Jorge S do C, Caixeta A M, Abizaid A, Arnoni A S, Paulista P P, de Sousa L C, Magalhães H M, Piegas L S, Sousa J E
Instituto Dante Pazzanese de Cardiologia, São Paulo.
Arq Bras Cardiol. 1994 Sep;63(3):173-7.
To assess infective endocarditis (IE) predisposing factors, etiologic agents and hospital course in infants and adolescents.
We Studied 222 patients admitted under compatible IE diagnosis, from 1985 to 1990. The population of this study is fifty patients (23%) under 16 years of age.
Rheumatic valvular disease, as predisposing cardiopathy was proeminent within 9 to 16 years of age, markedly Statistical difference when compared to age range of 0 to 8 years (p < 0.05). Among congenital cardiopathies, the most frequent were: interventricular septal defect (26.0%) and tetralogy of Fallot (21.7%). Blood cultures, surgical material or emboli cultures were positive in 35 (70.0%) assessed patients. Streptococcus viridans (45.7%) and Staphylococcus aureus (42.8%) were the etiologic agents most often isolated. It was found that endocarditis by Staphylococcus aureus had mortality rate of 53.3% [(clinical (66.6%) and surgical (44.4%)], (p < 0.05) when compared to those by Streptococcus viridans; with total mortality of 6.2% (no clinical death and 16.6% in the surgical group). Total in-hospital mortality (clinical and surgical) was 26.0% (13 deaths).
IE in infants and adolescents in this studied population presented Streptococcus viridans responsible for 46.7% of patients with endocarditis and the Staphylococcus aureus for 42.8% were the etiologic agents most often found. Total, clinical and surgical mortality was greater in patients with endocarditis by Staphylococcus aureus when compared with those by Streptococcus viridans. Among the congenital cardiopathies, whether operated on or not, ventricular septal defect and of Fallot's tetralogy were the most involved ones; rheumatic cardiopathy Still remains a significant predisposing factor to infective IE in our country.
评估婴幼儿及青少年感染性心内膜炎（IE）的易感因素、病原体及住院病程。
我们研究了1985年至1990年期间因符合IE诊断而入院的222例患者。本研究人群中有50例（23%）年龄在16岁以下。
风湿性瓣膜病作为易感心脏病在9至16岁年龄段最为突出，与0至8岁年龄组相比有显著统计学差异（p<0.05）。在先天性心脏病中，最常见的是室间隔缺损（26.0%）和法洛四联症（21.7%）。在35例（70.0%）接受评估的患者中，血培养、手术材料或栓子培养呈阳性。草绿色链球菌（45.7%）和金黄色葡萄球菌（42.8%）是最常分离出的病原体。发现金黄色葡萄球菌引起的心内膜炎死亡率为53.3%[临床（66.6%）和手术（44.4%）]，与草绿色链球菌引起的心内膜炎相比（p<0.05）；总死亡率为6.2%（无临床死亡，手术组为16.6%）。住院总死亡率（临床和手术）为26.0%（13例死亡）。
在本研究人群中，婴幼儿及青少年IE患者中，草绿色链球菌导致46.7%的心内膜炎患者，金黄色葡萄球菌导致42.8%，是最常发现的病原体。与草绿色链球菌引起的心内膜炎患者相比，金黄色葡萄球菌引起的心内膜炎患者的总死亡率、临床死亡率和手术死亡率更高。在先天性心脏病中，无论是否接受手术，室间隔缺损和法洛四联症是受累最多的；风湿性心脏病在我国仍然是感染性IE的重要易感因素。
