The ESC 2023 guidelines for the management of endocarditis stress that a multidisciplinary approach is needed to manage patients with infective endocarditis (IE). In our view the guidelines do not include the relevant perspectives from modern microbiology. The diagnostic criteria for IE were changed in the ESC 2023 guidelines and many IE-causing pathogens are either not clearly defined or not even mentioned. Moreover, the improved understanding of the relation between bacterial species and the risk for IE has not been implemented. The guidelines give detailed, and in our view not correct, instructions about diagnostic testing in blood culture negative IE without presenting proper evidence. Other important diagnostic aspects such as the value of repeated blood cultures and incubation time for blood cultures are not discussed. We believe that a multidisciplinary collaboration, including microbiologists, would have improved these guidelines and we hope for a future harmonization of diagnostic criteria for IE.

中文翻译：

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2023 年 ESC 感染性心内膜炎治疗指南使现代微生物学变得更加重要

ESC 2023 心内膜炎治疗指南强调，需要采用多学科方法来治疗感染性心内膜炎 (IE) 患者。我们认为该指南不包括现代微生物学的相关观点。 ESC 2023 指南中的 IE 诊断标准发生了变化，许多引起 IE 的病原体要么没有明确定义，要么甚至没有提及。此外，对细菌种类与 IE 风险之间关系的进一步了解尚未得到落实。该指南给出了关于血培养阴性 IE 诊断测试的详细说明，但我们认为这些说明并不正确，但没有提供适当的证据。其他重要的诊断方面，例如重复血培养的价值和血培养的孵育时间没有讨论。我们相信，包括微生物学家在内的多学科合作将会改进这些指南，我们希望未来能够统一 IE 的诊断标准。