Cahill Thomas J, Prendergast Bernard D
Department of Cardiology, Oxford University Hospitals, Oxford, UK.
Department of Cardiology, St Thomas's Hospital, London, UK.
F1000Res. 2015 Nov 18;4. doi: 10.12688/f1000research.6949.1. eCollection 2015.
Infective endocarditis is a life-threatening disease caused by a focus of infection within the heart. For clinicians and scientists, it has been a moving target that has an evolving microbiology and a changing patient demographic. In the absence of an extensive evidence base to guide clinical practice, controversies abound. Here, we review three main areas of uncertainty: first, in prevention of infective endocarditis, including the role of antibiotic prophylaxis and strategies to reduce health care-associated bacteraemia; second, in diagnosis, specifically the use of multimodality imaging; third, we discuss the optimal timing of surgical intervention and the challenges posed by increasing rates of cardiac device infection.
感染性心内膜炎是一种由心脏内感染灶引起的危及生命的疾病。对于临床医生和科学家而言，它一直是一个不断变化的目标，其微生物学在演变，患者群体也在变化。由于缺乏广泛的证据基础来指导临床实践，争议众多。在此，我们综述三个主要的不确定领域：第一，在感染性心内膜炎的预防方面，包括抗生素预防的作用以及降低医疗保健相关菌血症的策略；第二，在诊断方面，特别是多模态成像的应用；第三，我们讨论手术干预的最佳时机以及心脏设备感染率上升带来的挑战。
