Giannitsioti E, Chirouze C, Bouvet A, Béguinot I, Delahaye F, Mainardi J-L, Celard M, Mihaila-Amrouche L, Moing V L, Hoen B
Service de Maladies Infectieuses et Tropicales, CHU de Besançon, France, and University General Hospital Attikon, Athens, Greece.
Clin Microbiol Infect. 2007 Aug;13(8):770-6. doi: 10.1111/j.1469-0691.2007.01753.x. Epub 2007 May 14.
The proportion of infective endocarditis (IE) caused by group D streptococci (GDS; formerly Streptococcus bovis) increased markedly in France, to account for 25% of all cases of IE by 1999. In an attempt to explain this phenomenon, a comparative analysis of GDS and oral streptococci (OS) causing IE was performed. This study was based on data collected from a large cross-sectional population-based survey that was conducted in 1999. In total, 559 cases of definite IE were recorded, of which 142 involved GDS and 79 involved OS. Patients with GDS IE were older (62.7 vs. 56.6 years, p 0.01) and had a history of valve disease less frequently than did patients with OS IE (33.8% vs. 67.1%, p <0.0001). At-risk procedures for IE were performed less frequently in patients with GDS than in patients with OS (14.8% vs. 24.1%, p 0.08), but co-morbidities were more frequent in the GDS group (59.9% vs. 32.9%, p 0.0001). Diabetes, colon diseases and cirrhosis were also more frequent in the GDS group (p 0.006, p <0.0001 and p 0.08, respectively). Rural residents accounted for 31.0% of the GDS group, but for only 15.2% of the OS group (p 0.001). Likewise, the proportion of GDS IE was higher in regions with mixed (urban and rural) populations (Franche-Comté 81.8%, Marne 68.7%, Lorraine 70.3% and Rhône-Alpes 65.3%) than in exclusively urban regions (Paris and Ile de France 58.0%). Further investigations are required to elucidate the link in France between the incidence of GDS IE, rural residency and nutritional factors.
在法国，由D组链球菌（GDS；原牛链球菌）引起的感染性心内膜炎（IE）比例显著上升，到1999年占所有IE病例的25%。为解释这一现象，对引起IE的GDS和口腔链球菌（OS）进行了对比分析。本研究基于1999年开展的一项大规模基于人群的横断面调查所收集的数据。总共记录了559例确诊的IE病例，其中142例由GDS引起，79例由OS引起。GDS IE患者年龄更大（62.7岁对56.6岁，p<0.01），且有瓣膜病病史的频率低于OS IE患者（33.8%对67.1%，p<0.0001）。GDS患者进行IE高危操作的频率低于OS患者（分别为14.8%对24.1%，p<0.0８），但GDS组的合并症更常见（59.9%对32.9%，p<0.0001）。糖尿病、结肠疾病和肝硬化在GDS组也更常见（分别为p<0.006、p<0.0001和p<0.08）。农村居民在GDS组中占31.0%，而在OS组中仅占15.2%（p<0.001）。同样，在城乡混合人口地区（弗朗什-孔泰81.8%、马恩68.7%、洛林70.3%和罗纳-阿尔卑斯65.3%）GDS IE的比例高于纯城市地区（巴黎和法兰西岛58.0%）。需要进一步调查以阐明在法国GDS IE发病率、农村居住情况和营养因素之间的联系。
