Skip to content
DraconiticResearch
Search Sources API
197,768 studies31 sourcesUpdated 33 min ago
Peer-reviewedCC BY 4.0Infection

Clinical characteristics, risk factors, and outcome of Enterococcal bacteraemia: Assessment of the DENOVA score in a diverse patient cohort

  • Pia Wehage1
  • Jan Fuge2,3
  • Luca Hilberink2
  • Ralf-Peter Vonberg4
  • Liz Kinast2
  • Susanne Simon2
  • Oana Joean5
  • Jessica Rademacher2,3
5 affiliations
  1. 1Department of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
  2. 2Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
  3. 3Biomedical Research in Endstage and Obstructive Lung Disease, Member of the German Centre for Lung Research, Hannover, Germany
  4. 4Institute for Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany
  5. 5Institute of Infectious Diseases and Infection Control, Jena University Hospital, Jena, Germany
Read full textPDFDOICite

Abstract

Background: Enterococcal bacteraemia is associated with high mortality rates ranging from 14% to 50% and is one of the most common causes of infective endocarditis. The DENOVA score is a validated screening tool for patients with monomicrobial E. faecalis bacteraemia who require echocardiography to rule out infective endocarditis.

Methods: Adult patients hospitalized at Hannover Medical School during the years of 2021 and 2022 with at least one paired blood culture positive for Enterococcus species were included in this retrospective observational study. Risk factors associated with in-hospital mortality were identified through a multivariable analysis using logistic regression. Clinical differences associated with the underlying pathogen were analysed. The performance of the DENOVA score for predicting infective endocarditis in enterococcal bacteraemia was evaluated in a high-risk cohort outside its validated application for monomicrobial E. faecalis bacteraemia.

Results: A total of 271 cases of enterococcal bacteraemia were included (65.7% E. faecium, 31.4% E. faecalis, 3% other enterococci). Patients with E. faecium bacteraemia had more vancomycin-resistant cases, longer hospital stays and a higher in-hospital mortality rate in comparison to E. faecalis bacteraemia. The Charlson Comorbidity Index, the Pitt Bacteraemia Score, and E. faecium bacteraemia were all factors independently associated with in-hospital mortality. 5% of enterococcal bacteraemia resulted in infective endocarditis (10.6% E. faecalis vs. 3.4% E. faecium). Applying the DENOVA score in our cohort let to a sensitivity of 86.7% and a specificity of 67.5% for predicting infective endocarditis.

Conclusion: Enterococcal bacteraemia remains a clinical challenge with high morbidity and mortality. Our results suggest that the application of the DENOVA score might be possible in a high-risk cohort and even beyond its original validation. Future research should focus on personalized risk stratification and tailored management strategies to improve patient outcomes.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02856-1.

Related

  1. Clinical characteristics and exploratory factors associated with in-hospital mortality in pediatric severe viral encephalitis
    Ping He, Fangqi Hu, Fei Wang
    Frontiers in pediatricsPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Clinical characteristics, long-term outcomes, and prognostic factors in linear IgA bullous dermatosis: A retrospective cohort study across the age spectrum in China, 2008-2025.
    Zhe Wang, Zhenzhen Wang, Wenchao Li +9
    JAAD internationalPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  3. Cross Validation Assessment of Clinical Performance Characteristics of a Test Table for the Risk of Maternal Autoantibody-Related Autism in High-Risk Populations
    E. R. Wassman, M. Martin, J. Schauer +2
    medRxivPreprintCC BY-NC-NDFull textObstetrics, gynaecology & paediatricsmedRxiv
  4. Parenting stress characteristics and related factors among female clinical nurses working a shift schedule raising preschool children: a latent profile analysis
    Qingfang Yao, Jianghong Yu, Hu Jiang +3
    Frontiers in Public HealthPeer-reviewedCC BY 4.0Full textEpidemiology & public healthCrossrefEurope PMCPMC
  5. Treatment Adherence and its Association with Demographic Characteristics and Clinical Factors Among Patients with Hypertension: A Cross-Sectional, Descriptive-Correlational Study.
    Abbas-Ali Vafaei, Raheb Ghorbani, Parnian Zarvani +1
    Vascular health and risk managementPeer-reviewedCC BY-NCFull textGeneral medicineEurope PMCPMC

Cite

BibTeXRIS
BibTeX
@article{wehage2026clinical,
  title = {{Clinical characteristics, risk factors, and outcome of Enterococcal bacteraemia: Assessment of the DENOVA score in a diverse patient cohort}},
  author = {Pia Wehage and Jan Fuge and Luca Hilberink and Ralf-Peter Vonberg and Liz Kinast and Susanne Simon and Oana Joean and Jessica Rademacher},
  journal = {Infection},
  year = {2026},
  month = jun,
  doi = {10.1007/s15010-026-02856-1},
  url = {https://doi.org/10.1007/s15010-026-02856-1},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Clinical characteristics, risk factors, and outcome of Enterococcal bacteraemia: Assessment of the DENOVA score in a diverse patient cohort
AU  - Pia Wehage
AU  - Jan Fuge
AU  - Luca Hilberink
AU  - Ralf-Peter Vonberg
AU  - Liz Kinast
AU  - Susanne Simon
AU  - Oana Joean
AU  - Jessica Rademacher
PY  - 2026
DA  - 2026/06/17
JO  - Infection
DO  - 10.1007/s15010-026-02856-1
UR  - https://doi.org/10.1007/s15010-026-02856-1
AB  - Background: Enterococcal bacteraemia is associated with high mortality rates ranging from 14% to 50% and is one of the most common causes of infective endocarditis. The DENOVA score is a validated screening tool for patients with monomicrobial E. faecalis bacteraemia who require echocardiography to rule out infective endocarditis.  Methods: Adult patients hospitalized at Hannover Medical School during the years of 2021 and 2022 with at least one paired blood culture positive for Enterococcus species were included in this retrospective observational study. Risk factors associated with in-hospital mortality were identified through a multivariable analysis using logistic regression. Clinical differences associated with the underlying pathogen were analysed. The performance of the DENOVA score for predicting infective endocarditis in enterococcal bacteraemia was evaluated in a high-risk cohort outside its validated application for monomicrobial E. faecalis bacteraemia.  Results: A total of 271 cases of enterococcal bacteraemia were included (65.7% E. faecium, 31.4% E. faecalis, 3% other enterococci). Patients with E. faecium bacteraemia had more vancomycin-resistant cases, longer hospital stays and a higher in-hospital mortality rate in comparison to E. faecalis bacteraemia. The Charlson Comorbidity Index, the Pitt Bacteraemia Score, and E. faecium bacteraemia were all factors independently associated with in-hospital mortality. 5% of enterococcal bacteraemia resulted in infective endocarditis (10.6% E. faecalis vs. 3.4% E. faecium). Applying the DENOVA score in our cohort let to a sensitivity of 86.7% and a specificity of 67.5% for predicting infective endocarditis.  Conclusion: Enterococcal bacteraemia remains a clinical challenge with high morbidity and mortality. Our results suggest that the application of the DENOVA score might be possible in a high-risk cohort and even beyond its original validation. Future research should focus on personalized risk stratification and tailored management strategies to improve patient outcomes.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s15010-026-02856-1.
SN  - 0300-8126
SN  - 1439-0973
ER  -