Bentata Y, Haloui I, Haddiya I, Benzirar A, El Mahi O, Ismailli N, Elouafi N
Nephrology, Dialysis and Kidney Transplantation Unit, University Hospital Mohammed VI, Oujda, University Mohammed First, Oujda, Morocco.
Laboratory of Epidemiology, Clinical Research and Public Health, Medical School, University Mohammed First, Oujda, Morocco.
J Vasc Access. 2022 Jan;23(1):149-153. doi: 10.1177/1129729820970783. Epub 2020 Nov 4.
The incidence of infective endocarditis (IE) in chronic hemodialysis (CHD) patients remains high, despite the preventive measures implemented by nephrologists, especially the rigorous respect of hygiene, the use of antibiotic locks for catheters and the use of tunneled catheters instead of non-tunneled.
The objective of this study was to determine the clinical, biological, and echocardiographic characteristics, and the prognosis of IE in CHD.
It was a retrospective study, conducted from December 2010 to March 2020, at the Nephrology and Cardiology units of University Hospital in Oujda, Morocco.
We compiled a series of 31 CHD patients having developed IE. Eleven cases (35.4%) were collected between 2010 and 2015, and 20 cases (64.6%) between 2016 and 2020. The mean age was 47 ± 19 years, 58% were male, and 25.8% of patients had diabetes. Vascular access for hemodialysis was by arteriovenous fistula, non-tunneled catheter, and tunneled catheter in 22.5%, 32.2%, and 45.2%, of the cases, respectively. About 25.8% of patients had benefited from more than two catheters (tunneled or non-tunneled) during the 3 months preceding the occurrence of IE. The mitral, tricuspid, and aortic valves were the site of IE in 41.9%, 41.9%, and 13% of the cases, respectively. Right heart IE and left heart IE were observed in 42% (13 cases) and 58% (18 cases) of cases, respectively. Blood cultures were negative in 58.1% of the cases at the time of diagnosis of IE. was identified in 69.2% of the cases. Mortality occurred in 54.8% of the cases.
IE remains a severe condition in CHD patients with an increasing incidence. Rigorous prevention and screening strategies should be implemented at the hemodialysis centers.
尽管肾病学家采取了预防措施，尤其是严格遵守卫生规范、使用导管抗生素封管以及使用隧道式导管而非非隧道式导管，但慢性血液透析（CHD）患者感染性心内膜炎（IE）的发病率仍然很高。
本研究的目的是确定CHD患者IE的临床、生物学和超声心动图特征以及预后。
这是一项回顾性研究，于2010年12月至2020年3月在摩洛哥乌季达大学医院的肾病科和心内科进行。
我们收集了31例发生IE的CHD患者。2010年至2015年收集了11例（35.4%），2016年至2020年收集了20例（64.6%）。平均年龄为47±19岁，58%为男性，25.8%的患者患有糖尿病。血液透析的血管通路分别为动静脉内瘘、非隧道式导管和隧道式导管，占病例的22.5%、32.2%和45.2%。约25.8%的患者在发生IE前3个月内使用过两根以上（隧道式或非隧道式）导管。二尖瓣、三尖瓣和主动脉瓣分别是41.9%、41.9%和13%病例中IE的发病部位。右心IE和左心IE分别见于42%（13例）和58%（18例）的病例。IE诊断时58.1%的病例血培养为阴性。69.2%的病例中鉴定出[此处原文缺失具体内容]。54.8%的病例发生了死亡。
IE在CHD患者中仍然是一种严重疾病，发病率呈上升趋势。血液透析中心应实施严格的预防和筛查策略。
