Division of Cardiothoracic Surgery, Department for Clinical Sciences Lund, Skane University Hospital and Lund University, Getingevagen 4, 22185, Lund, Sweden.
Division of Infection Medicine, Department of Clinical Sciences Lund, Medical Faculty, Lund University, Lund, Sweden.
Sci Rep. 2021 Jan 13;11(1):1177. doi: 10.1038/s41598-020-80869-y.
The aim of the study was to compare background characteristics, microbiology and outcome of patients with right-sided and left-sided intravenous drug use (IDU) associated infective endocarditis (IE). A nationwide retrospective study using the Swedish Registry on Infective Endocarditis between 2008 and 2019 was conducted. A total of 586 people with IDU-IE were identified and divided into left-sided (n = 204) and right-sided (n = 382) IE. Descriptive statistics, Cox-regression and Kaplan-Meier survival estimates were used. The mean age of patients in the left-sided group was 46 years compared to 35 years in the right-sided group, p < 0.001. Left-sided IE had a higher proportion of females. Staphylococcus aureus was the causative pathogen in 48% of cases in the left-sided group compared to 88% in the right-sided group. Unadjusted and adjusted long-term survival was better in right-sided IE compared to left-sided IE. Independent predictors of long-term mortality were increasing age, end-stage renal disease, nosocomial infection, brain emboli and left-sided IE. Left-sided IE was common in people with IDU but the proportion of females with left-sided IE was low. S. aureus was twice as common in right-sided IE compared to left-sided IE, and the long-term prognosis of right sided IDU-associated IE was better compared to left-sided IE despite the fact that few were operated.
本研究旨在比较右心和左心静脉药物滥用（IDU）相关感染性心内膜炎（IE）患者的背景特征、微生物学和结局。采用 2008 年至 2019 年期间瑞典感染性心内膜炎登记处进行了一项全国性回顾性研究。共确定了 586 例 IDU-IE 患者，并将其分为左心（n=204）和右心（n=382）IE。使用描述性统计、Cox 回归和 Kaplan-Meier 生存估计进行分析。左侧 IE 患者的平均年龄为 46 岁，而右侧 IE 患者的平均年龄为 35 岁，p<0.001。左侧 IE 中女性比例较高。左侧 IE 中 48%的病例为金黄色葡萄球菌引起，而右侧 IE 中则为 88%。未经调整和调整后的长期生存率在右侧 IE 中优于左侧 IE。长期死亡率的独立预测因素包括年龄增加、终末期肾病、医院感染、脑栓塞和左侧 IE。左心 IE 在 IDU 患者中很常见，但女性左心 IE 的比例较低。与左侧 IE 相比，右侧 IE 中金黄色葡萄球菌更为常见，尽管很少进行手术，但右侧 IDU 相关 IE 的长期预后仍优于左侧 IE。
