Rapti Vasiliki, Giannitsioti Efthymia, Spernovasilis Nikolaos, Magiorakos Anna-Pelagia, Poulakou Garyfallia
Third Department of Internal Medicine, School of Medicine, National & Kapodistrian University of Athens, Sotiria General Hospital, 115 27 Athens, Greece.
First Department of Propaedeutic and Internal Medicine, Medical School, National & Kapodistrian University of Athens, Laiko General Hospital, 115 27 Athens, Greece.
J Clin Med. 2025 Mar 19;14(6):2087. doi: 10.3390/jcm14062087.
Infective endocarditis (IE) is a relatively rare but potentially life-threatening disease characterized by substantial mortality and long-term sequelae among the survivors. In recent decades, a dramatic change in the profile of patients diagnosed with IE has been observed primarily in developed countries, most likely due to an aging population and a recent increase in invasive medical procedures. Nowadays, the typical IE patient is usually older, with complex comorbidities, and a history significant for cardiac disease, including degenerative heart valve disease, prosthetic valves, or cardiovascular implantable electronic devices (CIEDs). Moreover, as patient risk factors change, predisposing them to more healthcare-associated IE, the microbiology of IE is also shifting; there are growing concerns regarding the rise in the incidence of IE caused by difficult-to-treat resistance (DTR) bacteria in at-risk patients with frequent healthcare contact. The present review aims to explore the evolving landscape of IE and summarize the current knowledge on novel diagnostics to ensure timely diagnosis and outline optimal therapy for DTR bacterial IE.
感染性心内膜炎（IE）是一种相对罕见但可能危及生命的疾病，其特征是死亡率高，幸存者有长期后遗症。近几十年来，主要在发达国家观察到确诊为IE的患者情况发生了巨大变化，这很可能是由于人口老龄化以及近期侵入性医疗程序的增加。如今，典型的IE患者通常年龄较大，有复杂的合并症，并且有重要的心脏病史，包括退行性心脏瓣膜病、人工瓣膜或心血管植入式电子设备（CIED）。此外，随着患者风险因素的变化，使他们更容易发生更多与医疗保健相关的IE，IE的微生物学也在发生变化；人们越来越担心，在经常接触医疗保健的高危患者中，由难治疗耐药（DTR）细菌引起的IE发病率上升。本综述旨在探讨IE不断变化的情况，并总结关于新型诊断方法的当前知识，以确保及时诊断，并概述DTR细菌性IE的最佳治疗方法。
