Table 5.

Reasons Why TTE and/or TEE Were Not Done in 96 Cases of Staphylococcus aureus Bacteremia

Reasons Why TEE and/or TTE Were Not Done		No TEE (n = 74)	No TTE (n = 10)	No TEE or TTE (n = 12)
Increased risk of TEE
Gastrointestinal	Dysphagia	6 (8%)a	0	0
	Anatomic abnormality	4 (5%)	0	0
	Bleeding	1 (1%)	0	0
	Prior esophagectomy	1 (1%)	0	0
Pulmonary	Respiratory distress	6 (8%)	0	0
Musculoskeletal	Cervical spine instability	2 (3%)	0	0
	Unable to position patient with arthritis	2 (3%)	0	0
Otolaryngological	Prior oropharynx or larynx cancer	3 (4%)	0	0
Hematologic	Thrombocytopenia or coagulopathy	3 (4%)	0	0
Psychiatric or neurological	Delirium or dementia	3 (4%)	0	0
Subtotal		31 (42%)	0	0
Patient refusal or intolerance or recent TTE
Patient refused		21 (28%)	0	0
Patient transitioned to comfort care		4 (5%)	0	4b (33%)
Patient intolerant of TEE		5 (7%)	0	0
TTE within previous 10 days		0	2 (20%)	0
Patient transferred to another hospital		1 (1%)	0	0
Subtotal		31 (42%)	2 (10%)	4 (33%)
Provider or ID decision or system issue
Cancelled by primary provider		0	3 (30%)	0
No TEE or TTE order, despite ID recommendation		6 (8%)	3 (30%)	3b (25%)
No ID consult		0	0	5b (42%)
ID consultant did not recommended TEE		3 (4%)	0	0
Error in order process		3 (4%)	2 (20%)	0
Subtotal		12 (16%)	8 (80%)	8 (66%)

Abbreviations: ID, infectious diseases; TEE, transesophageal echocardiography; TTE, transthoracic echocardiography.

^aData are expressed as n (column percent).

^bIn each of these cases, TTE and TEE were not done for the same reasons.