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架起分子科学与临床科学的桥梁,以实现心内膜炎的最佳治疗。

Bridging Molecular and Clinical Sciences to Achieve the Best Treatment of Endocarditis.

作者信息

Nappi Francesco, Avtaar Singh Sanjeet Singh, Jitendra Vikram, Fiore Antonio

机构信息

Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint-Denis, France.

Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.

出版信息

Microorganisms. 2023 Oct 21;11(10):2604. doi: 10.3390/microorganisms11102604.

Abstract

() is a commensal bacterium that causes various infections in surgical sites, the urinary tract, and blood. The bacterium is becoming a significant concern because it tends to affect the elderly population, which has a high prevalence of undiagnosed degenerative valvular disease and is often subjected to invasive procedures and implanted medical devices. The bacterium's actions are influenced by specific characteristics like pili activity and biofilm formation. This resistance significantly impedes the effectiveness of numerous antibiotic therapies, particularly in cases of endocarditis. While current guidelines recommend antimicrobial therapy, the emergence of resistant strains has introduced complexity in managing these patients, especially with the increasing use of transcatheter therapies for those who are not suitable for surgery. Presentations of the condition are often varied and associated with generalised symptoms, which may pose a diagnostic challenge. We share our encounter with a case study that concerns an octogenarian who had a TAVI valve and developed endocarditis. We also conducted a literature review to identify the essential treatment algorithms for such cases.

摘要

()是一种共生细菌,可在手术部位、泌尿道和血液中引发各种感染。这种细菌正成为一个重大问题,因为它往往影响老年人群,而该人群未确诊的退行性瓣膜病患病率很高,且经常接受侵入性手术和植入医疗设备。该细菌的行为受菌毛活性和生物膜形成等特定特征的影响。这种耐药性严重阻碍了许多抗生素疗法的有效性,尤其是在心内膜炎病例中。虽然当前指南推荐抗菌治疗,但耐药菌株的出现给这些患者的管理带来了复杂性,特别是对于那些不适合手术的患者越来越多地使用经导管治疗。该病的表现通常多种多样,并伴有全身性症状,这可能带来诊断挑战。我们分享我们遇到的一个病例研究,该病例涉及一位接受经导管主动脉瓣植入术(TAVI)瓣膜并发生心内膜炎的八旬老人。我们还进行了文献综述,以确定此类病例的基本治疗算法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d498/10609379/b6d6e11980d8/microorganisms-11-02604-g001.jpg

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