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成人感染性心内膜炎:诊断、抗菌治疗和并发症处理:美国心脏协会医疗保健专业人员科学声明。

Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association.

出版信息

Circulation. 2015 Oct 13;132(15):1435-86. doi: 10.1161/CIR.0000000000000296. Epub 2015 Sep 15.

Abstract

BACKGROUND

Infective endocarditis is a potentially lethal disease that has undergone major changes in both host and pathogen. The epidemiology of infective endocarditis has become more complex with today's myriad healthcare-associated factors that predispose to infection. Moreover, changes in pathogen prevalence, in particular a more common staphylococcal origin, have affected outcomes, which have not improved despite medical and surgical advances.

METHODS AND RESULTS

This statement updates the 2005 iteration, both of which were developed by the American Heart Association under the auspices of the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease of the Young. It includes an evidence-based system for diagnostic and treatment recommendations used by the American College of Cardiology and the American Heart Association for treatment recommendations.

CONCLUSIONS

Infective endocarditis is a complex disease, and patients with this disease generally require management by a team of physicians and allied health providers with a variety of areas of expertise. The recommendations provided in this document are intended to assist in the management of this uncommon but potentially deadly infection. The clinical variability and complexity in infective endocarditis, however, dictate that these recommendations be used to support and not supplant decisions in individual patient management.

摘要

背景

感染性心内膜炎是一种潜在致命的疾病,其宿主和病原体都发生了重大变化。由于当今与医疗保健相关的多种因素导致感染易感性增加,感染性心内膜炎的流行病学变得更加复杂。此外,病原体流行率的变化,特别是葡萄球菌起源的更为常见,影响了结果,尽管医学和外科技术有所进步,但并未改善。

方法和结果

本声明更新了 2005 年的迭代版本,这两个版本都是由美国心脏协会在风湿热、心内膜炎和川崎病委员会的支持下制定的,该委员会是心血管疾病青年理事会的一部分。它包括一个基于证据的诊断和治疗建议系统,该系统由美国心脏病学会和美国心脏协会用于治疗建议。

结论

感染性心内膜炎是一种复杂的疾病,患有这种疾病的患者通常需要由具有多种专业领域知识的医生和医疗保健提供者团队进行管理。本文档中提供的建议旨在帮助管理这种罕见但潜在致命的感染。然而,感染性心内膜炎的临床变异性和复杂性决定了这些建议应被用来支持而不是取代个别患者管理中的决策。

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