Lau Lawrence, Baddour Larry, Fernández Hidalgo Núria, Brothers Thomas D, Kong William K F, Borger Michael A, Duval Xavier, Tribouilloy Christophe, Obadia Jean-Francois, Golian Mehrdad, Corrales-Medina Vicente F, Auclair Francois, Mazighi Mikael, Chan Kwan Leung, Prendergast Bernard, Habib Gilbert, Rubens Fraser D, Messika-Zeitoun David
Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, K1Y 4W7 Ottawa, Ontario, Canada.
Departments of Medicine and Cardiovascular Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, MN, USA.
Eur Heart J. 2025 Apr 11. doi: 10.1093/eurheartj/ehaf219.
Infective endocarditis (IE) is a relatively rare but life-threatening systemic infection, which remains associated with high morbidity and mortality. The epidemiology of IE has shifted to involve an increasing numbers of older patients with both cardiovascular and other types of prosthetic devices, multiple comorbid conditions often requiring invasive procedures, increasingly virulent pathogens, in particular Staphylococcus aureus, or that can harbour anti-microbial resistance, and an escalation of injection drug use in many areas of the world. In parallel, advancements in diagnostic and therapeutic options have led to complex strategies in patients' management. Despite these epidemiologic shifts, clinical trials have been rare and most of the evidence guiding IE management derives from expert consensus or analysis of large registries. Because of this, a multi-disciplinary IE team-based approach has been recommended as the standard of care. The aim of this review is to explore the rationale for a multi-disciplinary team-based approach to the management of IE. This approach has proved to be potentially beneficial based on multiple investigations that have evaluated patient outcomes. In addition, implementation strategies, feasibility and options of the team approach have also been highlighted.
感染性心内膜炎（IE）是一种相对罕见但危及生命的全身性感染，其发病率和死亡率仍然很高。IE的流行病学已发生转变，涉及越来越多患有心血管疾病和其他类型假体装置的老年患者，多种合并症往往需要进行侵入性操作，病原体的毒性越来越强，特别是金黄色葡萄球菌，或者可能具有抗菌耐药性，并且在世界许多地区注射吸毒现象不断升级。与此同时，诊断和治疗选择的进步导致了患者管理的复杂策略。尽管有这些流行病学转变，但临床试验很少，指导IE管理的大多数证据来自专家共识或大型登记处的分析。因此，基于多学科IE团队的方法被推荐为护理标准。本综述的目的是探讨基于多学科团队的IE管理方法的基本原理。基于多项评估患者预后的调查，这种方法已被证明可能有益。此外，还强调了团队方法的实施策略、可行性和选择。
