Performance of Different Versions of Duke Criteria in Diagnosing Infective Endocarditis in Patients With Intracardiac Prosthetic Materials.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2025-08-19 eCollection Date: 2025-09-01 DOI:10.1093/ofid/ofaf507

Matthaios Papadimitriou-Olivgeris, Bruno Ledergerber, Jana Epprecht, Berit Siedentop, Pierre Monney, Michelle Frank, Georgios Tzimas, Nicolas Fourré, Virgile Zimmermann, Giulia Domenichini, Lars Niclauss, Matthias Kirsch, Mathias Van Hemelrijck, Omer Dzemali, Benoit Guery, Barbara Hasse

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Abstract

Background: Diagnosing infective endocarditis (IE) is a significant challenge. This study aimed to compare the diagnostic performance of the 2015 and 2023 European Society of Cardiology (ESC) and the 2023 International Society for Cardiovascular Infectious Diseases (ISCVID) Duke clinical criteria in a cohort of patients with suspected IE and intracardiac prosthetic material.

Methods: This retrospective study was conducted at 2 Swiss University Hospitals (2014-2024). The reference standard was the diagnosis of the Endocarditis Team or expert clinicians. Patients with IE (reference standard) classified as definite IE by the Duke criteria were considered true positives, while those without IE classified as rejected IE were considered true negatives.

Results: Of the 1025 episodes with suspected IE and intracardiac prosthetic material, 537 (61%) had IE. Using the 2015 ESC, 2023 ESC, and 2023 ISCVID clinical criteria, 324 (32%), 367 (36%), and 430 (42%) episodes were classified as definite IE, respectively. The sensitivity for the 2015 Duke-ESC, 2023 Duke-ESC, and 2023 Duke-ISCVID the clinical criteria was calculated to be 56% (95% CI: 52-60%), 61% (57-65%), and 71% (67-74%), respectively, while the specificity 67% (63-71%), 56% (51-61%), and 34% (29-38%), respectively.

Conclusions: The 2023 ISCVID Duke clinical criteria demonstrated the highest sensitivity for diagnosing IE compared to the 2015 and 2023 ESC Duke criteria in patients with intracardiac prosthetic material. However, this was at the expense of specificity.

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不同版本的Duke标准在诊断心脏内假体患者感染性心内膜炎中的表现。

背景：感染性心内膜炎（IE）的诊断是一个重大挑战。本研究旨在比较2015年和2023年欧洲心脏病学会（ESC）和2023年国际心血管传染病学会（ISCVID）杜克临床标准对疑似IE和心内假体材料患者队列的诊断性能。方法：本回顾性研究于2014-2024年在瑞士2所大学医院进行。参考标准是心内膜炎小组或专家临床医生的诊断。根据Duke标准，IE（参考标准）为明确IE的患者被认为是真阳性，而没有IE的患者被认为是拒绝IE的患者被认为是真阴性。结果：在1025例疑似IE并发心内假体的病例中，537例（61%）发生IE。根据2015年ESC、2023年ESC和2023年ISCVID临床标准，分别有324（32%）、367（36%）和430（42%）次发作被归类为明确的IE。2015年Duke-ESC、2023年Duke-ESC和2023年Duke-ISCVID临床标准的敏感性分别为56% （95% CI: 52-60%）、61%（57-65%）和71%(67-74%)，特异性分别为67%（63-71%）、56%（51-61%）和34%（29-38%）。结论：与2015年和2023年ESC Duke标准相比，2023年ISCVID Duke临床标准对使用心内假体材料的患者诊断IE的敏感性最高。然而，这是以牺牲特异性为代价的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.