title: Relationship Between Enterococcus faecalis Infective Endocarditis and Colorectal Neoplasm: Preliminary Results From a Cohort of 154 Patients.
abstract: OBJECTIVE
  The association between Streptococcus bovis group infective endocarditis and colorectal neoplasm (CRN) is well-known. However, no studies have assessed the association between Enterococcus faecalis infective endocarditis (EFIE) and CRN. We aimed to determine whether the prevalence of CRN is higher in patients with EFIE and an unclear source of infection than in patients with EFIE and a known source of infection or in the general population.
  
  
  METHODS
  Retrospective analysis of a cohort of 154 patients with definite EFIE (109 with an unclear source of infection and 45 with an identified source) from 2 Spanish teaching hospitals to determine the prevalence of CRN and other colorectal diseases.
  
  
  RESULTS
  In the group with an unknown source of infection, 61 patients (56%) underwent colonoscopy; of these, 31 (50.8%) had CRN. Nonadvanced colorectal adenoma was detected in 22 patients (36%), advanced adenoma in 5 (8.2%), and colorectal carcinoma (CRC) in 4 (6.6%). Among patients who survived the EFIE episode with ≥ 2 years of follow-up, 1 case of CRC was subsequently diagnosed. Only 6 patients (13.3%) with an identified focus of infection underwent colonoscopy; 1 of these patients (16.7%) was diagnosed with CRN. The prevalence of adenomas was slightly higher than that of the Spanish population in the same age range, whereas that of CRC was 17-fold higher.
  
  
  CONCLUSIONS
  CRN was found in more than half of patients with EFIE and an unclear focus of infection who underwent colonoscopy. Colonoscopy should be recommended in patients with EFIE and an unclear source of infection.
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Pericàs
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Corredoira
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.
authors.forename: Asunción
authors.initials: A
authors.lastname: Moreno
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: M José
authors.initials: MJ
authors.lastname: García-País
authors.affiliation: Servicio de Cardiología, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Falces
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Rabuñal
authors.affiliation: Servicio de Cirugía Cardiaca, Hospital Clínic de Barcelona, Barcelona, Spain; Servicio de Cirugía Cardiaca, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Mestres
authors.affiliation: Servicio de Microbiología, Hospital Lucus Augusti, Lugo, Spain.
authors.forename: M Pilar
authors.initials: MP
authors.lastname: Alonso
authors.affiliation: ISGlobal, Fundació Privada Centre de Recerca en Salut Internacional de Barcelona (CRESIB), Servicio de Microbiología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Marco
authors.affiliation: Servicio de Cirugía Cardiaca, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Quintana
authors.affiliation: Servicio de Microbiología, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Almela
authors.affiliation: Servicio de Cardiología, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Paré
authors.affiliation: Departamento de Estadística, Facultad de Biología, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Llopis
authors.affiliation: Departamento de Gastroenterología, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Castells
authors.affiliation: Servicio de Enfermedades Infecciosas, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain. Electronic address: jmmiro@ub.edu.
authors.forename: José M
authors.initials: JM
authors.lastname: Miró
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000382:microbiology; D013293:Enterococcus faecalis / Q000302:isolation & purification*; D005260:Female; D005500:Follow-Up Studies; D016908:Gram-Positive Bacterial Infections / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
keywords: Colonoscopia; Colonoscopy; Colorectal cancer; Colorectal disease; Cáncer colorrectal; Endocarditis; Enfermedad colorrectal; Enterococcus faecalis; Epidemiology; Epidemiología