title: Risk factors for infective endocarditis in patients with enterococcal bacteremia: a case-control study.
abstract: BACKGROUND
  Based on previous studies, enterococcal infective endocarditis (IE) is considered a unimicrobial, community-acquired disease of older Caucasian men.
  
  
  METHODS
  We evaluated the relationship between enterococcal bacteremia and IE by comparing clinical and demographic characteristics of all cases of enterococcal IE within an 8-year period (n = 41) with controls randomly chosen from patients with enterococcal bacteremia without IE.
  
  
  RESULTS
  By univariate and multivariable analyses, the presence of a prosthetic valve (PV) and infection with Enterococcus faecalis were significantly associated with IE, while age, gender, race, polymicrobial infection and community-acquired infection were not. Almost an equal number of women and men had enterococcal IE. Cases of enterococcal IE were commonly nosocomial (39%) and polymicrobial (17%).
  
  
  CONCLUSIONS
  Enterococcal endocarditis can no longer be considered exclusively a unimicrobial, community-acquired disease of Caucasian men. Instead, our data suggest that the presence of a PV and infection by E. faecalis are associated with an increased risk for IE.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Anderson
authors.forename: D R
authors.initials: DR
authors.lastname: Murdoch
authors.forename: D J
authors.initials: DJ
authors.lastname: Sexton
authors.forename: L B
authors.initials: LB
authors.lastname: Reller
authors.forename: J E
authors.initials: JE
authors.lastname: Stout
authors.forename: C H
authors.initials: CH
authors.lastname: Cabell
authors.forename: G R
authors.initials: GR
authors.lastname: Corey
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016022:Case-Control Studies; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D016983:Enterococcus / Q000187:drug effects / Q000302:isolation & purification*; D005260:Female; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D012016:Reference Values; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis
chemical_list: D000900:Anti-Bacterial Agents