Dahl Anders, Bruun Niels Eske
Gentofte University Hospital, Niels Andersens vej 65, 2900 Hellerup, Denmark.
Expert Rev Cardiovasc Ther. 2013 Sep;11(9):1247-57. doi: 10.1586/14779072.2013.832482.
Enterococcus faecalis infective endocarditis (IE) is a disease of increasing importance, with more patients infected, increasing frequency of health-care associated infections and increasing incidence of antimicrobial resistances. The typical clinical presentation is a subacute course with fever, malaise and generalized aches, difficult to distinguish from other more common diseases. Of paramount importance is transthoracic- and transesophageal-echocardiography to establish the diagnosis. At the moment, the predominant strategies recommend ampicillin in combination with either gentamicin or ceftriaxone. E. faecalis infective endocarditis continues to be a very serious disease with considerable percentages of high-level gentamicin resistant strains and in-hospital mortality around 20%. Strategies to prevent E. faecalis IE, improve diagnostics, optimize treatment and reduce morbidity will be necessary to improve the overall prognosis.
粪肠球菌感染性心内膜炎（IE）是一种日益重要的疾病，感染患者增多，医疗保健相关感染频率增加，抗菌药物耐药性发生率上升。典型的临床表现为亚急性病程，伴有发热、不适和全身疼痛，难以与其他更常见的疾病区分开来。至关重要的是经胸和经食管超声心动图来确立诊断。目前，主要策略推荐氨苄西林联合庆大霉素或头孢曲松。粪肠球菌感染性心内膜炎仍然是一种非常严重的疾病，高水平庆大霉素耐药菌株的比例相当高，住院死亡率约为20%。预防粪肠球菌IE、改善诊断、优化治疗和降低发病率的策略对于改善总体预后将是必要的。
