Nappi Francesco, Martuscelli Giorgia, Bellomo Francesca, Avtaar Singh Sanjeet Singh, Moon Marc R
Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France.
Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 81100 Naples, Italy.
Metabolites. 2022 Jul 25;12(8):682. doi: 10.3390/metabo12080682.
Infective endocarditis remains an illness that carries a significant burden to healthcare resources. In recent times, there has been a shift from sp. to sp. as the primary organism of interest. This has significant consequences, given the virulence of and its propensity to form a biofilm, rendering non-surgical therapy ineffective. In addition, antibiotic resistance has affected treatment of this organism. The cohorts at most risk for Staphylococcal endocarditis are elderly patients with multiple comorbidities. The innovation of transcatheter technologies alongside other cardiac interventions such as implantable devices has contributed to the increased risk attributable to this cohort. We examined the pathophysiology of infective endocarditis carefully. Inter alia, the determinants of virulence, interaction with host immunity, as well as the discovery and emergence of a potential vaccine, were investigated. Furthermore, the potential role of prophylactic antibiotics during dental procedures was also evaluated. As rates of transcatheter device implantation increase, endocarditis is expected to increase, especially in this high-risk group. A high level of suspicion is needed alongside early initiation of therapy and referral to the heart team to improve outcomes.
感染性心内膜炎仍然是一种给医疗资源带来重大负担的疾病。近年来,作为主要关注的病原体,已经从[某种菌]转变为[另一种菌]。鉴于[该菌]的毒力及其形成生物膜的倾向,这具有重大后果,使得非手术治疗无效。此外,抗生素耐药性也影响了对这种病原体的治疗。金黄色葡萄球菌性心内膜炎风险最高的人群是患有多种合并症的老年患者。经导管技术与其他心脏干预措施(如植入式设备)的创新导致了这一人群风险的增加。我们仔细研究了感染性心内膜炎的病理生理学。特别调查了[该菌]毒力的决定因素、与宿主免疫的相互作用以及潜在疫苗的发现和出现。此外,还评估了牙科手术期间预防性使用抗生素的潜在作用。随着经导管设备植入率的增加,预计心内膜炎会增加,尤其是在这个高危人群中。需要高度怀疑,并尽早开始治疗并转诊至心脏团队以改善治疗结果。