ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Evaluation of the HANDOC Score and the 2023 International Society of Cardiovascular Infectious Diseases and European Society of Cardiology Duke Clinical Criteria for the Diagnosis of Infective Endocarditis Among Patients With Streptococcal Bacteremia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- Reply to Letter to the Editor "Challenges in the Implementation of Blood Culture Parameters to Identify Patients at Low Risk of Infective Endocarditis".Open forum infectious diseases · 2025Article
- Factors associated with persistent bacteraemia among patients with suspected infective endocarditis.Infection · 2025Article
- Evaluating Blood Culture Parameters to Identify Patients at Low Risk of Infective Endocarditis Among Those With Bacteremia by Gram-positive Cocci.Open forum infectious diseases · 2025Article
- Performance of Different Versions of Duke Criteria in Diagnosing Infective Endocarditis in Patients With Intracardiac Prosthetic Materials.Open forum infectious diseases · 2025Article
- Streptococcal endocarditis: a meta-analysis of species dependant risk.EClinicalMedicine · 2025Article
- Article
- Evaluation of Different Versions of the Duke Criteria for the Diagnosis of Infective Endocarditis Among Patients With Enterococcal Bacteremia; a Multicenter Study.Open forum infectious diseases · 2025Article
- Interpreting Blood Culture Results as Early Guidance for Infective Endocarditis.JAMA network open · 2025Article
- Comparison of the 2015 and 2023 Duke-European Society of Cardiology Criteria Among Patients With Suspected Infective Endocarditis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Role of the New Physical Examination Minor Criterion (New Heart Murmur) for the Diagnosis of Infective Endocarditis.Open forum infectious diseases · 2025Article
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Abstract
backgroundStreptococci are a common cause of infective endocarditis (IE). We aimed to evaluate the performance of the HANDOC score to identify patients at high risk for IE and the Duke clinical criteria of the European Society of Cardiology (ESC; 2015 and 2023 versions) and the 2023 version from the International Society of Cardiovascular Infectious Diseases (ISCVID) in diagnosing IE among patients with streptococcal bacteremia.
methodsThis retrospective study included adult patients with streptococcal bacteremia hospitalized at Lausanne University Hospital. Episodes were classified as IE by the Endocarditis Team. A HANDOC score >2 classified patients as high risk for IE.
resultsAmong 851 episodes with streptococcal bacteremia, IE was diagnosed in 171 episodes (20%). Among 607 episodes with non-β-hemolytic streptococci, 213 (35%) had HANDOC scores >2 points; 132 (22%) had IE. The sensitivity of the HANDOC score to identify episodes at high risk for IE was 95% (95% confidence interval [CI], 90%-98%), the specificity 82% (95% CI, 78%-85%), and the negative predictive value (NPV) 98% (95% CI, 96%-99%). 2015 Duke-ESC, 2023 Duke-ISCVID, and 2023 Duke-ESC clinical criteria classified 114 (13%), 145 (17%), and 126 (15%) episodes as definite IE, respectively. Sensitivity (95% CI) for the 2015 Duke-ESC, 2023 Duke-ISCVID, and 2023 Duke-ESC clinical criteria was calculated at 65% (57%-72%), 81% (74%-86%), and 73% (65%-79%), respectively, with specificity (95% CI) at 100% (98%-100%), 99% (98%-100%), and 99% (98%-100%), respectively.
conclusionsThe HANDOC score showed an excellent NPV to identify episodes at high risk for IE. Among the different versions of the Duke criteria, the 2023 Duke-ISCVID version fared better for the diagnosis of IE among streptococcal bacteremia.
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