Reisinger Maximilian, Kachel Mateusz, George Isaac
Division of Cardiac, Thoracic & Vascular Surgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY 10032, USA.
Center for Cardiovascular Research and Development, American Heart of Poland, 40-028 Katowice, Poland.
Pathogens. 2024 Jun 27;13(7):543. doi: 10.3390/pathogens13070543.
Infective endocarditis (IE) is a microbial infection of the endocardial surface, most commonly affecting native and prosthetic valves of the heart. The epidemiology and etiology of the disease have evolved significantly over the last decades. With a growing elderly population, the incidence of degenerative valvopathies and the use of prosthetic heart valves have increased, becoming the most important predisposing risk factors. This change in the epidemiology has caused a shift in the underlying microbiology of the disease, with Staphylococci overtaking Streptococci as the main causative pathogens. Other rarer microbes, including , , and , have also emerged or re-emerged. Valvular IE caused by these pathogens, especially , is often associated with a severe clinical course, leading to high rates of morbidity and mortality. Therefore, prompt diagnosis and management are crucial. Due to the high virulence of these pathogens and an increased incidence of antimicrobial resistances, surgical valve repair or replacement is often necessary. As the epidemiology and etiology of valvular IE continue to evolve, the diagnostic methods and therapies need to be progressively advanced to ensure satisfactory clinical outcomes.
感染性心内膜炎（IE）是心内膜表面的微生物感染，最常累及心脏的天然瓣膜和人工瓣膜。在过去几十年中，该疾病的流行病学和病因学发生了显著变化。随着老年人口的增加，退行性瓣膜病的发病率和人工心脏瓣膜的使用有所上升，成为最重要的易感危险因素。这种流行病学的变化导致了该疾病潜在微生物学的转变，葡萄球菌取代链球菌成为主要致病病原体。其他较罕见的微生物，包括……、……、……和……，也已出现或再次出现。由这些病原体引起的瓣膜性IE，尤其是……，通常与严重的临床病程相关，导致高发病率和死亡率。因此，及时诊断和管理至关重要。由于这些病原体的高毒力和抗菌耐药性的增加，手术瓣膜修复或置换往往是必要的。随着瓣膜性IE的流行病学和病因学不断演变，诊断方法和治疗方法需要逐步改进，以确保获得满意的临床结果。
