title: [Infective endocarditis in intensive cardiac care unit - clinical and biochemical differences of blood-culture negative infective endocarditis].
abstract: Diagnosis and treatment of infective endocarditis (IE) is still a challenge for physicians. Group of patients with the worst prognosis is treated in Intensive Cardiac Care Unit (ICCU). Etiologic agent can not be identified in a substantial number of patients.
  
  
  OBJECTIVE
  The aim of study is to find differences between patients with blood culture negative infective endocarditis (BCNIE) and blood culture positive infective endocarditis (BCPIE) treated in ICCU by comparing their clinical course and laboratory parameters.
  
  
  METHODS
  Retrospective analysis of 30 patients with IE hospitalized in ICCU Swietokrzyskie Cardiac Centre between 2010 and 2016. This group consist of 26 men (86,67%) and 4 women (13,3%). Mean age was 58 years ±13. Most of the cases were new disease, recurrence of the disease was observed in 2 cases (6,7%). 8 patients (26,7%) required artificial ventilation, 11 (36,7%) received inotropes and 6 (20%) vasopresors. In 14 (46,7%) cases blood cultures was negative (BCNIE), the rest of patients (16, 53,3%) was blood cultures - positive infective endocarditis (BCIE).
  
  
  RESULTS
  Both of the groups were clinically similar. There were no statistically significant differences in incidence of cardiac implants, localization of bacterial vegetations, administered catecholamines, antibiotic therapy, artificial ventilation, surgical treatment, complication and in-hospital mortality. Incidence of cardiac complications in all of BCNIE cases and in 81,3% cases of BCPIE draws attention, but it is not statistically significant difference (p=0,08). There was statistically significant difference in mean BNP blood concentration (3005,17 ng/ml ±2045,2 vs 1013,42 ng/ml ±1087,6; p=0,01), but there were no statistically significant differences in rest of laboratory parameters.
  
  
  CONCLUSIONS
  BCNIE group has got higher mean BNP blood concentration than BCPIE group. There were no statistically significant differences between these groups in others laboratory parameters, clinical course and administered antibiotic therapy. In our endemic region major cause of BCNIE seems to be early antibiotic therapy prior to collection of blood samples, but further studies are necessary.
authors.affiliation: Intensive Cardiac Care Unit, Swietokrzyskie Cardiac Centre in Kielce, Poland.
authors.forename: Karol
authors.initials: K
authors.lastname: Kaziród-Wolski
authors.affiliation: Intensive Cardiac Care Unit, Swietokrzyskie Cardiac Centre in Kielce, Poland; The Jan Kochanowski University, Kielce, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Sielski
authors.affiliation: Intensive Cardiac Care Unit, Swietokrzyskie Cardiac Centre in Kielce, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Ciuraszkiewicz
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D000071997:Blood Culture; D004696:Endocarditis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D020097:Natriuretic Peptide, Brain
keywords: BNP; antibiotics; blood cultures; endocarditis; mortality