• Rev Esp Cardiol (Engl Ed) · Sep 2020

    Multicenter Study Observational Study

    Prevalence of colorectal disease in Enterococcus faecalis infective endocarditis: results of an observational multicenter study.

    • Laura Escolà-Vergé, Maddalena Peghin, Filippo Givone, María Teresa Pérez-Rodríguez, Milagros Suárez-Varela, Yolanda Meije, Gabriela Abelenda, Benito Almirante, and Nuria Fernández-Hidalgo.
    • Servicio de Enfermedades Infecciosas, Hospital Universitari Vall d'Hebron, Departamento de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: lauraescola@gmail.com.
    • Rev Esp Cardiol (Engl Ed). 2020 Sep 1; 73 (9): 711-717.

    Introduction And ObjectivesThe aim of this study was to determine the prevalence of colorectal disease in Enterococcus faecalis infective endocarditis (EFIE) patients.MethodsAn observational, retrospective, multicenter study was performed at 4 referral centers. From the moment that a colonoscopy was systematically performed in EFIE in each participating hospital until October 2018, we included all consecutive episodes of definite EFIE in adult patients. The outcome was an endoscopic finding of colorectal disease potentially causing bacteremia.ResultsA total of 103 patients with EFIE were included; 83 (81%) were male, the median age was 76 [interquartile range 67-82] years, and the median age-adjusted Charlson comorbidity index was 5 [interquartile range 4-7]. The presumed sources of infection were unknown in 63 (61%), urinary in 20 (19%), gastrointestinal in 13 (13%), catheter-related bacteremia in 5 (5%), and others in 2 (2%). Seventy-eight patients (76%) underwent a colonoscopy, and 47 (60%) had endoscopic findings indicating a potential source of bacteremia. Thirty-nine patients (83%) had a colorectal neoplastic disease, and 8 (17%) a nonneoplastic disease. Of the 45 with an unknown portal of entry who underwent a colonoscopy, gastrointestinal origin was identified in 64%. In the subgroup of 25 patients with a known source of infection and a colonoscopy, excluding those with previously diagnosed colorectal disease, 44% had colorectal disease.ConclusionsPerforming a colonoscopy in all EFIE patients, irrespective of the presumed source of infection, could be helpful to diagnose colorectal disease in these patients and to avoid a new bacteremia episode (and eventually infective endocarditis) by the same or a different microorganism.Copyright © 2019 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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