Department of Cardiology, Ca' Foncello Hospital, Treviso, Italy.
J Cardiovasc Med (Hagerstown). 2013 Sep;14(9):659-68. doi: 10.2459/JCM.0b013e32835ec585.
Even in the modern era of advanced diagnostic imaging, improved antibiotic therapy and potentially curative surgery, infective endocarditis remains a serious disease with high rates of morbidity and mortality. Reasons for such a persistently poor outcome may be represented by the changing epidemiology and microbiology, with new groups of patients at risk and new and more aggressive microorganisms. However, the inadequate use of both diagnostic (blood cultures and echocardiography) and therapeutic (antibiotics and surgery) means can influence the generally delayed diagnosis and poor prognosis seen in patients with infective endocarditis. We tried to identify the critical points in the management of patients with infective endocarditis and to elaborate a formal multidisciplinary approach based on the strict collaboration of specialists in infectious diseases, microbiology, cardiology and cardiac surgery. We hypothesized that this approach could increase the adherence to the published guidelines, and could represent a means to improve the outcome of patients with infective endocarditis.
即使在先进的诊断影像学、改良的抗生素治疗和可能的治愈性手术的现代时代，感染性心内膜炎仍然是一种发病率和死亡率都很高的严重疾病。造成如此持续不良预后的原因可能是流行病学和微生物学的变化，新的患者群体面临风险，新的、更具侵袭性的微生物也在出现。然而，诊断（血培养和超声心动图）和治疗（抗生素和手术）手段的使用不足，可能会影响感染性心内膜炎患者普遍延迟的诊断和不良预后。我们试图确定感染性心内膜炎患者管理中的关键点，并根据传染病学、微生物学、心脏病学和心脏外科专家的严格协作，制定出正式的多学科方法。我们假设这种方法可以提高对已发表指南的遵循程度，并可能成为改善感染性心内膜炎患者预后的一种手段。
