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感染性心内膜炎的流行病学、诊断和治疗进展:综述。

Update on the epidemiology, diagnosis, and management of infective endocarditis: A review.

机构信息

Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, No. 167 Fuwai Hospital, Beilishi Rd. Xicheng District, Beijing 10037, China.

Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science, Peking Union Medical College, No. 167 Fuwai Hospital, Beilishi Rd. Xicheng District, Beijing 10037, China.

出版信息

Trends Cardiovasc Med. 2024 Nov;34(8):499-506. doi: 10.1016/j.tcm.2024.01.001. Epub 2024 Jan 8.

Abstract

Despite advancements in the diagnosis and treatment of infective endocarditis (IE), the burden of IE has remained relatively high over the past decade. With an ageing population and an increasing proportion of healthcare-associated IE, the epidemiology of IE has undergone significant changes. Staphylococcus aureus has evolved as the most common causative microorganism, even in most low- and middle-income countries. Several imaging modalities and novel microbiological tests have emerged to facilitate the diagnosis of IE. Outpatient parenteral antibiotic treatment and oral step-down antibiotic treatment have become new trends for the management of IE. Early surgical intervention, particularly within seven days, should be considered in cases of IE with appropriate surgical indications. We comprehensively review the updated epidemiology, microbiology, diagnosis, and management of IE.

摘要

尽管感染性心内膜炎 (IE) 的诊断和治疗取得了进展,但在过去十年中,IE 的负担仍然相对较高。随着人口老龄化和与医疗保健相关的 IE 比例增加,IE 的流行病学发生了重大变化。金黄色葡萄球菌已演变为最常见的致病微生物,即使在大多数低收入和中等收入国家也是如此。已经出现了几种成像方式和新的微生物学检测方法,以促进 IE 的诊断。门诊静脉注射抗生素治疗和口服降阶梯抗生素治疗已成为 IE 管理的新趋势。对于有适当手术指征的 IE 患者,应考虑在七天内进行早期手术干预。我们全面回顾了 IE 的最新流行病学、微生物学、诊断和管理。

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