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印度一家四级心脏转诊机构的11年回顾性观察研究:人工瓣膜心内膜炎的临床特征

Clinical Profile of Prosthetic Valve Endocarditis due to : An 11-year Retrospective Observational Study from a Quaternary Cardiac Referral Institute in India.

作者信息

Ponnambath Dinoop K, Gopalakrishnan Arun, Pillai Vivek V, Kaviyil Jyothi E, Raja Kavita

机构信息

Department of Microbiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.

出版信息

Indian J Crit Care Med. 2021 Aug;25(8):860-865. doi: 10.5005/jp-journals-10071-23915.

Abstract

Recent changes in the diagnostic criteria and the introduction of newer technologies like prosthetic valve replacement require the need to identify the changing epidemiology of prosthetic valve endocarditis (PVE). This is a retrospective, cross-sectional, observational study. Patients diagnosed with definite and possible PVE as per modified Duke's criteria for a period of 11 years from January 2010 to December 2020 were included for the analysis. Twelve of the 47 PVE cases (25.5%) were caused by . The median age of the patients was 52 years. Males were predominantly affected (58%). Based on the modified Duke's criteria, eight (67%) were definite infective endocarditis (IE) cases. The single valve was affected in 11 cases (92%) with the mitral valve being the commonest ( = 8, 67%). The type of valve commonly involved was mechanical [ = 10, 83%]. The mean size of the vegetation was 13.15 mm. Most cases ( = 7, 58%) were late-onset PVE. The mean C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) levels for PVE were 70.2 mg/L, 51.08 mm/hour, and 0.3 ng/mL, respectively. The rates of complications and in-hospital mortality were 75% each. The most common observed complication was embolic events ( = 8, 67%). Statistical significance ( ≤ 0.05) was observed for mean vegetation size, overall complications, embolic events, and mortality for PVE when compared with bacterial PVE. was the commonest etiological agent causing PVE. Predominant mitral valve involvement, higher rates of late-onset presentation, complications, and mortality were key differential characteristics observed. The manuscript throws light on the changing epidemiology, clinical, and microbiological profile of PVE due to sp., which are scarcely studied and reported in low- and middle-income countries like India. Ponnambath DK, Gopalakrishnan A, Pillai VV, Kaviyil JE, Raja K. Clinical Profile of Prosthetic Valve Endocarditis due to : An 11-year Retrospective Observational Study from a Quaternary Cardiac Referral Institute in India. Indian J Crit Care Med 2021;25(8):860-865.

摘要

诊断标准的近期变化以及人工瓣膜置换等新技术的引入,使得有必要确定人工瓣膜心内膜炎(PVE)不断变化的流行病学特征。这是一项回顾性、横断面观察性研究。纳入了根据改良的杜克标准在2010年1月至2020年12月的11年期间被诊断为确诊和可能的PVE的患者进行分析。47例PVE病例中有12例(25.5%)由……引起。患者的中位年龄为52岁。男性受影响为主(58%)。根据改良的杜克标准,8例(67%)为确诊感染性心内膜炎(IE)病例。11例(92%)单瓣膜受累,其中二尖瓣最常见(n = 8,67%)。常见的瓣膜类型为机械瓣膜[n = 10,83%]。赘生物的平均大小为13.15毫米。大多数病例(n = 7,58%)为晚期PVE。PVE患者的平均C反应蛋白(CRP)、红细胞沉降率(ESR)和降钙素原(PCT)水平分别为70.2毫克/升、51.08毫米/小时和0.3纳克/毫升。并发症发生率和住院死亡率均为75%。最常见的观察到的并发症是栓塞事件(n = 8,67%)。与细菌性PVE相比,PVE在平均赘生物大小、总体并发症、栓塞事件和死亡率方面观察到统计学显著性(P≤0.05)。……是引起PVE最常见的病原体。主要累及二尖瓣、较高的晚期发病、并发症和死亡率是观察到的关键鉴别特征。该手稿揭示了印度等低收入和中等收入国家中因……菌引起的PVE不断变化的流行病学、临床和微生物学特征,而这些在这些国家很少被研究和报道。Ponnambath DK、Gopalakrishnan A、Pillai VV、Kaviyil JE、Raja K。因……菌引起的人工瓣膜心内膜炎的临床特征:来自印度一家四级心脏转诊机构的11年回顾性观察研究。《印度危重症医学杂志》2021年;25(8):860 - 865。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5ce/8559738/b1bf3a2689f7/ijccm-25-860-g001.jpg

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