Division of Functional Diagnostics, Department of Health Sciences, Osaka University Graduate School of Medicine, Yamadaoka, Suita 565-0871, Japan.
Circ J. 2013;77(6):1558-64. doi: 10.1253/circj.cj-12-1101. Epub 2013 Mar 23.
It is important to manage a potentially fatal disease such as infective endocarditis (IE) based on evidence and guidelines for treatment published by academic societies. To clarify the current status of IE in Japan, we conducted a nationwide survey of IE (CArdiac Disease REgistration-Infective Endocarditis [CADRE-IE]).
We collected data on every aspect of IE using web-based survey. Only a Japanese Circulation Society-certified cardiologists who had managed a case of IE could register the patient when the outcome was known. There were 513 cases (320 men, 193 women) from 114 institutions. The median age was 61 years and more than 80% of the patients had underlying cardiac diseases. The majority was valvular heart disease, in which mitral regurgitation was a leading cause. Most of the patients had some predisposing factors, among which, decayed teeth or periodontitis was a leading factor. Streptococci were found in approximately 52% and staphylococci were found in 32% in positive-culture cases. Methicillin-resistant Staphylococcus aureus was found in 7.5%. Congestive heart failure was found in 43% and intracranial complications were found in 31%. Most of the patients were discharged (65%) but in-hospital death occurred in 11%.
IE is still a lethal disease affecting older patients. The information obtained from the survey should be very helpful for physicians.
根据学术协会发布的治疗感染性心内膜炎（IE）的证据和指南来管理这种潜在致命疾病非常重要。为了阐明日本 IE 的现状，我们对 IE 进行了一项全国性调查（CArdiac Disease REgistration-Infective Endocarditis [CADRE-IE]）。
我们使用基于网络的调查收集了 IE 的各个方面的数据。只有管理过 IE 病例且获得日本循环协会认证的心脏病专家才能在结果已知时注册患者。共有 114 家机构的 513 例（320 名男性，193 名女性）患者入组。中位年龄为 61 岁，超过 80%的患者有基础心脏疾病。大多数为瓣膜性心脏病，其中二尖瓣反流是主要原因。大多数患者存在某些易患因素，其中龋齿或牙周炎是主要因素。阳性培养病例中约有 52%为链球菌，32%为葡萄球菌。耐甲氧西林金黄色葡萄球菌占 7.5%。43%的患者存在充血性心力衰竭，31%的患者存在颅内并发症。大多数患者出院（65%），但住院期间死亡 11%。
IE 仍然是一种影响老年患者的致命疾病。该调查获得的信息将对医生非常有帮助。
