Lalani Tahaniyat, Person Anna K, Hedayati Susan S, Moore Laura, Murdoch David R, Hoen Bruno, Peterson Gail, Shahbaz Hasan, Raoult Didier, Miro Jose M, Olaison Lars, Snygg-Martino Ulrika, Suter Fredy, Spelman Dennis, Eykyn Susannah, Strahilevitz Jacob, Van der Meer Jan T, Verhagen Dominique, Baloch Khaula, Abrutyn Elias, Cabell Christopher H
Duke Clinical Research Institute, Duke University Medical Center, 2400 Pratt Street, Cube 7545, Durham, NC 27710 USA.
Scand J Infect Dis. 2007;39(10):840-8. doi: 10.1080/00365540701367793.
Propionibacterium species are occasionally associated with serious systemic infections such as infective endocarditis. In this study, we examined the clinical features, complications and outcome of 15 patients with Propionibacterium endocarditis using the International Collaboration on Endocarditis Merged Database (ICE-MD) and Prospective Cohort Study (ICE-PCS), and compared the results to 28 cases previously reported in the literature. In the ICE database, 11 of 15 patients were male with a mean age of 52 y. Prosthetic valve endocarditis occurred in 13 of 15 cases and 3 patients had a history of congenital heart disease. Clinical findings included valvular vegetations (9 patients), cardiac abscesses (3 patients), congestive heart failure (2 patients), and central nervous system emboli (2 patients). Most patients were treated with beta-lactam antibiotics alone or in combination for 4 to 6 weeks. 10 of the 15 patients underwent valve replacement surgery and 2 patients died. Similar findings were noted on review of the literature. The results of this paper suggest that risk factors for Propionibacterium endocarditis include male gender, presence of prosthetic valves and congenital heart disease. The clinical course is characterized by complications such as valvular dehiscence, cardiac abscesses and congestive heart failure. Treatment may require a combination of medical and surgical therapy.
丙酸杆菌属偶尔与严重的全身感染有关，如感染性心内膜炎。在本研究中，我们使用国际心内膜炎协作合并数据库（ICE-MD）和前瞻性队列研究（ICE-PCS），对15例丙酸杆菌性心内膜炎患者的临床特征、并发症及预后进行了研究，并将结果与之前文献报道的28例病例进行了比较。在ICE数据库中，15例患者中有11例为男性，平均年龄52岁。15例中有13例发生人工瓣膜心内膜炎，3例患者有先天性心脏病史。临床发现包括瓣膜赘生物（9例）、心脏脓肿（3例）、充血性心力衰竭（2例）和中枢神经系统栓塞（2例）。大多数患者单独或联合使用β-内酰胺类抗生素治疗4至6周。15例患者中有10例行瓣膜置换手术，2例死亡。文献回顾也发现了类似的结果。本文结果提示，丙酸杆菌性心内膜炎的危险因素包括男性、人工瓣膜的存在和先天性心脏病。临床病程以瓣膜裂开、心脏脓肿和充血性心力衰竭等并发症为特征。治疗可能需要药物和手术治疗相结合。
