Cusumano Jaclyn A, Kalogeropoulos Andreas P, Le Provost Mathieu, Gallo Nicolas R, Levine Steven M, Inzana Thomas, Papamanoli Aikaterini
Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, New York, USA.
Renaissance School of Medicine Division of Cardiology, Stony Brook University, Stony Brook, New York, USA.
Clin Microbiol Rev. 2024 Dec 10;37(4):e0016823. doi: 10.1128/cmr.00168-23. Epub 2024 Sep 5.
SUMMARYInfective endocarditis (IE) is a life-threatening infection that has nearly doubled in prevalence over the last two decades due to the increase in implantable cardiac devices. Transcatheter aortic valve implantation (TAVI) is currently one of the most common cardiac procedures. TAVI usage continues to exponentially rise, inevitability increasing TAVI-IE. Patients with TAVI are frequently nonsurgical candidates, and TAVI-IE 1-year mortality rates can be as high as 74% without valve or bacterial biofilm removal. a historically less common IE pathogen, is the primary cause of TAVI-IE. Treatment options are limited due to enterococcal intrinsic resistance and biofilm formation. Novel approaches are warranted to tackle current therapeutic gaps. We describe the existing challenges in treating TAVI-IE and how available treatment discovery approaches can be combined with an "Living Heart" model to create solutions for the future.
摘要
感染性心内膜炎（IE）是一种危及生命的感染，在过去二十年中，由于可植入心脏设备的增加，其患病率几乎翻了一番。经导管主动脉瓣植入术（TAVI）是目前最常见的心脏手术之一。TAVI的使用量持续呈指数级增长，不可避免地增加了TAVI-IE的发生。接受TAVI治疗的患者通常不适合进行手术，并且在不清除瓣膜或细菌生物膜的情况下，TAVI-IE的1年死亡率可能高达74%。肠球菌是一种历史上不太常见的IE病原体，是TAVI-IE的主要病因。由于肠球菌的固有耐药性和生物膜形成，治疗选择有限。需要新的方法来解决当前的治疗差距。我们描述了治疗TAVI-IE时存在的挑战，以及现有的治疗发现方法如何与“活体心脏”模型相结合，为未来创造解决方案。
