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中国东部一家三级医院感染性心内膜炎的特征

Characteristics of Infective Endocarditis in a Tertiary Hospital in East China.

作者信息

Xu Huimin, Cai Siyu, Dai Haibin

机构信息

Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.

出版信息

PLoS One. 2016 Nov 18;11(11):e0166764. doi: 10.1371/journal.pone.0166764. eCollection 2016.

Abstract

The epidemiology, clinical presentation, and treatment of infective endocarditis (IE) has significantly changed over the past few years in developed countries. However, relevant data from developing countries are different and remain scarce. The objective of this study was to evaluate the clinical presentations, treatment and outcomes of IE patients in a tertiary hospital in East China over an 8-year period. This was a retrospective observational study of consecutive cases of definite or possible IE as per the modified Duke criteria between January 2008 and December 2015. A total of 135 definite and 39 probable IE cases were identified. The mean age was 47.8 ± 15.7 years, with a male preponderance (1.9: 1). Degenerative valve disease accounted for 30.5% cases of IE, followed by congenital heart disease (29.9%) and rheumatic heart disease (14.9%). Native cardiac valves were present in 93.7% of the IE patients. Echocardiography and blood culture were performed in all patients, of whom 55.2% were found to have large vegetations (≥10 mm) and the positive rate of blood culture was 60.3%. Streptococcus remained the chief causative agent that was identified in 61.9% of culture-positive patients. Glycopeptide antibacterials and cephalosporins were the most frequently used antimicrobial drugs for IE therapy. Seventy-six (43.7%) of the IE patients were surgically treated. The mortality rate during hospital stay was 10.9%. Our data reflected clinical and microbiological profile, and treatment of IE in a tertiary hospital located in the East China.

摘要

在过去几年中,发达国家感染性心内膜炎(IE)的流行病学、临床表现及治疗方法发生了显著变化。然而,发展中国家的相关数据有所不同且仍然匮乏。本研究的目的是评估中国东部一家三级医院8年间IE患者的临床表现、治疗及转归情况。这是一项回顾性观察研究,纳入了2008年1月至2015年12月期间根据改良Duke标准确诊或可能为IE的连续病例。共确诊135例明确IE病例和39例疑似IE病例。平均年龄为47.8±15.7岁,男性居多(1.9∶1)。退行性瓣膜病占IE病例的30.5%,其次是先天性心脏病(29.9%)和风湿性心脏病(14.9%)。93.7%的IE患者为自身心脏瓣膜。所有患者均进行了超声心动图检查和血培养,其中55.2%的患者发现有大的赘生物(≥10mm),血培养阳性率为60.3%。链球菌仍然是主要病原体,在61.9%的血培养阳性患者中被检出。糖肽类抗菌药物和头孢菌素是IE治疗中最常用的抗菌药物。76例(43.7%)IE患者接受了手术治疗。住院期间死亡率为10.9%。我们的数据反映了中国东部一家三级医院IE的临床和微生物学特征及治疗情况。

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