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凝固酶阴性葡萄球菌和金黄色葡萄球菌心内膜炎的临床病程相当。

Comparable clinical course between coagulase-negative staphylococcal and Staphylococcus aureus endocarditis.

机构信息

Infectiology Unit, Clinique Pasteur, Toulouse, France.

CHU Hotel Dieu, Nantes, France.

出版信息

Infection. 2022 Apr;50(2):483-490. doi: 10.1007/s15010-021-01738-y. Epub 2022 Jan 10.

DOI:10.1007/s15010-021-01738-y
PMID:35006535
Abstract

PURPOSE

Staphylococcus aureus (SA) is involved in almost one-third of endocarditis events (known as E-SA) and is frequently associated with unfavorable outcomes compared to infectious endocarditis (IE) caused by other pathogens including coagulase-negative staphylococci (CNS). The aim of this study was to compare the morbidity and mortality of patients with E-SA and endocarditis due to CNS (known as E-CNS).

METHODS

A monocentric retrospective cohort analysis was conducted including all patients admitted with IE from January 2010 to December 2017. Lengths of stay, complications, in-hospital and 1-year mortality were described from medical records and compared between E-SA and E-CNS.

RESULTS

Among the 428 patients included, 102 had staphylococcus (50 E-SA and 52 E-CNS). Half of the IE events due to staphylococcus occurred in the year following a cardiac procedure [p = 0.029]. A septic embolism occurred in 41% and 48% of patients with E-CNS and E-SA, respectively [p = 0.439]. Cardiac surgery was indicated in 50% of E-SA and 48% of E-CNS cases [p = 0.846]. The intra-hospital and 1-year mortality rates were 25% and 31% for E-CNS and 34% and 45% for E-SA [p = 0.699, p = 0.234].

CONCLUSION

Embolic complications, surgical management rate and mortality rates of E-SA and E-CNS were comparable, which may suggest a similar morbidity and mortality irrespective of the pathogen involved in IE.

摘要

目的

金黄色葡萄球菌(SA)与近三分之一的感染性心内膜炎(IE)事件(即 E-SA)有关,与其他病原体(包括凝固酶阴性葡萄球菌[CNS])引起的 IE 相比,其预后通常较差。本研究旨在比较 E-SA 和 CNS 引起的 IE(即 E-CNS)患者的发病率和死亡率。

方法

进行了一项单中心回顾性队列分析,纳入了 2010 年 1 月至 2017 年 12 月期间所有因 IE 入院的患者。从病历中描述了住院时间、并发症、住院和 1 年死亡率,并比较了 E-SA 和 E-CNS 之间的差异。

结果

在纳入的 428 例患者中,有 102 例为金黄色葡萄球菌(50 例为 E-SA,52 例为 E-CNS)。一半的金黄色葡萄球菌引起的 IE 事件发生在心脏手术后的一年内[P=0.029]。E-CNS 和 E-SA 患者分别有 41%和 48%发生感染性栓塞[P=0.439]。50%的 E-SA 和 48%的 E-CNS 患者需要心脏手术[P=0.846]。E-CNS 和 E-SA 的院内和 1 年死亡率分别为 25%和 31%,34%和 45%[P=0.699,P=0.234]。

结论

E-SA 和 E-CNS 的栓塞并发症、手术治疗率和死亡率相似,这表明无论 IE 中涉及的病原体如何,发病率和死亡率可能相似。

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