Leis Benjamin T, Parekh Dwip D, Macknak Brendon F, Kogilwaimath Siddharth
Division of General Internal Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
CJC Open. 2022 Feb 3;4(5):474-478. doi: 10.1016/j.cjco.2022.01.009. eCollection 2022 May.
is a virulent coagulase-negative that is a rare cause of infective endocarditis (IE) associated with high mortality. A linear growth of IE has occurred over the past several years in Saskatchewan, with overlapping epidemics of human immunodeficiency virus (HIV)/hepatitis C virus driven by injection drug use (IDU). We hypothesized that given the unique challenges faced by our population with IDU and inequitable healthcare access, our cases of IE might differ from those in the published literature.
We retrospectively reviewed the cases of endocarditis admitted at our tertiary care hospitals in Saskatoon over a 6-year period and analyzed their baseline characteristics, antimicrobial susceptibility data, management, and outcome data, where available, for each patient.
Of the 24 blood cultures positive for as identified by our laboratory, we verified 6 cases of definite IE, and 2 cases of probable IE, applying the modified Duke's criteria. A total of 5 of 8 cases involved native valves, with only 1 infection of the bioprosthetic mitral valve, seen in patient with IDU. A total of 5 of 8 cases involved the left-sided valves, with 1 of 8 involving the tricuspid valve. Only 1 death was recorded.
The male predominance and primarily left-sided valve infection we noted in our review were similar to results in the published literature. We noted a lower rate of surgical intervention and mortality than previously observed, which merits further study. We did not find coinfection with HIV and/or hepatitis C virus as an epidemiologic risk factor, likely owing to the low rate of IDU in our study.
[具体病原菌名称未给出]是一种毒性很强的凝固酶阴性菌，是感染性心内膜炎（IE）的罕见病因，与高死亡率相关。在萨斯喀彻温省，过去几年IE呈线性增长，同时存在由注射吸毒（IDU）驱动的人类免疫缺陷病毒（HIV）/丙型肝炎病毒重叠流行。我们推测，鉴于我们的IDU人群面临的独特挑战以及医疗保健获取的不平等，我们的IE病例可能与已发表文献中的病例不同。
我们回顾性分析了在萨斯卡通的三级护理医院6年内收治的[具体病原菌名称未给出]心内膜炎病例，并分析了每个患者的基线特征、抗菌药敏数据、治疗管理和结局数据（如可获得）。
根据我们实验室鉴定，在24份血培养阳性的样本中，应用改良的杜克标准，我们确诊了6例明确的IE病例和2例可能的IE病例。8例病例中共有5例累及天然瓣膜，仅1例生物人工二尖瓣感染，见于IDU患者。8例病例中共有5例累及左侧瓣膜，8例中有1例累及三尖瓣。仅记录到1例死亡。
我们在回顾中注意到的男性占主导以及主要是左侧瓣膜感染与已发表文献中的结果相似。我们注意到手术干预率和死亡率低于先前观察到的水平，这值得进一步研究。我们未发现HIV和/或丙型肝炎病毒合并感染是一种流行病学危险因素，可能是由于我们研究中IDU的发生率较低。
