The microbiology, epidemiology, diagnosis, and treatment of infective endocarditis have changed significantly since the Duke criteria were published in 1994 and modified in 2000.
The International Society of Infectious Cardiovascular Diseases (ISCVID) convened a multidisciplinary Working Group to update the diagnostic criteria for infective endocarditis.
The resulting Duke-ISCVID 2023 infective endocarditis criteria propose significant changes, including new microbiological diagnostics (enzyme immunoassay for Bartonella species, PCR, amplicon/metagenomics sequencing, in situ hybridization), diagnostic imaging ([18F]FDG PET/CT , cardiac computed tomography) and inclusion of intraoperative inspection as a new Main Clinical Criterion.
The list of "typical" microorganisms causing infective endocarditis was expanded and included pathogens that will only be considered typical in the presence of intracardiac prostheses. Venipuncture timing and spacing requirements for blood cultures were waived.
Finally, additional predisposing conditions (transcatheter valve implantations, endovascular cardiac implantable electronic devices, previous infective endocarditis) were clarified.
These diagnostic criteria should be updated periodically by making the ISCVID-Duke Criteria available online as a “living document.”
* Full document (subscription required)
The 2023 Duke-ISCVID Criteria for Infective Endocarditis: Updating the Modified Duke Criteria. Clin Infect Diseases. 2023 May 4;ciad271. doi: 10.1093/cid/ciad271. Online ahead of print.
