Department of Cardiology, Oxford University Hospitals, Oxford, United Kingdom.
Division of Infectious Diseases, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, Minnesota.
J Am Coll Cardiol. 2017 Jan 24;69(3):325-344. doi: 10.1016/j.jacc.2016.10.066.
Infective endocarditis is defined by a focus of infection within the heart and is a feared disease across the field of cardiology. It is frequently acquired in the health care setting, and more than one-half of cases now occur in patients without known heart disease. Despite optimal care, mortality approaches 30% at 1 year. The challenges posed by infective endocarditis are significant. It is heterogeneous in etiology, clinical manifestations, and course. Staphylococcus aureus, which has become the predominant causative organism in the developed world, leads to an aggressive form of the disease, often in vulnerable or elderly patient populations. There is a lack of research infrastructure and funding, with few randomized controlled trials to guide practice. Longstanding controversies such as the timing of surgery or the role of antibiotic prophylaxis have not been resolved. The present article reviews the challenges posed by infective endocarditis and outlines current and future strategies to limit its impact.
感染性心内膜炎是指心脏内的感染灶，在心脏病学领域是一种令人担忧的疾病。它通常在医疗保健环境中获得，现在超过一半的病例发生在没有已知心脏病的患者中。尽管进行了最佳治疗，1 年后的死亡率仍接近 30%。感染性心内膜炎带来了重大挑战。它在病因、临床表现和病程方面存在异质性。金黄色葡萄球菌已成为发达国家的主要致病病原体，导致疾病呈侵袭性，常发生在脆弱或老年患者群体中。研究基础设施和资金不足，几乎没有随机对照试验来指导实践。一些长期存在的争议，如手术时机或抗生素预防的作用，尚未得到解决。本文综述了感染性心内膜炎带来的挑战，并概述了目前和未来限制其影响的策略。
