Work

Low Yield of Blood Cultures After End of Therapy of an Episode of Infective Endocarditis: 12 Years’ Experience From a Referral Center

Year: 2026

Type: article

Abstract: Background Infective endocarditis (IE) carries a significant risk of recurrence. European clinical guidelines recommend performing follow-up blood cultures (BCs), although evidence regarding their utility is limited. We aimed to assess the yield of follow-up BCs in these patients. Methods Single-center post hoc analysis of a prospective cohort including IE survivors diagnosed between 2012 and 2023 with at least 12 months of follow-up. Results Among 225 patients included, follow-up BCs were performed in 153 (68.0%). Recurrence was diagnosed in 19 patients (8.4%). Patients with recurrence had higher mortality during follow-up (15.8% vs 4.4%, P = .025). Among patients with follow-up BCs, there was 1 contaminant (0.7%) and 2 true-positive results (1.3%), both of them representing IE reinfections due to different microorganisms. One of them had fever at BC extraction. The 1-year recurrence rate and IE-associated mortality (including complications or recurrences) were similar in patients with and without BCs (7.8% vs 9.7%, P = .789 and 1.4% vs 0.7%, P = .538, respectively). In the index IE episode, patients with recurrence more frequently presented with previous IE (21.1% vs 5.3%, P = .035), fungal etiology (10.5% vs 1.5%, P = .010), and mycotic aneurysms (15.8% vs 1.0%, P = .004), while they had a lower frequency of native-valve (31.6% vs 54.6%, P = .049) and Staphylococcus aureus (5.3% vs 23.2%, P = .012) endocarditis. Conclusions Follow-up BC after an IE episode appears to have low utility, with similar rates of true positives and contaminants. Patients with follow-up BCs did not have more recurrences diagnosed or lower mortality during follow-up.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofag228