bertran
Author

Frédérique Gouriet
Author

Andreas Hagendorff
Author

R Brugada Tarradellas
Author

P Loma-Osorio Ricon
Author

Krasimira Hristova
Author

Bernard Iung
Author

C Tiron de Llano
Author

M A Arnau
Author

Otto Kamp
Author

William K F Kong
Author

A Bel
Author

M Blanes
Author

A Osa
Author

M Anguita
Author

Duk-Hyun Kang
Author

F Carrasco
Author

William Kong
Author

Patrizio Lancellotti
Author

J Castillo
Author

Simon Matskeplishvili
Author

Aldo Maggioni
Author

Marwa Meshaal
Author

Maja Mirocevic
Author

J L Zamorano
Author

Aleksandar N Neskovic
Author

Julien Mancini
Author

J L Moya Mur
Author

M Alvaro
Author

Michal Pazdernik
Author

C Fernandez-Golfin
Author

J M Monteagudo
Author

E Navas Elorza
Author

Bernard Prendergast
Author

Edyta Plonska-Gosciniak
Author

Antonia Sambola
Author

M C Farinas Alvarez
Author

Bogdan A Popescu
Author

Shantanu P Sengupta
Author

Ana Timoteo
Author

Christophe Tribouilloy
Author

J Aguero Balbin
Author

C Arminanzas
Author

Joost P van Melle
Author

F Arnaiz de las Revillas
Author

Bernard Prendergast
Author

Maha Raissouni
Author

A Arnaiz Garcia
Author

M Cobo Belaustegui
Author

Roch Giorgi
Author

Ricardo Ronderos
Author

Leyla Elif Sade
Author

Anita Sadeghpour
Author

M Fernandez Sampedro
Author

Gilbert Habib
Author

Antonia Sambola
Author

M Gutierrez Cuadra
Author

R Ferrari
Author

Shantanu Sengupta
Author

J F Gutierrez-Diez
Author

J Zarauza
Author

L Garcia Cuello
Author

C Gonzalez Rico
Author

A Alonso
Author

R Rodriguez-Alvarez
Author

J Bax
Author

Masaaki Takeuchi
Author

J Goikoetxea
Author

M Montejo
Author

C Blomström-Lundqvist
Author

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Edwin Tucay
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M Hernandez-Meneses
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Hosam Zaky
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E van Dongen
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J Schoep
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V Stolk
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O Axler
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F Baumann
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S Lebras
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T Edvardsen
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J T Offstad
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J O Beitnes
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T Helle-Valle
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H Skulstad
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R Skardal
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N Qamar
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S Furnaz
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B Ahmed
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M H Butt
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M F Khanzada
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T Saghir
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A Wahid
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T Hryniewiecki
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P Szymanski
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K Marzec
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M Misztal-Ogonowska
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W Kosmala
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M Przewlocka-Kosmala
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A Rojek
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K Woznicka
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J Zachwyc
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A Lisowska
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M Kaminska
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J Kasprzak
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E Kowalczyk
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D F Strzecka
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P Wejner-Mik
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M Trabulo
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P Freitas
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S Ranchordas
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G Rodrigues
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P Pinto
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C Queiros
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J Azevedo
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L Marques
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D Seabra
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L Branco
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J Abreu
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M Cruz
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A Galrinho
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R Moreira
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P Rio
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A T Timoteo
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M Selas
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N M Cardim
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V Carmelo
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B Duque Neves
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H Pereira
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I Cruz
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A Guerra
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A Marques
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I Pintassilgo
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M C Tomescu
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N-M Trofenciuc
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M Andor
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A Bordejevic
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H S Branea
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F Caruntu
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L Cirin
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I M Citu
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C A Cotoraci
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D Darabantiu
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R Farcas
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I Marincu
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A Mavrea
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M F Onel
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T Parvanescu
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D Pop
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A L Pop-Moldovan
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M I Puticiu
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L A Velcean
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A Ionac
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D Cozma
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C Mornos
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F Goanta
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I Popescu
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R Beyer
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R Mada
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R Rancea
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H Rosianu
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R Tomoaia
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C Stanescu
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Z Kobalava
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J Karaulova
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E Kotova
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A Milto
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A Pisaryuk
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N Povalyaev
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M Sorokina
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J Alrahimi
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A Elshiekh
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A Jamiel
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A Ahmed
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M Al-Mallah
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N Attia
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B Putnikovic
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A Neskovic
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A Dimic
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B Ivanovic
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S Matic
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D Trifunovic
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J Petrovic
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D Kosevic
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P Dabic
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P Milojevic
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I Petrovic
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I Stojanovic
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I Srdanovic
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M Kovacevic
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A Redzek
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M Stefanovic
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S Susak
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L Velicki
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A Vulin
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T C Yeo
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W K F Kong
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K K Poh
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I Vilacosta
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M Abd El-Nasser
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C Ferrera
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C Olmos
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F Calvo Iglesias
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E Blanco-Gonzalez
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M Bravo Amaro
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A N Germinas
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E Lopez-Rodriguez
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J Lugo Adan
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P Pazos-Lopez
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M Pereira Loureiro
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M T Perez
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S Raposeiras-Roubin
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S Rasheed Yas
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M-M Suarez-Varela
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F Vasallo Vidal
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D Garcia-Dorado
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A Sambola
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N Fernandez-Hidalgo
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T Gonzalez-Alujas
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J Lozano
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O Maisterra
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N Pizzi
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R Rios
Author

