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感染性心内膜炎的前瞻性临床随访结果

Prospective Clinical Follow-Up Results of Infective Endocarditis.

作者信息

Arslan Merve, Kaleli İlknur, Kutlu Murat

机构信息

Department of Infectious Diseases and Clinical Microbiology, Pamukkale University School of Medicine, Denizli, Türkiye.

Department of Medical Microbiology, Pamukkale University School of Medicine, Denizli, Türkiye.

出版信息

Infect Dis Clin Microbiol. 2024 Jun 28;6(2):133-140. doi: 10.36519/idcm.2024.327. eCollection 2024 Jun.

Abstract

OBJECTIVE

Infective endocarditis incidence has been rising in recent years, with high mortality. Risk factors such as underlying heart diseases, chronic diseases, healthcare-associated infections, advanced age, and intravenous (IV) drug use have gained importance in the incidence, the treatment approach, and the disease course. The aim of this study is to contribute to Türkiye's data on infective endocarditis epidemiology and risk factors.

MATERIALS AND METHODS

This study examined risk factors, diagnostic and treatment approaches, and prognosis of infective endocarditis cases at Pamukkale University Faculty of Medicine Hospital. It was carried out prospectively for 28 months.

RESULTS

During this period, 67 endocarditis cases were detected in 65 patients. Among cardiac diseases, the rate of congenital heart diseases (41%), degenerative heart diseases (37%), and acute rheumatic fever (ARF) related valvular heart disease (31%) were found to be high. Hospitalization in the last six months (53.7%), history of cardiac surgery (41.8%), use of IV catheters (22.4%), hemodialysis (14.9%) and IV drug use (7.5%) were also determined. Staphylococci, streptococci, and enterococci were the primary agents. The most used empirical treatments were ampicillin, ampicillin-sulbactam, and gentamicin. Natural valve endocarditis was most determined. Surgical treatment was applied in 56.7% of endocarditis cases. Septic embolism and cardiac failure were the most common complications.

CONCLUSION

This study's findings regarding the epidemiology and prognosis of infective endocarditis pointed out that it is still a disease with a high mortality rate.

摘要

目的

近年来感染性心内膜炎的发病率呈上升趋势,死亡率很高。诸如潜在心脏病、慢性病、医疗相关感染、高龄以及静脉注射毒品等危险因素在发病率、治疗方法和病程中变得愈发重要。本研究的目的是为土耳其关于感染性心内膜炎流行病学和危险因素的数据提供补充。

材料与方法

本研究调查了棉花堡大学医学院附属医院感染性心内膜炎病例的危险因素、诊断和治疗方法以及预后情况。前瞻性开展了28个月。

结果

在此期间,在65名患者中检测到67例心内膜炎病例。在心脏疾病中,发现先天性心脏病(41%)、退行性心脏病(37%)以及急性风湿热(ARF)相关瓣膜性心脏病(31%)的比例较高。还确定了过去六个月内住院(53.7%)、心脏手术史(41.8%)、使用静脉导管(22.4%)、血液透析(14.9%)以及静脉注射毒品(7.5%)等情况。葡萄球菌、链球菌和肠球菌是主要病原体。最常用的经验性治疗药物是氨苄西林、氨苄西林 - 舒巴坦和庆大霉素。最常确定的是天然瓣膜心内膜炎。56.7%的心内膜炎病例接受了手术治疗。脓毒性栓塞和心力衰竭是最常见的并发症。

结论

本研究关于感染性心内膜炎流行病学和预后的结果指出,它仍然是一种死亡率很高的疾病。

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本文引用的文献

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Inflammation in Hypertension.高血压中的炎症反应。
Can J Cardiol. 2020 May;36(5):635-647. doi: 10.1016/j.cjca.2020.01.013. Epub 2020 Jan 24.
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Infective endocarditis in intravenous drug users.静脉药物使用者中的感染性心内膜炎。
Trends Cardiovasc Med. 2020 Nov;30(8):491-497. doi: 10.1016/j.tcm.2019.11.007. Epub 2019 Nov 26.
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Am J Emerg Med. 2018 Sep;36(9):1686-1692. doi: 10.1016/j.ajem.2018.06.074. Epub 2018 Jul 2.
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Clinical Risk Factors for Infective Endocarditis in Bacteremia.菌血症中感染性心内膜炎的临床危险因素
Tex Heart Inst J. 2017 Feb 1;44(1):10-15. doi: 10.14503/THIJ-15-5359. eCollection 2017 Feb.

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