a Section of Infectious Disease, Department of Medicine , Haukeland University Hospital , Bergen , Norway.
b Department of Medicine , Haraldsplass Deaconess Hospital , Bergen , Norway.
Infect Dis (Lond). 2018 Oct;50(10):757-763. doi: 10.1080/23744235.2018.1482419. Epub 2018 Jun 19.
To investigate epidemiological trends of infective endocarditis (IE) in western Norway a retrospective study was performed.
Characteristics of 706 IE admissions from 1996 to 2005 and 2006 to 2015 were analysed and compared using the Chi-square test for categorical variables and the t-test for age. Survival was analysed by multiple Cox regression and reported by the hazard ratio (HR).
Mean annual incidence rates increased from 4.6 to 7.4 per 100,000 inhabitants (rate ratio: 1.97, 95% confidence interval: 1.52-2.56, p < .001). Non-viridans streptococci, enterococci and Staphylococcus aureus (S. aureus), were all independently associated with increased mortality. The frequency of IE caused by enterococci increased from 3.7 to 13.0% (p < .001). The proportion of intravenous drug users (IVDU) increased from 16.5 to 23.5% (p = .015) and had increasing aortic valve involvement (p = .023). Prosthetic valve endocarditis (PVE) constituted 30% of IE cases in both decades with biological PVE increasing from 9.4 to 22.1% (p < .001) and mechanical PVE decreasing from 18.7 to 8.9% (p < .001). In the last decade, valve replacement surgery was performed in 37.6% of the patients, of which 85.5% received a bioprosthesis.
The incidence of IE increased significantly. Non-viridans streptococci, enterococci and S. aureus were all significantly associated with increased mortality. The increased number of enterococcal IE and the increased number of IVDUs with left-sided IE constituted new challenges. Biological implants were preferred in a majority of patients requiring surgery.
为了研究挪威西部感染性心内膜炎（IE）的流行病学趋势，进行了一项回顾性研究。
分析比较了 1996 年至 2005 年和 2006 年至 2015 年 706 例 IE 住院患者的特征，使用卡方检验进行分类变量分析，t 检验进行年龄分析。采用多因素 Cox 回归分析生存情况，并以风险比（HR）报告。
年发病率从 4.6 增至 7.4/10 万居民（发生率比：1.97，95%置信区间：1.52-2.56，p<0.001）。非草绿色链球菌、肠球菌和金黄色葡萄球菌（金葡菌）均与死亡率增加独立相关。肠球菌引起的 IE 频率从 3.7%增至 13.0%（p<0.001）。静脉吸毒者（IDU）的比例从 16.5%增至 23.5%（p=0.015），且主动脉瓣受累的比例增加（p=0.023）。生物瓣心内膜炎（PVE）在两个十年中均占 IE 病例的 30%，其中生物瓣 PVE 从 9.4%增至 22.1%（p<0.001），机械瓣 PVE 从 18.7%降至 8.9%（p<0.001）。在过去十年中，37.6%的患者接受了瓣膜置换手术，其中 85.5%接受了生物假体。
IE 的发病率显著增加。非草绿色链球菌、肠球菌和金葡菌与死亡率增加显著相关。肠球菌性 IE 数量增加和左心 IE 中 IDU 数量增加构成了新的挑战。大多数需要手术的患者更倾向于使用生物植入物。
