Wilson W R, Danielson G K, Giuliani E R, Geraci J E
Mayo Clin Proc. 1982 Mar;57(3):155-61.
Prosthetic valve endocarditis is an infrequent but serious complication of cardiac valve replacement. The overall frequency of prosthetic valve endocarditis is approximately 2%. The frequency of early-onset and late-onset infections is 0.78% and 1.1%, respectively. Staphylococci are the most common isolate from patients with early-onset infection, accounting for 47.5% of the total number of isolates. Staphylococcus epidermidis causes 27% of these staphylococcal infections. Among patients with late-onset infection, streptococci are the predominant microorganism, constituting 42% of the total number of isolates from patients in this group. The overall mortality among patients with prosthetic valve endocarditis is high--59%; the mortality among patients with early- or late-onset infections is 77% and 46%, respectively. Most patients with staphylococcal prosthetic valve endocarditis should undergo cardiac valve replacement in addition to antimicrobial therapy. Closely monitored anticoagulant therapy should be cautiously continued in patients with prosthetic valve endocarditis.
人工瓣膜心内膜炎是心脏瓣膜置换术后一种少见但严重的并发症。人工瓣膜心内膜炎的总体发生率约为2%。早发性和晚发性感染的发生率分别为0.78%和1.1%。葡萄球菌是早发性感染患者中最常见的分离菌，占分离菌总数的47.5%。表皮葡萄球菌引起这些葡萄球菌感染的27%。在晚发性感染患者中，链球菌是主要微生物，占该组患者分离菌总数的42%。人工瓣膜心内膜炎患者的总体死亡率很高，为59%；早发性或晚发性感染患者的死亡率分别为77%和46%。大多数葡萄球菌性人工瓣膜心内膜炎患者除抗菌治疗外还应接受心脏瓣膜置换术。人工瓣膜心内膜炎患者应谨慎继续密切监测的抗凝治疗。
