Şimşek-Yavuz Serap, Akar Ahmet Rüçhan, Aydoğdu Sinan, Berzeg-Deniz Denef, Demir Hakan, Hazırolan Tuncay, Özatik Mehmet Ali, Özer Necla, Sargın Murat, Topcuoğlu Emine Nursen, Turhan Nesrin, Yılmaz Mehmet Birhan, Azap Özlem, Başaran Seniha, Çağ Yasemin, Çağatay Atahan, Çınar Güle, Doğan-Kaya Sibel, Hızmalı Lokman, Işık Mehmet Emirhan, Kılıçaslan Nirgül, Menekşe Şirin, Meriç-Koç Meliha, Öztürk Serpil, Şensoy Ayfer, Tezer-Tekçe Yasemin, Tükenmez-Tigen Elif, Uygun-Kızmaz Yeşim, Velioğlu-Öcalmaz Mutlu Şeyda, Yeşilkaya Ayşegül, Yılmaz Emel, Yılmaz Neziha, Yılmaz-Karadağ Fatma
Turkish Society of Clinical Microbiology and Infectious Diseases, Istanbul, Turkey.
Turkish Society of Cardiovascular Surgery, Istanbul, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jan 23;28(1):2-42. doi: 10.5606/tgkdc.dergisi.2020.01954. eCollection 2020 Jan.
Infective endocarditis (IE) is rare, but associated with significant morbidity and mortality rates. Estimates of the incidence of IE in Turkey are compromised by the absence of population-based prospective studies. Due to the frequent presence of predisposing cardiac conditions and higher rates of nosocomial bacteremia in highrisk groups, the incidence of IE is expected to be higher in Turkey. Additionally, while IE generally affects older people in developed countries, it still affects young people in Turkey. In order to reduce the mortality and morbidity, it is critical to diagnose the IE to determine the causative agent and to start treatment rapidly. However, most of the patients cannot be diagnosed in their first visits, about half of them can be diagnosed after three months, and the disease often goes unnoticed. In patients diagnosed with IE, the rate of identification of causative organisms is significantly lower in Turkey than in developed countries. Furthermore, most of the centers do not perform some essential microbiological diagnostic tests as a routine practice. Some antimicrobials that are recommended as the first-line of treatment for IE, particularly antistaphylococcal penicillins, are not available in Turkey. These problems necessitate reviewing the epidemiological, laboratory, and clinical characteristics of IE in our country, as well as the current information about its diagnosis, treatment, and prevention together with local data. Physicians can follow patients with IE in many specialties. Diagnosis and treatment processes of IE should be standardized at every stage so that management of IE, a setting in which many physicians are involved, can always be in line with current recommendations. Study Group for Infective Endocarditis and Other Cardiovascular Infections of the Turkish Society of Clinical Microbiology and Infectious Diseases has called for collaboration of the relevant specialist organizations to establish a consensus report on the diagnosis, treatment, and prevention of IE in the light of current information and local data in Turkey.
感染性心内膜炎（IE）较为罕见，但发病率和死亡率都很高。由于缺乏基于人群的前瞻性研究，土耳其IE发病率的估算受到影响。由于高危人群中常存在易患心脏疾病且医院获得性菌血症发生率较高，预计土耳其IE的发病率会更高。此外，虽然IE在发达国家通常影响老年人，但在土耳其仍影响年轻人。为降低死亡率和发病率，关键在于诊断IE以确定病原体并迅速开始治疗。然而，大多数患者在首次就诊时无法确诊，约一半患者在三个月后才能确诊，而且该病常常未被注意到。在确诊为IE的患者中，土耳其致病微生物的识别率显著低于发达国家。此外，大多数中心并未将一些基本的微生物学诊断检查作为常规操作。一些被推荐为IE一线治疗药物的抗菌药物，尤其是抗葡萄球菌青霉素，在土耳其无法获得。这些问题使得有必要审视我国IE的流行病学、实验室和临床特征，以及目前关于其诊断、治疗和预防的信息并结合本地数据。许多专科的医生都可以随访IE患者。IE的诊断和治疗过程应在每个阶段都实现标准化，以便让涉及众多医生的IE管理始终符合当前建议。土耳其临床微生物学和传染病学会感染性心内膜炎及其他心血管感染研究组呼吁相关专业组织开展合作，根据土耳其的当前信息和本地数据，就IE的诊断、治疗和预防制定一份共识报告。
