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

P Tornos
Author

Nuno Miguel Cardim
Author

A Bayes-Genis
Author

Kwan-Leung Chan
Author

L Pedro Botet
Author

Bernard Cosyns
Author

N Vallejo
Author

Robinson Gravier Dumonceau
Author

E Berastegui
Author

C Llibre
Author

L Mateu
Author

Rodolfo Citro
Author

R Nunez
Author

Bernard Cosyns
Author

D Quesada
Author

Erwan Donal
Author

D Bosch Portell
Author

Paola Anna Erba
Author

Ines Cruz
Author

J Aboal Vinas
Author

Thor Edvardsen
Author

Georg Goliasch
Author

Frédérique Gouriet
Author

Gilbert Habib
Author

X Albert Bertran
Author

R Brugada Tarradellas
Author

William K F Kong
Author

Andreas Hagendorff
Author

P Loma-Osorio Ricon
Author

Krasimira Hristova
Author

C Tiron de Llano
Author

Patrizio Lancellotti
Author

M A Arnau
Author

Aldo Maggioni
Author

A Bel
Author

Julien Mancini
Author

M Blanes
Author

Bernard Iung
Author

A Osa
Author

Otto Kamp
Author

M Anguita
Author

Duk-Hyun Kang
Author

William Kong
Author

F Carrasco
Author

J Castillo
Author

Simon Matskeplishvili
Author

J L Zamorano
Author

Bernard Prendergast
Author

Antonia Sambola
Author

Shantanu P Sengupta
Author

J L Moya Mur
Author

M Alvaro
Author

Ana Timoteo
Author

Christophe Tribouilloy
Author

Joost P van Melle
Author

Roch Giorgi
Author

C Fernandez-Golfin
Author

Gilbert Habib
Author

Marwa Meshaal
Author

J M Monteagudo
Author

Maja Mirocevic
Author

E Navas Elorza
Author

Aleksandar N Neskovic
Author

R Ferrari
Author

Michal Pazdernik
Author

M C Farinas Alvarez
Author

A Alonso
Author

J Bax
Author

Edyta Plonska-Gosciniak
Author

C Blomström-Lundqvist
Author

Bogdan A Popescu
Author

Bernard Prendergast
Author

S Gielen
Author

J Aguero Balbin
Author

Maha Raissouni
Author

C Arminanzas
Author

Ricardo Ronderos
Author

Leyla Elif Sade
Author

P Lancellotti
Author

F Arnaiz de las Revillas
Author

Anita Sadeghpour
Author

A Arnaiz Garcia
Author

A P Maggioni
Author

Antonia Sambola
Author

M Cobo Belaustegui
Author

M Fernandez Sampedro
Author

N Maniadakis
Author

Shantanu Sengupta
Author

F Pinto
Author

M Gutierrez Cuadra
Author

Masaaki Takeuchi
Author

J F Gutierrez-Diez
Author

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Author

L Garcia Cuello
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Edwin Tucay
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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
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