2015-2023 年中国一家三级医院因嗜养颗粒菌和金氏菌致感染性心内膜炎的流行病学、临床特征和结局：一项回顾性研究。

Epidemiology, clinical characteristics, and outcome of infective endocarditis due to Abiotrophia and Granulicatella in a Tertiary Hospital in China, 2015-2023: a retrospective study.

机构信息

Department of Infectious Diseases, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.

Department of Microbiology, Zhongshan Hospital, Fudan University, Shanghai, China.

出版信息

BMC Infect Dis. 2024 Sep 20;24(1):1022. doi: 10.1186/s12879-024-09943-4.

DOI:10.1186/s12879-024-09943-4

PMID:39304837

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11415980/

Abstract

BACKGROUND

Abiotrophia (ABI) and Granulicatella (GRA) are rare causative pathogens in infective endocarditis (IE). This study aims to describe the epidemiology, clinical characteristics, and outcome of ABI/GRA-IE. The main features of ABI/GRA-IE were compared with Viridans group streptococci (VGS) IE.

METHODS

From January 2015 to December 2023, a total of 1531 definite IE in Zhongshan Hospital, Fudan University, Shanghai, China were retrospectively enrolled in this study. Clinical and laboratory data were collected.

RESULTS

Forty-five ABI/GRA-IE cases were identified, representing 2.9% of all IE cases in Zhongshan Hospital between 2015 and 2023, compared to 20.1% of VGS-IE. ABI and GRA IE shared similar clinical characteristics. Congenital valvulopathy was reported in 21 (46.7%) ABI/GRA-IE and 85 (28.8%) VGS-IE (P = 0.025). Pulmonary valve was more frequently affected in ABI/GRA-IE (6 [13.3%]) than VGS-IE (7 [2.4%]) (P = 0.002). Congestive heart failure was observed in 30 (66.7%) ABI/GRA-IE and 103 (34.9%) VGS-IE (P < 0.001). Systemic embolization excluding central nervous system (CNS) occurred in 13 (28.9%) ABI/GRA-IE and 39 (13.2%) VGS-IE (P = 0.012). In-hospital mortality was reported as 4.4% in ABI/GRA-IE and 3.7% in VGS-IE (P = 0.854).

CONCLUSION

GRA/ABI-IE was approximately one-seventh as prevalent as VGS-IE. Congestive heart failure and systemic embolization (excluding CNS) were more frequent in GRA/ABI-IE compared to VGS-IE. Mortality of ABI/GRA-IE in this study was comparable to that of VGS-IE and lower than previously reported results.

摘要

背景

嗜养颗粒菌（ABI）和金氏菌属（GRA）是感染性心内膜炎（IE）少见的致病病原体。本研究旨在描述 ABI/GRA-IE 的流行病学、临床特征和结局。比较 ABI/GRA-IE 的主要特征与草绿色链球菌（VGS）IE。

方法

2015 年 1 月至 2023 年 12 月，回顾性纳入复旦大学附属中山医院的 1531 例明确诊断的 IE。收集临床和实验室数据。

结果

共发现 45 例 ABI/GRA-IE，占 2015 年至 2023 年中山医院 IE 病例的 2.9%，而 VGS-IE 占 20.1%。ABI 和 GRA IE 具有相似的临床特征。21 例（46.7%）ABI/GRA-IE 和 85 例（28.8%）VGS-IE 存在先天性瓣膜病（P=0.025）。ABI/GRA-IE 中更常累及肺动脉瓣（6[13.3%]）而非 VGS-IE（7[2.4%]）（P=0.002）。30 例（66.7%）ABI/GRA-IE 和 103 例（34.9%）VGS-IE 存在充血性心力衰竭（P<0.001）。13 例（28.9%）ABI/GRA-IE 和 39 例（13.2%）VGS-IE 发生除中枢神经系统（CNS）以外的全身栓塞（P=0.012）。ABI/GRA-IE 住院死亡率为 4.4%，VGS-IE 为 3.7%（P=0.854）。