Yuan Shi-Min
Teaching Hospital, Fujian Medical University, Putian, People's Republic of China.
Rev Bras Cir Cardiovasc. 2015 Jan-Mar;30(1):93-103. doi: 10.5935/1678-9741.20140113.
A systematic analysis was made in view of the epidemiology, clinical features, diagnosis, treatment and main outcomes of mycobacterial endocarditis.
The data source of the present study was based on a comprehensive literature search in MEDLINE, Highwire Press and Google search engine for publications on mycobacterial endocarditis published between 2000 and 2013.
The rapidly growing mycobacteria become the predominant pathogens with Mycobacterium chelonae being the most common. This condition has changed significantly in terms of epidemiology since the 21st century, with more broad patient age range, longer latency, prevailed mitral valve infections and better prognosis.
Mycobacterial endocarditis is rare and the causative pathogens are predominantly the rapidly growing mycobacteria. Amikacin, ciprofloxacin and clarithromycin are the most frequently used targeted antimicrobial agents but often show poor responses. Patients with deep infections may warrant a surgical operation or line withdrawal. With periodic multidrug therapy guided by drug susceptibility testing, and surgical managements, patients may achieve good therapeutic results.
对分枝杆菌性心内膜炎的流行病学、临床特征、诊断、治疗及主要转归进行系统分析。
本研究的数据来源基于对MEDLINE、Highwire Press和谷歌搜索引擎进行全面文献检索，以获取2000年至2013年间发表的关于分枝杆菌性心内膜炎的文献。
快速生长分枝杆菌成为主要病原体，其中龟分枝杆菌最为常见。自21世纪以来，这种疾病在流行病学方面发生了显著变化，患者年龄范围更广，潜伏期更长，二尖瓣感染占优势，预后较好。
分枝杆菌性心内膜炎较为罕见，致病病原体主要是快速生长分枝杆菌。阿米卡星、环丙沙星和克拉霉素是最常用的靶向抗菌药物，但疗效往往不佳。深部感染患者可能需要手术或拔除导管。通过药敏试验指导的周期性多药治疗和手术管理，患者可能获得良好的治疗效果。
